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 

Life Insurance

• Aetna EOI Form
• Aetna Beneficiary Designation Form

Miscellaneous

• Johns Hopkins FCU Membership Application
• Loan Request Form
• Professional Services Agreement Form (Independent Contractor)
• Tuition Remission Form
• Workday Delegations Policy

Employment

• Business Card Request Form + (Policy)
• New Hire Technology Set-up Request Form
• Employee Data Record

Payroll

• Calendar Year 2024-2025 Payroll Calendar
• Certification of Academic Activity
• Understanding Your W2
• W-2 Reissue Form