Eastern Michigan University
Human Resources
Develops, implements, counsels and enrolls all faculty and staff in specific benefit programs. Processes all benefit claims. Administers the employee tuition waiver program. Administers all University retirement programs and processes tax deferred annuity plans.
Forms
Benefits Forms (see all Forms)
- 2013 Benefits Change Form
- Aetna Life and Disability Enrollment/Change Request Form
- Aetna Life Insurance Designation of Beneficiary Form
- Aetna Evidence of Insurability Statement Life and Disability Coverage and Form
- BASIC Flex Additional Debit Card Request Form
- BASIC Flex Reimbursement Form
- Blue Cross/Blue Shield International Claim Form
- Dependent Eligibility Verification FAQs
- Emeritus Application(Staff)
- Emeritus Application(Faculty)
- Employee Occupational Injury or Illness
- Medco Rx Mail In Form
- Medco Physician Rx Mail In Form
- Instructions for Enrolling in 403(b) for Part-Time Employees
- MPSERS Retired Employee Approvals Form
- MPSERS Notice of Intent to Retire
- MPSERS Verification Form
- Retirement Party Expense Guidelines
- Retirement Party Form
- Request for Accommodation
- Salary Reduction Agreement (2013) - 457(b)
- Salary Reduction Agreement (2013) - 403(b)
- Stop SRA Form
- Tuition Waiver Agreement/Application for Employees
- Tuition Waiver Agreement/Application for Spouse/Dependents
- Vacation Accrual Guidelines
Leave of Absence
- Campus Leave Authorization form for Staff
- FMLA Notice of Eligibility and Rights & Responsibilities
- FMLA Certification of Health Care Provider for Employee's Serious Health Condition
- FMLA - Certification of Health Care Provider for Family Member's Serious Health Condition
- FMLA - Certification of Qualifying Exigency for Military Family Leave
- FMLA - Certification for Serious Injury or Illness of Covered Servicemember - for Military Family Leave
- FMLA - Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
- FMLA - Designation Notice
- Educational Leave of Absence Addendum
- Family Medical Leave Guidelines
- Fitness for Duty Report
- Flexible Spending Account (Health) Leave of Absence Form
- Leave of Absence Form - Staff
- Release of Medical Information Form
- Workers' Compensation Buy-Back Guidelines
- Workers' Compensation Buy-Back Request Form
