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Benefit Forms

Health Care

(Please complete your benefit elections online via your MyUT portal):听

• Spousal Healthcare Eligibility Affidavit听
• Health Savings Account (HSA) Employee Election/Contribution Form

Tuition Waiver

• Tuition Waiver Form- To be used for employee out of state tuition (undergraduate and graduate), dependent out of state tuition (undergraduate), and all dependents of retirees.听 听 听 听 听 听 听 听 听 听 听 听 听 听 听 听 听 听

Life Insurance

• Main Campus Life Enrollment听 听 听 听
• Health Science Life Enrollment Form
• Beneficiary Designation Form