RCUH Policies and Procedures
RCUH Monthly Premium Rate Sheets
| Related Information | Related Policy/Procedure |
|---|---|
| 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 |
Domestic Partnerships/Reciprocal Beneficiaries
| Forms | Related Policy/Procedure |
|---|---|
| RCUH Affidavit of Dependency for Tax Purposes Form (B-16) | 3.520, 3.520A |
| 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 Guidelines and Information on Domestic Partners/Reciprocal Beneficiaries | 3.520, 3.520A |
Family & Medical Leave
Health Enrollment/Change
Other Benefits
| Forms | Related Policy/Procedure |
|---|---|
| RCUH Flexible Spending Plan Enrollment/Change Form (B-5F) | 3.530, 3.530A |
| RCUH ID 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 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 |