Employee Benefits : New Faculty Enrollment Forms

You must complete and submit the following seven forms (six if not covering a spouse or qualified same-sex domestic partner) to the Human Resources (HR) Department in Bouillon Hall 140 or at mailstop 7425.

Completed health plan and retirement enrollment forms must be returned within the first 31 days of eligibility and life insurance enrollment forms within the first 60 days of eligibility.

If you choose to waive any coverage, indicate so on the enrollment form. Dental coverage may not be waived.

Call (509) 963-1202 with questions or email humanres@cwu.edu.

ENROLLMENT FORMS Completed forms must be returned to HR within 31 days of hire

1. 2008 Employee Enrollment/Change Form [REQUIRED]
2. Spouse or Same-Sex Domestic Partner Certification [REQUIRED if covering spouse or SSDP]

Medical
Choose between managed care plans:	Group Health Classic or Value
	Aetna
Or the state's preferred provider plan:	Uniform Medical

Dental
Choose between managed care plans:	DeltaCare
	Willamette
Or the preferred provider plan:	Uniform Dental

ENROLLMENT FORM Completed form must be returned to HR within 60 days of hire

3. Life Insurance Enrollment Form [REQUIRED]

CWU provides a $25,000 term life insurance policy. Additional coverage is available.

ENROLLMENT FORM Completed form must be returned to HR within 31 days of hire

4. LTD Insurance Enrollment Form [REQUIRED]

CWU provides basic coverage after 90 days of disability for all benefits eligible employees and aditional coverage replacing 60% of salary for faculty with tenure-track or one-year appointments. Part-time faculty may purchase the additional coverage.

ENROLLMENT FORMS Completed forms must be returned to HR within 31 days of hire

You must submit the CWURP Enrollment Form, an enrollment form for each selected vendor, and the Retirement Status Form.

5. CWURP Enrollment Form [REQUIRED]
6. Vendor Enrollment Forms [One or more REQUIRED]
   Fidelity (Print form; complete, sign, and return to HR)
   TIAA-CREF (Enroll online)
   Vanguard (Complete form online; print, sign, and return to HR)
7. Retirement Status Form [REQUIRED]

Contributions to the mandatory retirement plan are matched by the university. Funds may be invested with Fidelity, TIAA-CREF, and/or Vanguard.

Eligibility	Investment Choices
Overview	Retirement Planning Workshops