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UCSC Insurance Continuation Election Form,
instructions, and rates for Unit 18 employees on Benefits Bridge. |
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COBRA insurance continuation rates.
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Declaration of Relationship for Family and In Loco Parentis Medical Leave Purposes- (Sample Form)
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UCSC Insurance Continuation Election Form, instructions, and rates
for employees on furlough. |
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Template for notice of furlough. |
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Sample notice of
an investigatory leave of absence
to investigate an allegation. |
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To inform an employee not covered under a collective bargaining agreement of their layoff. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform an employee of an indefinite layoff or reduction in time. |
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To inform a probationary employee (99, CX, NX, and HX) of an indefinate layoff. |
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To inform employees of their temporary layoff. |
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To inform a limited appointment employee not covered under a collective bargaining unit of their temporary layoff. |
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To inform employees of their temporary reduction in time. |
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Medical Certification for Leave of Absence,
to be completed by employee/service center and health care provider.
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Sample transmittal letter for a leave of absence
request.
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Leave of Absence Return to Work Certification,
to be completed by employee/service center and health care provider.
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Leave of Absence Return to Work Certification
for Exempt Employee for Family and Medical Leave.
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This checklist explains how benefits are affected when on an approved leave of absence with pay (paid leave). |
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This checklist explains how benefits are affected when on an approved leave of absence without pay. |
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UCSC Insurance Continuation Election Form, instructions, and rates for employees on leave without pay. |
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Used by current and former staff employees to request access to their personnel file from Staff Human Resources. Requests for files from service centers must be made directly to the service center. Academic employees should contact AHR. |
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Fill out and attach with original and copies when proof of service or
statement of delivery or mailing is required. Copies to appropriate files. (e.g., Notice of Intent) |
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Required when employees are called to active military duty while employed by the University; form helps determine if employee is eligible for military pay according to University policy and implementing guidelines. For more information, see Supplement to Military Pay Policies (UCOP). |
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Unemployment Insurance Termination Report
to be completed by the department(s) for all separating employees. |
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