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NEW EMPLOYEE BENEFITS ENROLLMENT CHECKLIST
Welcome to the University of Texas Health Science Center at Houston. As a new employee, you have 31 days
from your first day of employment to enroll in benefits.
If you are full-time benefits eligible (appointed to work 40 hours per week for at least 4 ½ months) or a benefits
eligible graduate assistant (appointed to work at least 20 hours per week for at least 4 ½ months), you will
automatically be enrolled in the Basic Coverage Package if you do not enroll in benefits within 31 days of
employment.
If you are part-time benefits eligible (appointed to work at least 20 but less than 40 hours per week for at least 4
½ months), you will have no coverage if you do not enroll in benefits within 31 days of employment.
Be sure to download, read and print a copy of the following documents:
UT Benefits Handbook for Employees: http://www.utsystem.edu/documents/docs/benefits-handbooks-
and-cost-worksheet/ut-benefits-handbook-employees-2014-2015
UT Retirement Plan Providers: http://www.utsystem.edu/offices/employee-benefits/approved-providers
Use the Employee Rate Sheet to calculate your monthly out-of-pocket cost for benefits.
Complete and return the following to the benefits office within 31 days of employment.
UT Benefits Enrollment/Change Application
Documentation to enroll eligible dependents
Beneficiary Designation Form for Group Term Life & AD&D
Submit forms and documentation by fax: 713-500-0342 or email: [email protected].
Complete and return the following to the address on the form within 31 days of employment.
Evidence of Insurability Form if applying for more than 3 times your annual salary in life insurance
or $25,000 or $50,000 for your spouse
Long Term Care Enrollment Form if enrolling in long term care
Log on to UT Retirement Manager to enroll in a voluntary retirement savings plan at any time.
Log in to Employee Self Service after your benefits effective date to be sure your coverage is correct.
The effective date of medical coverage for new hires is the 1st of the month following 30 days of employment.
Based on when your paperwork is received by the benefits office, your optional benefits may be effective on:
1) Your first day of employment;
2) The first of the month following your first day of employment; or
3) The first of the month following your date of election.
For more information or questions, contact the benefits office at (713) 500-3935 or [email protected].
