Staff Separatin Checklist Please print and use as a reference guide t cmplete the separatin prcess. Benefits Checklist fr Staff Separatin Health Benefits: COBRA Frms Received Retirement: Received infrmatin regarding TRS ptins Received TRS 6 Frm (applicatin fr refund) Vluntary Retirement Optins (if applicable): Check ne r mre f the ptins belw, that applies t yu: Received Vesting/Terminatin frm fr TSA 403b - Traditinal Received Vesting/Terminatin frm fr TSA 403b - Rth Received Vesting/Terminatin frm fr DCP 457b Remaining Sick Leave Balance: Transferring t anther state agency Dnated t Sick Leave Pl Direct Sick Leave Dnatin Dnr Frm Remaining Vacatin Leave Balance: Transferring t anther state agency Vacatin Payut Deferred t a DCP-457(b) accunt: All Partial 1
Staff Separatin Prcess Cntinued 1. Cmplete and submit final timecard thrugh Time Entry functin in Oracle. (If the emplyee has separated and n lnger has access t Oracle t cmplete the timecard, a paper timecard will need t be submitted t the supervisr r t HR at hr@utrgv.edu) 2. Return university equipment such as ipad, secure USB flash drive, laptp, and/r any ther equipment that belngs t the institutin. 3. Return prcurement card and/r travel cards, if any and supervisr will frward them t the Purchasing Office. 4. Submit keys t the Facilities Operatins Department (this includes vehicle keys r keys t any ther facility r equipment). 5. Submit ID badge (access card) supervisr will submit t Campus Card Services 6. Cntact the Office f Human Resurces t facilitate separatin. 7. Cntact the University Library fr any pending fees/checked ut items. Instructins fr the Staff Separatin Checklist As an emplyee wh is separating frm UTRGV, yu will receive an Emplyee Separatin email. We have created an emplyee separatin checklist t assist yu in cmpleting yur separatin with UTRGV (yu may review this checklist with yur supervisr t crdinate with the cmpletin prcess; this frm is fr yur recrds). Belw are the instructins fr the separatin checklist. Emplyee submits letter a resignatin The supervisr will enter the emplyee separatin n epaf. *Please nte that the supervisr is respnsible in cmpleting the separatin frm and this is nly prcessed when the emplyee separates frm the university. Health Benefits Benefits cverage will end at the end f the mnth fllwing separatin Example: if separating n 01/05/17, benefits end n 01/31/2017 (if separatin date is 01/31/17, benefits will end n 01/31/17) 2
COBRA COBRA (Cnslidated Omnibus Budget Recnciliatin Act) is a Federal law under which emplyees and their cvered dependents have the pprtunity fr a temprary extensin f medical, dental and/r visin cverage at grup rates in instances where cverage under the plan wuld therwise end. In certain cases, it may be pssible t cntinue HCRA cverage. The emplyee r dependent is respnsible fr the entire premium fr COBRA cverage plus a tw percent administrative fee. Please select by placing a check mark t indicate that yu received yur COBRA dcuments. This includes yur: Optin t purchase in COBRA (cntinue health cverage medical, prescriptin, dental, and visin - fr up t 18 mnths) COBRA Ntice is attached t yur separatin email frms include yur benefits cverage end date; please print fr yur recrds If yu chse t enrll in COBRA, yu must submit the COBRA applicatin within 60 days f lss f cverage The COBRA ntice will als be sent t yu by mail, t the address we have n file. If yu d nt receive the ntice frms by mail, please cntact benefits@utrgv.edu. Fr mre infrmatin regarding COBRA click n the link belw: http://www.utsystem.edu/ffices/emplyee-benefits/cbra-cverage Teacher Retirement System (TRS) Yur Teacher Retirement System cntributin ptins are: Keep cntributins in yur existing TRS accunt; n further actin is needed frm yu If cntinuing emplyment with anther State Agency r ther TRS retirement cntributin entity, n further actin is needed frm yu Yu may leave the funds in yur TRS accunt until retirement; n further actin is needed frm yu Cntributins may be refunded r rlled int an apprved retirement accunt (see TRS 6 Frm: Applicatin fr Refund) Please place a check mark n Received infrmatin regarding TRS ptins nce yu are aware f yur ptins The TRS 6 frm is attached t yur separatin email, if yu chse t have yur TRS cntributins refunded t yu r if yu will be rlling them int an apprved retirement accunt. It is recmmended that yu speak t a TRS representative prir t cmpleting and sending the TRS 6 frm by calling 1-800-223-8778. 3
Vluntary Retirement Prgram If Applicable Please cntact yur vendr regarding any f the fllwing vluntary retirement accunt(s) (see separatin email fr mre details) Received Vesting/Terminatin frm fr TSA 403b - Traditinal Received Vesting/Terminatin frm fr TSA 403b - Rth Received Vesting/Terminatin frm fr DCP 457b Please visit the nearest Office f Human Resurces t receive yur Vesting/Terminatin Status Frm fr yur vluntary retirement accunt(s) Sick Leave Hurs Yur remaining unused sick leave hurs can be transferred t anther state agency within 12 mnths r the hurs will expire (see HOP ADM 04-603); If cntinuing emplyment with anther State Agency please ntify HR (we will cntact salary admin/recrds t indicate cntinuance f ther state emplyment n yur file); n further actin is needed, frm yu If yu are nt transferring t anther state agency, yu may dnate remaining sick leave hurs t the Sick Leave Pl (see HOP ADM 04-604); the Sick Leave Pl (SLP) dnatin frm is attached t yur separatin email (cmplete and email t benefits@utrgv.edu) r submit t the Human Resurces ffice Or yu may als dnate hurs t a specific recipient, wh has previusly applied fr SLP hurs and has exhausted the hurs awarded (please see the Sick Leave Pl Dnr frm attached t yur separatin email fr agreement requirements; if dnating t a recipient, please cmplete and email the frm t benefits@utrgv.edu r submit t the Human Resurces ffice) Please a check mark n the ptin yu have chsen **Please nte that yur supervisr will need t enter the crrect reasn cde indicated n the separatin frm if yu will be transferring t anther state agency (this will indicate sick leave balance will be transferred). Vacatin Leave Hurs If yu will be emplyed with anther state agency, withut a break in service (within 30 days f separatin frm UTRGV), the unused vacatin leave balance will be transferred t the receiving state agency. (see HOP ADM 04-602) If cntinuing emplyment with anther State Agency please ntify HR (we will cntact salary admin/recrds t indicate cntinuance f ther state emplyment n yur file); n further actin is needed, frm yu Yu may chse t receive a vacatin leave settlement (payut) f yur remaining vacatin leave hurs (in rder t prvide an accurate accunt f remaining vacatin leave hurs, the settlement payment will be paid ut ne mnth after separatin) Or yu may defer a prtin r the entire vacatin payut amunt int a DCP (Deferred Cmpensatin Plan) r 457(b) accunt, pre-taxed (Purchase/Change Agreement is attached) Please place a check mark n the ptin yu have chsen 4
Please ntify ur ffice f yur decisin fr yur remaining vacatin leave balance as sn as pssible s that we can prcess the settlement r deferment in a timely manner. **Please nte that yur supervisr will need t enter the crrect reasn cde indicated n the separatin frm if yu will be transferring t anther state agency (this will indicate vacatin leave balance will be transferred). Staff Separatin Prcess Checklist Place a check mark next t numbers 1 thrugh 7 after yu: Cmplete and submit yur timecard (timecards that are nt cmpleted may cause a delay n the vacatin settlement); If the emplyee has separated and n lnger has access t Oracle t cmplete the timecard, a paper timecard will need t be submitted t the supervisr r t HR at hr@utrgv.edu Return any/all equipment Return any/all prcurement/travel cards t yur supervisr (yur supervisr will frward them t the Purchasing Office. Submit all keys (t vehicles r buildings) t the Facilities Operatins Dept. Have cntacted and received clearance frm the Library f any fees/checked ut items Please cntact Benefits at benefits@utrgv.edu r at the phne numbers listed belw, if yu have any questins. Office f Human Resurces Brwnsville: (956) 882-8205 Edinburg: (956) 665-2451 5