Employee Records & Payroll
Employee Records: New Employees
Federal & State
- I-9 Form (PDF) *this is a fillable PDF
- Checklist for I-9 Verifiers(docx)
- I-9 Remote Hire Notice Form(PDF)
- I-9 Remote Hire Instructions (PDF)
- Hiring Incentives to Restore Employment (HIRE) Act (link to IRS.gov)
Leave, Overtime & Time Related
- Additional Pay Form (XLSX)
- FMLA Certification for Employee's Serious Health Condition(PDF)
- FMLA Certification for Family Member's Serious Health Condition(PDF)
- FMLA Checklist (PDF)
- FMLA Tracking Spreadsheet(XLS)
- Leave of Absence Request(PDF)
- Parental Leave Request - Faculty(PDF)
- Teaching Availability Form (Part-Time Faculty)(PDF)
Misc
Telework
Telework Agreement Form
2024 Benefits
2024 Medical Forms
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes:Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
2024 Dental Insurance
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes:Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
- Dental Enrollment Form (PDF)*Do not use this form for Open Enrollment. Open enrollment elections must be submitted via .
- Dental Waiver Form (PDF)
Voluntary Vision
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes:Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
Flex Spending Account
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes:Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
Reimbursement claim forms must be submitted directly to EBPA:
- Medical Expense Flexible Spending Claim (PDF)
- Dependent Care Flexible Spending Claim (PDF)
- (scan the above ̽̽ claim form and receipts, then upload)
Group Term Life Insurance
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes: Please complete in PeopleSoft Self-Service.
- Outside of Open Enrollment Changes: Please complete BCBSVT Medical Enrollment/Change Request Form and Certification of Dependents Form below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
Short-Term Disability Insurance
Enrollment Registration is ONLY Available During Annual Benefits Open Enrollment each fall and coverage would begin in January. Visit .
Long-Term Disability Insurance
- All New Hires: Please use the emailed link for online enrollment as part of New Employee Orientation.
- All Active Employee Open Enrollment Changes:Please complete request in PeopleSoft Self-Service.
-Outside of Open Enrollment Changes: Please complete Group Long-Term Disability Enrollment/Change Form and Medical History Statement below to change coverage due to qualifying life event (marriage, divorce, birth/adoption of a child, etc).
Tuition Remission
Retirement
All Active Employee Deferral or Vendor Changes: Please complete request in PeopleSoft Self-Service via the Self-Service tile.
New 403(b) Enrollments Only:
- 403(b) Retirement Plan Salary Reduction Agreement (PDF)
- Fidelity 403(b) Enrollment(PDF) - updated 1/28/24
- TIAA 403(b) Enrollment (PDF)
403(b) Catch-Up Request:
New 457(b) Enrollments and 50+ Catch-Up Elections Only:
Fidelity 457(b) Enrollment (PDF) updated 1/28/24
New ̽̽ Retiree Health Savings Plan Enrollment:
Manager Tasks
Recruiting, Hiring, and Position Management
- Approval for Employment-Related Actions and Increases (XLSX)
- Approval for Employment-Related Actions and Increases (PDF)
- PeopleAdmin Access Request Form
- Exempt Staff Salary Letter Template (docx)
- Non-Exempt Staff Salary Letter Template (docx)
- Position Description for Staff(doc)
- Reference Check for Job Applicants(doc)
- Graduate Assistantship Offer Letter Template (doc)
- Job Codes for new bargaining units (xlsx)
- Distribution Form (xlsx)
Forms and Templates for Faculty Appointment and Reappointment
Temporary Employee & Paid Non-Employee Forms
Please visit the Temporary Employee & Paid Non-Employee Resources webpage for forms.