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Indicates an electronic process using HR Connection, PayFlex, MetLife, or TRS

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Indicates a paper form to be completed and submitted per form instructions, or other method

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Dental enrollment using HRconnection
Request a change in dental coverage using HRconnection
Dental expense claim form
Insurance request for dependent, unmarried students
Dental enrollment form for surviving dependent
Employee request form to continue dental coverage (COBRA)
Dependent request form to continue dental coverage (COBRA)

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Enroll for AD&D coverage using HR Connection
Request a change in AD&D coverage using HR Connection
Designate or change AD&D beneficiaries using HR Connection
Proof of loss claim statement (contact Employee Benefits)

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Enroll for LTD using HR Connection
LTD Statement of Health form
How to file an LTD claim

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Enroll in a dependent care flexible spending account using HRconnection
Request a change in a dependent care account using HRconnection
Dependent Care spending account reimbursement using PayFlex

Print the HRconnection enrollment guide for NEW EMPLOYEES
Print the HRconnection enrollment guide for CURRENT EMPLOYEES

Enroll in a health flexible spending account using HRconnection
Request a change in a health care account using HRconnection
Health flexible spending account reimbursement using PayFlex
Health care flexible spending account lump sum payment application (for terminating & retiring employees only)

New employees (establish your account, request optional or dependent coverage, establish your beneficiaries):
Log on to the MetLife secure Web site, establish your account, and make your selections there, OR
Call the MetLife toll-free customer service number: 1-866-492-6983

Current, active employees: to request optional or dependent coverage, change coverage, change beneficiaries, or cancel coverage, you may:
Log on to the MetLife secure Web site, establish your account, and make your selections there, OR
Call the MetLife toll-free customer service number: 1-866-492-6983

For retirees only:

To change beneficiaries:
Log on to the MetLife secure Web site, establish your account, and make your changes there, OR
Call the MetLife toll-free customer service number: 1-866-492-6983

To decrease or cancel optional or dependent life coverage, notify UGA Employee Benefits in writing

Teachers Retirement System (TRS) application for membership (register online after receiving a letter from TRS)

ORP election form **
ORP change form **

** If you enroll or change ORP companies, you must also complete and submit company applications. Company contact information.

Georgia Defined Contribution Plan enrollment form
Georgia Defined Contribution Plan reimbursement request form

Bank draft form (for retirees only)

Workers' Compensation first report of injury
Workers's Compensation Wage Statement

529 Higher Education Savings Plan
Enrollment • Change • Cancellation

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