Benefits

Medical / Dental / Vision

• Prescription Drug Claim Form
• United Concordia Companies Inc. (UCCI) Claim Form
• United Concordia Companies Inc. (UCCI) Dep. Certification Form
• EyeMed Claim Form
• Carefirst Claim Form
• Carefirst HIPPA Authorization Form
• Waiver of Coverage Form
• HIPAA Release Form
• Partner Affidavit
• Tax Dependent Status Form
• HIPAA- Notice of Privacy Practice 

Retirement

• Retirement Annuity Salary Election Form

Life Insurance

• Aetna EOI Form
• Aetna Beneficiary Designation Form

Miscellaneous

• Johns Hopkins FCU Membership Application
• Loan Request Form
• Tuition Remission Form
• Tuition Remission Form - MPS Program

Employment

• Employee Action Form (EAF)
• Student Action Form (SAF)
• Faculty Action Form (FAF)
• Postion Action Form (PAF)
• Business Card Request Form + (Policy)
• New Hire Technology Set-up Request Form
• Employee Data Record
• Employee Emergency Contact Form

Payroll

• Fiscal Year 2018-2019 Payroll Calendar
• Fiscal Year 2019-2020 Payroll Calendar
• Federal Tax Form (W-4)
• I-9 Form (Employee Eligibility Verification)
• State Tax Form (MW 507)
• Direct Deposit Form
• E. Employee v. Independent Contractor Determination Form
• Professional Services Agreement (Ind. Contractor)
• Certification of Academic Activity
• Payroll News - Winter 2017
• Understanding Your W2
• W-2 Reissue Form
• Payroll Request Form
• Payroll Correction Form

MICA Timesheets

• Model
• Student Non Work-Study
• Student Work-Study

Performance Appraisals

• Employee Appraisal Form
• Employee Self-Appraisal Form
• Supervisor Self-Assessment