Benefits

Insurance and Claim Forms:

Affidavits for Domestic Partners

Dental Claim _^(Aetna)

COVID Test Pharmacy Benefit Claim Form

Health Savings Account (HSA) Payroll Deduction Form

Injury/Incident Report

Life Insurance Beneficiary Designation

Healthcare Flexible Spending Account Claim Form

Dependent Care Claim Form

Medical Claim _^(Aetna)

Vision Claim _^(Aetna)

Non-Insurance Related Benefits:

Computer Purchase Agreement

Education Assistance

Leave of Absence Request

Privacy of Medical Information:

Authorization to Release _^(Aetna)

HIPAA Privacy Notice

Additional Forms:

Enrollment Change & Flexible Spending Account Forms

Employment

Supervisors/Hiring Managers:

Personnel Action Form – _{^{for use when hiring (budgeted and temp positions), personnel changes, payment requests, and more!}}

Related – PAF Due Date Calendar

Related – PAF User Guides: Quick Start Guide | Detailed User Guide

Related – PAF – Correction – _{^{for use if a correction is needed on a previously submitted PAF}}

Related – Employee Onboarding Guide _{^{(Used by Managers/Supervisors)}}

End of Employment Notification – _{^{for use when an individual will no longer be employed by Bates}}

Related – EoEN User Guide

Request to Fill a Position

Position Description _{^{(Create or edit a position description in the PageUp library)}}

Employees:

Employee Name and Campus Address Change Form – _{^{Employees only – students contact records@bates.edu for changes}}

Remote Work Agreement _{^{(Updated July 2022)}}

Payroll

Biweekly – Staff Time Sheet

Biweekly – Student Time Sheet

Monthly – Staff Time Sheet

Direct Deposit Information

W-4 Form – Federal Income Tax Withholding

W-4 Form – State of Maine Income Tax Withholding