Telework

Telework Agreement Form

2024 Benefits

2024 Medical Forms

- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

2024 Dental Insurance

- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

​Voluntary Vision

- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

Flex Spending Account

- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

Reimbursement claim forms must be submitted directly to EBPA:

Group Term Life Insurance

- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

Short-Term Disability Insurance

Enrollment Registration is ONLY Available During Annual Benefits Open Enrollment each fall and coverage would begin in January. Visit PeopleSoft.

Long-Term Disability Insurance

- All New Hires:  Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes:  Please complete request in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete Group Long-Term Disability Enrollment/Change Form and Medical History Statement below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).

Tuition Remission

Retirement

All Active Employee Deferral or Vendor Changes: Please complete request in PeopleSoft Self-Service via the Self-Service tile.

New 403(b) Enrollments Only:

403(b) Catch-Up Request:

New 457(b) Enrollments Only:

New UVM Retiree Health Savings Plan Enrollment:

 

Contact Human Resources

 

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