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

Workers' Compensation Internal Process

Academic Personnel Leaves of Absence

Academic Personnel Retirement Programs

Life Insurance

Flexible Spending Accounts