Maine's Public Universities - University of Maine System

Human Resources

Forms

Dental Insurance

CIGNA Dental Claim Form

Domestic Partner

Affidavit of Domestic Partnership

Flexible Spending Account

Flexible Spending Account Claim Form

EBPA Additional FSA Benefits Card Request Form

Health Insurance

Authorization for the Use and/or Disclosure of Protected Health Information

Life Insurance

Beneficiary Designation Form

Evidence of Insurability Form

Medical Leave

Request for Family Medical Leave

Certification of Ability to Return to Work

USDOL Certification of Health Care Provider

Retirement Savings

Salary Reduction Agreement for Salaried Employees

Salary Reduction Agreement for Hourly-Paid Employees

Tuition Waiver

Request Employee Tuition Waiver

Request Dependent Tuition Waiver

Vision

CIGNA Vision Claim Form

 

Disclaimer Statement

The documents and information of the Office of Human Resources for the University of Maine System are made available on the Internet as a public service.  Reliance on such information is at the user's own risk.  We will make all reasonable efforts to ensure that the information is accurate and current, but cannot guarantee the accuracy, reliability, completeness or timeliness of information obtained from the website any may not be held liable for any losses caused by any person's reliance on such information.

Contents at links outside the University of Maine System Human Resources Website are neither created nor endorsed by the University of Maine System.  If you have any questions concerning the information on this webiste, contact your university.

 

 

Last Updated:  October 8, 2008->