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New York University
About
Benefits
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Learning & Development
Employee Relations
Life Resources
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Benefits Forms
Full-Time Employees
Adjunct Faculty
Part-Time Employees
Retirees
Benefits Forms
FAQs
Vendor Links for Benefits
Rights & Policies
Benefits Forms
Enrollment Forms
Benefits Enrollment Form - Code 100, 102, 103
Benefits Enrollment Form - Code 104, 106 and 107 (Non-Union Service Staff) Only
Benefits Enrollment Form - Code 107 810
Benefits Enrollment Form - Code 107 PRG (Local One Security Officers)
Benefits Enrollment Form - Sergeant Guards in Code 107 PRG SGT
Benefits Enrollment Form - Code 112
Medical & Dental Claim Forms
Retiree Medical (UnitedHealthcare) Claim Form
Point-of-Service Plan (UnitedHealthcare) Claim Form
UnitedHealthcare Foreign Providers Claim Form
Dental (MetLife) Claim Form
Prescription Drugs
Caremark Claim Form
Caremark Mail Service Order Form (Prescription Drug)
Reimbursement Accounts Claim Forms
2008 Commutation Expense Reimbursement Account (CERA) Claim Form
Dependent Care Spending Account (UnitedHealthcare) Claim Form
Health Care Spending Account (UnitedHealthcare) Claim Form
Domestic Partner Affidavit for FSA Claims
Domestic Partner
Domestic Partner Declaration of Federal Tax Status
Domestic Partnership Statement
Domestic Partnership Termination Form
Life Insurance
Life Insurance Enrollment Form Codes 100, 102, 103
Life Insurance Enrollment Form Codes 104, 106, 107 Non-Union
Life Insurance Enrollment Form Code 107 SGT
Life Insurance Enrollment Form Code 107 PRG
Life Insurance Enrollment Form Code 107 Local 810
Life Insurance Medical History Statement for NY Residents
Life Insurance - Application for Conversion of Group Insurance
Absolute Assignment of Life Insurance
Life Insurance Claim Form for Beneficiary Benefits
Retirement Plans
Retirement Plan Enrollment and Investment Selection
TIAA-CREF Designation of Beneficiary Form - for NYU Retirement Plans
TIAA-CREF Direct Transfer/Rollover Authorization to TIAA-CREF
TIAA-CREF Retirement Annuities & Suppl. Retirement Annuities Enrollment Form
TIAA-CREF Supplemental Retirement Annuities Enrollment Form
Vanguard Asset Transfer Authorization
Vanguard Designation of Beneficiary Form
Vanguard Distribution Request/Direct Rollover
Vanguard Enrollment/Change Form
Vanguard In-Service Withdrawal Request
STDA Salary Reduction Agreement and Investment Selection Form
Tuition Assistance
Adjusted Work Schedule for Classes
Graduate Student Assistantships Tuition Award Application
Local 3882 Tuition Reimbursement 20%
Portable Tuition for Dependants - Current Employee
Portable Tuition for Dependants - Former Employee
Tuition Remission - Former Full Time NYU Employees
Tuition Remission 100% for Job Related Non-Credit SCPS Courses
Tuition Remission Application for Non-Credit SCPS Courses
Tuition Remission - Statement of Job Relatedness for Employee Graduate Courses
Tuition Remission - Statement of Job Relatedness for Employee Graduate Courses PRE-APPROVAL
Family Leave
FMLA - Certification of Health Care Provider
FMLA - Request for Family and Medical Leave
Other Benefits
Mortgage Origination Fee Reimbursement - Code 100
Mortgage Origination Fee Reimbursement - Code 102
