Work Life Event

Title Get Item
AFSCME Extension of Sick Leave Application Download
AFSCME Sick Leave Bank Application Download
BHE/MTA MetLife Dental Insurance Enrollment/Change Form Download
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave Download
Certification for Serious Injury or Illness of Covered Service Member for Military Family Leave (Family and Medical Leave Act) Download
Certification of Health Care Provider for U.S. Department of Labor Employee’s Serious Health Condition (Family and Medical Leave Act) Download
Certification of Health Care Provider for U.S. Department of Labor Family Member’s Serious Health Condition (Family and Medical Leave Act) Download
Certification of Qualifying Exigency For Military Family Leave (Family and Medical Leave Act) Download
Departure from Employment - Benefited University Employees Download
Departure from Employment – Non-Benefited University Employees Download
Employee Family / Medical Leave Checklist Download
Employer Family / Medical Leave Checklist Download
Employment and Income Verifications - The Work Number Download
Family and Medical Leave Act (FMLA) WH-382 Designation Notice Download
Family Medical Leave Act (FMLA) WH-381 Notice of Eligibility and Rights & Responsibilities Download
Federal Family Medical Leave Act Download
GIC Dependent Age 19 to 26 Enrollment and Change Form Download
Group Health Continuation Coverage Under COBRA Election Notice and Application Download
How to File for Unemployment Benefits Download
Insurance - Employment Status Change Form-1A Download
MA Group Insurance Commission Employment Status Change Form (Form 1-A) Download
MA Group Insurance Commission Enrollment and Change Form (Form 1) Download
Massachusetts Act Relative to Parental Leave Download
Massachusetts Earned Sick Time Employee Rights Download
Massachusetts Pregnant Workers Fairness Act Download
Non-Unit Dental Insurance Plan Enrollment Form Download
Notice of Injury Form Download
PSU/MTA Parental Leave and Sick Leave Bank Application Download
PSU/MTA Sick Leave Bank Policy and Form Download
UMA/PostDoctoral Health Insurance Plan: BCBS New PPO Member Transition of Care Request Download
UMA/Unit B Health Insurance Enrollment form Download
UMass Amherst/Postdoctoral Enrollment/Add/Termination Form Download
USA/MTA Sick Leave Bank Application Download