Open search
Dashboard
Search
Apply
Explore
Give
Menu
Academics
Academic Affairs
Centers
Colleges
Degrees
Library
Research
Admission
First-year
Transfer
Graduate degrees
International
Visit campus
Campus Life
Activities
Athletics
Wellness
Housing
Community
Traditions
Resources
Academic calendar
Admin and finance
Cost calculator
Records
Reports and data
University careers
Services
Academic support
Enrollment
Financial aid
Safety
Transportation
About
Accreditation
Administration
Campus
Inclusion
President
Strategic plan
Maps
News
Events
Alumni
Search
University Personnel
Section Menu
Arrow down icon
About UP
Benefits and Leaves
Benefits and Wellness
Leaves and Time Off
Open Enrollment
Employment
Events and announcements
Forms
All forms
Benefit Forms
Employee Forms
Fee Waiver Forms
Leave Forms
Non-recruited Staffing Forms
Recruited Positions Forms
Legal postings
Benefit Forms
2022 DCRA/HCRA Enrollment Form
Dental Plan Enrollment Form
Acknowledgement & Missed Premium AR Agreement
Additions and Deletions Worksheet
Affidavit of Marriage or Domestic Partnership
Affidavit of Parent-Child Relationship
Anthem Claim Form
CalPERS Beneficiary Designation
Computer Vision Care Form
DCRA / HCRA Reimbursement Form
Declaration of Health Coverage
Dental Claim Form
Domestic Partner Tax Dependent Certification Form
Flexcash Enrollment Form
FSA / ASIFlex debit card request
2022 New Employee Benefits Enrollment Worksheet
The Standard Insurance Co Beneficiary Designation
VSP Vision Premier Enrollment Form
VSP Vision Reimbursement Form