Forms are listed below. If you are faxing a benefits form to our office, send to 501.686.5386 with a fax cover sheet. Keep the original and fax confirmation for your files.
If you don’t see the benefit form you need, contact Human Resources/Employee Services at 501.686.5650. Many forms are triplicate copy, therefore are only available in our office. We are located on the 4th floor of the Central Building, Wing C.
How to verify your benefit change has been keyed
1. Log into Employee Self Service.
2. Click on Benefits and Payment, then Participation Overview.
3. Change Show Participation Overview as of date to a future date, the date your change should take effect.
4. Click Go.
5. Click on a particular plan. It defaults to to the one at the top, but you can click on any plan.
6. Go to the bottom and click Show Participation Details.
8. If you want to do this for each benefit plan, click Back and select another plan.
Not sure what you have now?
You can also view your Benefits Statement in ESS. This option differs from Participation Overview because it shows all benefit plans, even the ones you don’t have. Here’s how to view your Benefits Statement:
1. Log into Employee Self Service (same as your email sign on).
2. Click Benefits and Payment.
3. Click UAMS Benefits Statement.
4. Use the scroll bar or Page Up/Down keys to view each page.
5. You can only view your statement in ESS. If you prefer a printed copy, ask your department SAP person to assist you. Or you can visit our HR Employees Services office to request a copy.
UMR transition of care form
Onlife physician screening
MedImpact prescription claim
QualChoice medical claim (through 12-31-2012)
UMR medical claim (starting 1-1-2013)
Weight Loss Physician Attestation Form
Weight Loss Reimbursement Form
Life beneficiary change
Accelerated Life Claim (access half of your life insurance now if you are diagnosed with a terminal illness)
Life conversion application, rates
Life portability application, rates
Disability, Accidental Death
Flexible Spending Accounts
QualChoice healthcare and dependent care FSA claim
QualChoice substantiation form
UMR healthcare FSA claim (starting 1-1-2013)
UMR dependent care FSA claim (starting 1-1-2013)
UMR FSA direct deposit
Pre-Tax Premium Conversion
UA Retirement Plan
Change your retirement contribution (send us page 1, you keep page 2)
Report other employer retirement contributions, 2013
Retirement Plan Acknowledgement, front (this is the page new employees fill out)
Retirement Plan Acknowledgement, back (info only)
TIAA-CREF new member application
TIAA-CREF name change
TIAA-CREF beneficiary change
TIAA-CREF direct transfer
Fidelity new member application
Fidelity name change
Fidelity direct transfer