RCUH Monthly Premium Rate Sheet — Active Employees | 3.520, 3.520A |
RCUH Monthly Premium Rate Sheet — COBRA | 3.285, 3.520, 3.520A |
RCUH Monthly Premium Rate Sheet — Retiree | 3.520, 3.520A, 3.560 |
RCUH Affidavit of Dependency for Tax Purposes Form (B-16) | 3.520 |
RCUH Declaration of Domestic Partnership Form (B-14) | 3.215, 3.520, 3.520A |
RCUH Declaration of Termination of Domestic Partnership Form (B-15) | 3.530, 3.520A |
RCUH Employee Claimant Consent Form - Workers’ Compensation (Form D-26WC) | 3.580 |
RCUH Employee Claimant Consent Form – Non-Workers’ Compensation (Form D-26NWC) | 3.640 |
RCUH Family Leave Application Form: Care for Family Member (B-11) | 3.660 |
RCUH Family Leave Application Form: Care for Self/Own Condition (B-11a) | 3.660 |
RCUH Flexible Spending Enrollment/Change Form (B-5F) | 3.530, 3.530A |
RCUH Group Health Insurance Enrollment/Change Form: Regular-Status Employees (B-5H) | 3.520, 3.540 |
RCUH Group Health Insurance Waiver Form: Regular-Status Employees (B-5Wb) | 3.340 |
RCUH Group Health ACA Insurance Enrollment/Change/Waive Form: Non-Recruited Employees (B-5A) | 3.340 |
RCUH Guidelines and Information on Domestic Partners/Reciprocal Beneficiaries | |
RCUH ID Card Application Form (E-18) | 3.610 |
RCUH Leave for Parent-Teacher Conference Request Form (B-1) | 3.520, 3.678 |
RCUH Life Insurance Change Form (B-5L) | 3.520, 3.540 |
RCUH Retiree Group Health & Life Insurance Enrollment Application (B-27) | 3.550 |
RCUH Supplemental Retirement Annuity (TIAA) Agreement for Salary Reduction Form (B-6) | 3.560 |
RCUH Tuition Reimbursement Program Application Authorization Form | 3.460 |
RCUH Victims Leave Form (B-21) | 3.650 |
2022 Personnel Action & Payroll Calendar | |
2022 Personnel Action & Payroll Schedule | |
2021 Personnel Action & Payroll Calendar | |
2021 Personnel Action & Payroll Schedule | |
EEO is the Law Poster | 3.110, 3.920 |
EEO Complaint Form (O-3) | 3.110, 3.120 |
Equal Employment Opportunity Policy Statement | 3.110 |
RCUH Withdrawal of Complaint and Release Form (O-4) | 3.110, 3.120 |
Independent Contractor Memo Template | 3.225 |
Independent Contractor Memo - Instructions | 3.225 |
Guest Speaker Memo Template | 3.225 |
Guest Speaker Memo - Instructions | 3.225 |
Master EIC Determination - Non-Employee Research Study Participant | 3.225 |
Master EIC Determination - Non-Employee Non-Compensated Project Support | 3.225 |
Master EIC Determination - Non-Employee Special Duty Police | 3.225 |
Employees - Completing an eTimesheet (Standard) | |
Principal Investigators - Approving eTimesheets (Standard) | |
Employees - Completing an eTimesheet (Task Order) | |
Principal Investigators - Approving eTimesheets (Task Order) | |
Acknowledgement - Receipt of Company Property Financial Obligation Form (O-6) | |
Ethics Checklist | 3.210 |
Ethics Guide | 3.210 |
Form I-9 with RCUH Address | |
New Hire Reference Guide (for Non-Recruited Hires) | 3.005 |
New Hire Reference Guide (for Regular Hires) | 3.005 |
Personnel Action Form | 3.342, 3.350, 3.360, 3.620, 3.674 |
Student Assistant Pay Schedule | 3.211 |
HR Portal Access Form | 3.710 |
HR Portal Access Form — Additional Users | 3.710 |
RCUH User Acknowledgement | 3.710 |
Part A - HR Portal User Guide - Overview | 3.710, 3.810 |
Part B - HR Portal User Guide - Recruitment & Employment I | |
Part C - HR Portal User Guide - Recruitment & Employment II | |
Part D - HR Portal User Guide - Payroll | |
Part E - HR Portal User Guide - HR Information Systems I | |
Part F - HR Portal User Guide - HR Information Systems II | 4.400 |
Confidentiality Requirements for Personal Identifiable Information Acknowledgement Form | 3.480 |
Memo - Unforeseen Disruption in Work Schedules | 3.262 |
Model RCUH Safety Program | 3.930 |
Supervisors Report of Industrial Injury Form | 3.930 |
RCUH 12-Month/Needs Based Performance Evaluation Short Form (Excel Format) | 3.410 |
RCUH 12-Month/Needs Based Performance Evaluation Long Form (Excel Format) | 3.410 |
Attachment B User Guide | 3.234 |
Common External Publications | 3.234 |
Employment of Relatives & Other Close Relationships Form | 3.255, 3.262 |
Interview Comment Sheet | 3.235 |
Job Description Template | 3.234 |
Position Requisition Form | 3.234 |
RCUH Certification of Compliance - Prospective New Hire | |
Telephone Reference Check Form | 3.235 |
HMSA Akamai Advantage Form | 3.550 |
HMSA Automatic Payment Application | 3.550 |
HMSA Authorized Contact Form | 3.550 |
HMSA Akamai Advantage Summary of Benefits | 3.550 |
Kaiser Senior Advantage Form | 3.550 |
Kaiser Automatic Payment Application | 3.550 |
Kaiser Senior Advantage Summary of Benefits | 3.550 |
MetLife Life Insurance Policy (RCUH Retirees) | 3.550 |
Termination of Employment Form | 3.285 |
Termination General Information (Regular, Non-Regular, Relief status employees) | 3.285 |
Termination General Information (Non-Recruited Employees) | 3.285 |
COBRA Monthly Rate Sheet (Medical and Dental premiums): Effective 07/01/2021 - 06/30/2022 | 3.285 |
COBRA Notification - For reference only (actual notification to be sent upon processing of termination action) | 3.285 |
HDS (Dental) COBRA Enrollment Form | 3.285 |
Kaiser (Medical) COBRA Enrollment Form | 3.285 |
UNUM (Long Term Care) Continuation of Coverage Application | 3.285 |
MetLife (Life Insurance) Portability Application | 3.285 |
MetLife (Life Insurance) Conversion Application | 3.285 |
NBS (Flexible Spending Healthcare) Continuation of Coverage Application | 3.285 |
TIAA (Retirement Account) Options When Terminating with RCUH | 3.285 |
RCUH Mahalo Survey | 3.285 |
Employee Time/Leave Certification Form | 3.340, 3.342, 3.344, 3.620, 3.640, 3.650, 3.670, 3.672, 3.674, 3.676, 3.678 |
RCUH Request for Timesheet Correction Form | 3.810 |
Dependent Information Form | 3.212 |
E-3 Request Form | 3.212 |
H-1B Request Form | 3.212 |
J-1 Change Form | 3.212 |
J-1 Completion Form | 3.212 |
J-1 Request Form | 3.212 |
J-2 Information Form | 3.212 |
O-1 Request Form | 3.212 |
RCUH Pre-Arrival and Orientation Information for J-1 Exchange Visitors | 3.212 |
TN Request Form | 3.212 |
Belgium (Research) | |
Bulgaria (Research) | |
China (Research) | |
Commonwealth of Independent States (Research) | |
Czech Republic (Research) | |
Egypt (Research) | |
France (Research) | |
Germany (Research) | |
Greece (Research) | |
Hungary (Research) | |
India (Research) | |
Indonesia (Research) | |
Israel (Research) | |
Italy (Research) | |
Jamaica (Research) | |
Korea (Research) | |
Luxembourg (Research) | |
Netherlands (Research) | |
Norway (Research) | |
Pakistan (Research) | |
Phillipines (Research) | |
Portugal (Research) | |
Romania (Research) | |
Slovak Republic (Research) | |
Slovenia (Research) | |
Thailand (Research) | |
Trinidad & Tobago (Research) | |
United Kingdom (Research) | |
Venezuela (Research) | |
Belgium (Student) | |
Bulgaria (Student) | |
China (Student) | |
Cyprus (Student) (Student) | |
Czech Republic (Student) (Student) | |
Egypt (Student) (Student) | |
Estonia (Student) (Student) | |
France (Student) (Student) | |
Germany (Student) | |
Iceland (Student) | |
Indonesia (Student) | |
Israel (Student) | |
Latvia (Student) | |
Lithuania (Student) | |
Morocco (Student) | |
Netherlands (Student) | |
Norway (Student) | |
Pakistan (Student) | |
Phillipines (Student) | |
Poland (Student) | |
Portugal (Student) | |
Romania (Student) | |
Slovak Republic (Student) | |
Slovenia (Student) | |
Spain (Student) | |
Thailand (Student) | |
Trinidad & Tobago (Student) | |
Tunisia (Student) | |
Venezuela (Student) | |