You are here: Human Resources / Benefits
- ACTIONS REQUIRED: When Employees Separate (COBRA Enrollment Process)
- Beneficiary Designation Form EF-1245.pdf
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Blue Cross Claim Form
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Blue Cross Insurance Enrollment Form - COBRA
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Blue Cross Mail Service Prescription Drug Program Form
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Blue Cross Plan Details
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Blue Cross Prescription Drug Form
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CA Life & AD&D Death Claim Form EF - Reliance Standard Life Insurance Company
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CA Life Conversion Application, Reliance Standard Life Insurance Company
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COBRA Acknowledgement Form
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- COBRA Contacts (where to send premiums)
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Declaration of Domestic Partnership Form
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Declaration of Tax Dependency and Declaration of Registration of Domestic Partnership in CA, 2007
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Declination of Coverage
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Delta Dental Details
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Delta Dental Plan Enrollment Form - COBRA
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Disability Claim Form, Reliance Standard
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- FAQs
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Graduate Medical Education
The UCSF School of Medicine offers Residency and Clinical Fellowship Programs as well as dozens of other specialty training programs.
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Health Net Claim Form
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Health Net Insurance Enrollment Form - COBRA
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- Health Net Plan Details
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Health Net Prescription Claim Form
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- Health Plan Contacts
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Insurance Action Form
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- Insurance Action Form (4)
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Insurance Choices Comparison
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- Insurance Contacts
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Life & Accidential Death & Dismemberment (AD & D) Insurance
Life and Accidental Death & Dismemberment coverage is automatically included for all primary enrollees: Residents, Clinical Fellows, but not dependents. This additional minimum cost is included in the premium structure.
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Long Term Disability Conversion Insurance Questionaire
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- Medical Insurance: The Basics (How to Enroll)
- Premium Rates for Individual Plans - For Department Use Only
- Premium Rates, 2007-2008
- Premium Rates, 2008-2009
- Rates, 2007-2008 - COBRA
- Rates, 2008-2009 - COBRA
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Reliance Long Term Disability SPD, 2007
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Reliance Standard Group Basic Life & Basic AD&D SPD
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Reliance Standard Group Long Term Disability
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Residents & Clinical Fellows, Benefits Open Enrollment 2008
This is your annual opportunity to change medical plans for the coming fiscal year, enroll in insurance plans, and add eligible family members.
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Taxability Letter to Residents Clinical Fellows
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The UC contributions paid towards health benefits for some Residents/Clinical Fellows are taxable. Please review the attached document to determine how this may affect you.
- Taxibility of UC Health Plan Contributions
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Vision Service Plan Details
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Vision Service Plan Enrollment Form - COBRA
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- Visiting Foreign Scholar Insurance & Repatriation Insurance