Extension Policies
Templates - Employee: Benefits
View Policy: CESP 8-21
EBEN-105: Dental Enrollment Application; Cancellation of Coverage; Add/Changes to Coverage (PDF)
View Policy: CESP 8-24
EBEN-106: University of Arkansas Health Insurance Enrollment Application (PDF)
View Policy: CESP 8-2
EBEN-107: Application for Maternity Leave
View Policy: CESP 7-13
EBEN-108: University of Arkansas Superior Vision Plan Enrollment Application
View Policy: None
EBEN-109: Employee Request - Leave for Study
View Policy: CESP 3-35
View Policy: CESP 8-2
EBEN-112: University of Arkansas Flexible Benefits Plan Enrollment Form (PDF)
View Policy: CESP 8-21
EBEN-226: University of Arkansas Group Benefits Change Form (PDF)
View Policy: None
EBEN-227: University of Arkansas Group Benefits Enrollment Form (PDF)
View Policy: None
EBEN-228: Voluntary Salary Deferral Agreement Form (PDF)
View Policy: None
EBEN-231: Request for Consideration Under the Family and Medical Leave Act
View Policy: UASP 425.1
EBEN-328: Families First Coronavirus Response Act (FFCRA) Leave Request Form
View Policy: None
PMGS 17-A Employee Request for Registration Fee Discount
PMGS 17-B Request for Registration Fee Discount for Spouse