Benefits Forms

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Health Benefits

Retirement Programs

  • If you are in the process or have already separated from all CalPERS-covered employment, you will need to consider whether you want to keep your retirement contributions on deposit with CalPERS or receive a refund.
  • This booklet contains information and a payment application to help you select the payment method that best meets your needs.

Voluntary Benefits Programs

  • A Cal-Ore Life Flight membership ensures the patient will have no out-of-pocket flight expenses if flown by the Company or another AirMedCare Network participating provider

Fee Waiver Program, Fee Waiver Registration Instructions

Workers' Compensation, Workers' Compensation Internal Process

  • Employee’s Report of Injury (DWC-1) – Must be given to employee at the time injury is reported to Supervisor, or as soon as possible after medical treatment is received
  • Supervisor’s Report of Injury – MUST BE SUBMITTED TO HUMAN RESOURCES WITHIN 24 HOURS OF KNOWLEDGE OF INJURY
  • Employee’s Report of Injury (DWC-1) – Must be given to employee at the time injury is reported to Supervisor, or as soon as possible after medical treatment is received
  • Supervisor’s Report of Injury – MUST BE SUBMITTED TO HUMAN RESOURCES WITHIN 24 HOURS OF KNOWLEDGE OF INJURY

Workers' Compensation

Academic Personnel Leaves of Absence

Academic Personnel Retirement Programs

Life Insurance

Flexible Spending Accounts