Arizona Department of Administration, Benefit Services Office

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This website is a location for Benefit Liaisons to find special information to better serve their agency’s employees All of the information on the left navigation will redirect you to the main Benefit Services Office website. However, documents and resources for Liaisons can be found in the page below.

2013 Benefits Enrollment

Benefit Guides
Active Employees 2013 Benefit Guide (including University)
Retired State Employee 2013 Benefit Guide

Enrollment Forms
Active State Employee Enrollment Form
Retired State Employee Enrollment Form
Domestic Partner Enrollment Form & Instructions
Domestic Partner’s Child Enrollment Form & Instructions

Other Forms
Beneficiary Elections Form
Flexible Spending Account Enrollment Form
Limited Flexible Spending Account Enrollment Form
Request to Cancel Domestic Partner Benefits Form
Transition of Care Form

Other Resource Documents
2013 LWOP Personal Payment Form
2013 Active Employees Rates
2013 Retired Employees Rates
2013 Payroll Calendar
2013 Open Enrollment BSD Liaison Training Presentation
2013 Open Enrollment Vendor Liaison Training Presentation

2012 Resource Documents
Implementation of SB1609, SB1614 & HB2024 - Training Materials
2011 Resource Documents
2009-2010 Resource Documents
Training Documents
Benefit ListServ
Benefit ListServ Archive

2012 Resource Documents

Forms
Active Employee Enrollment Form
Retired State Employee Enrollment Form - Updated June 11, 2012
Same-Sex Domestic Partner Enrollment Form & Instructions
Same-Sex Domestic Partner’s Child Enrollment Form & Instructions

Guides

New Hire 2012 Benefit Guide (including University)
Active Employees (including University) - 2012 Open Enrollment Guide
Retired State Employees - 2012 Open Enrollment Guide
COBRA Participants - 2012 Open Enrollment Guide

Others
2012 Pay Period Calendar
Presentation - Open Enrollment 2012 Plan Year
2012 Active Employees Rates
2012 Retired Employees Rates
Benefit-Retirement Waiting Period Calculator

Implementation of SB1609, SB1614 & HB2024 - Training Materials
Presentation - Implementation of SB1609, SB1614 & HB2024
New Employee Process
New Tax Table
Payroll 2011
Payroll 2012
Common Questions

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Resource Documents

2012 LWOP Personal Payment Form
2012 Pay Period Calendar
2011 Notice of Dual Enrollment Members utilizing Medicare Part B and the State of Arizona, Benefit Options prescription coverage
2011 Declaration for Change Cover Sheet
2011 ASRS LTD Claim Packet
2011 Instructions for Former Elected Officials Life Insurance Coverage Enrollment
2011 Former Elected Officials Life Insurance Enrollment Form
2011 HITF Personal Payment Form
2011 Active Employee Enrollment/Change Form
2011 Retired Employee/LTD Enrollment Form
2011 Same-Sex Domestic Parner Enrollment Form & Instructions
2011 Same-Sex Domestic Partner's Child Enrollment Form & Instructions
2011 Flexible Spending Account Enrollment Form
2011 Limited Flexible Spending Account Open Enrollment Form
2011 Actives Benefit Guide
2011 Retirees Benefit Guide
2011 Active Rates
2011 Pay Period Calendar

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2009-2010 Resource Documents
2009-2010 Pay Period Calendar
HITF Personal Payment Form 2009-2010
Imputed Income Calculation
Personal Payment Preparation Document
MedImpact Rx Reimbursement Form
ASRS (Sedgwick) LTD Employer Packet 2009-2010
ASRS (Sedgwick) LTD Employee Packet 2009-2010
Group Policy Numbers
USERRA Continuation of Coverage
Hartford Life/ADD Highlight Sheet
Hartford STD/LTD Highlight Sheet

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Training Documents

2012 March Liaison Training - Leave Without Pay
2012 December Liaison Training - 12.12.11
2011 July Liaison Training - 07.19.11
2011 June Liaison Training - 06.21.11
2011 April Liaison Training - 04.19.11
2011 Benefit Basics Training - 02.15.11
2011 Benefit Basics Training Handouts - 02.15.11
2011 Open Enrollment Training #2 with vendor presentations
2011 Open Enrollment Presentation #1
2010 ADOA Health Reform Presentation
2010 The Hartford LTD, STD, Life Training Presentation

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Benefit ListServ

To subscribe to the listserv:

Send an email to list@list.arizona.edu from the e-mail address you want to use. This is not a person but a mailing list management system, so messages should only contain commands.
In the subject line of your email, type in: subscribe beneissues Firstname Lastname (replace Firstname Lastname with your own first name and last name).
Leave the message body blank. Delete or turn off any automatic signature

To unsubscribe from the listserv:

Send an email from the address you are subscribed with to beneissues@list.arizona.edu.
In the subject line of your email, type in: unsubscribe beneissues
Leave the message body blank. Delete or turn off any automatic signature.

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ListServ Archive

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