Separation Checklist
Date Completed:_________________________
Employee Name:____________________
- ____ Personnel Transaction Request Form
- ____ IDOC (give two copies of IDOC to the employee)
- ____ Unemployment Insurance Termination Report (send the original to the Unemployment Coordinator, Human Resources, Suite 305, and retain one copy in department personnel file)
- ____ “Termination of Employment” Benefits Checklist
- ____ “UC Account Distribution Line” Booklet
- ____ COBRA Notice and Application Procedures
- ____ COBRA Continuation of Group Coverage Mailing Addresses/Rate Information
- ____ COBRA Continuation Election/Open Enrollment Form (UBEN 102)
- ____ Print two copies of the Inquiry Insurance screen: give one to the employee and place the other in the employee’s department personnel file
- ____ Process last time sheet (for vacation and sick leave balances)
- ____ Explain final salary and vacation payout
- ____ Send “Additional Pay Form” to Payroll to pay out vacation balance
- ____ Retrieve UC ID Card and return to the UC Police Department
- ____ Close out the employee’s file
- ____ Remove keypad access
- ____ Change pay disposition address information in the Payroll system (ECHK)
- ____ Revise Campus Locator Update screen
- ____ Remove Employee Database (OLPPS) access (Inquiry) (if appropriate)
- ____ Cancel email and Outlook calendar access.
- ____ Update department organizational chart and phone list.
- ____ Provide copy of “Employee’s Guide to Layoff”