Employee Forms and Resources
A guide to your plan basics for AD&D and Supplemental Life. Explains the general purposes of Accidental Death & Dismemberment Insurance and Supplemental Life Insurance.
Enrollment forms for AD&D and Basic & Supplemental Life Insurance
- AD&D Enrollment Form (This is voluntary insurance.) You are eligible to purchase this coverage if you are an employee within the North American Division working a minimum of 20 hours per week. The premium cost will be deducted from your payroll.
- Basic & Supplemental Life Enrollment Form. (Employer provided and voluntary insurance.) Each active full-time employee of the North American Division is eligible for the Basic Group Life Insurance. This is an employer paid benefit. Please contact HR for further details.
- AD&D Plan Document
- Basic Life Insurance Plan Document
An Option for Basic Life Insurance (Please contact HR for further details.)
Evidence of Insurability: Enrollment form for Supplemental Life Insurance (required if Supplemental Life is over $250,000 for newly-hired employees; $30,000 for spouses or for current employees beyond 31 days of hire).
Long-term Disability Group Benefit Plan
Adventist Risk Management website with access to additional information relative to AD&D, Group Life, Long-term Disability, and Supplemental Life
Application for leave of absence.
Travel Expense Report—Provides online assistance in filling out and printing your expense report. Attach receipts and submit to financial vice president’s office.
New Employee Forms
Authorization form for submitting to a background check. Additional State Forms may be required dependent upon states that employee has resided in in the previous 7 years.
Service Record Information Form—Completion of this form helps us either find your current service record or start a record if you are a new denominational employee.
Payroll Direct Deposit (Required) —Authorization for Southwestern Adventist University to deposit your pay directly into your bank account.
Federal form which establishes employee identity and employment authorization.
Employee’s withholding allowance certificate.
403B Retirement Salary Reduction Agreement
North American Division Health Care Assistance Plan (HCAP)
Access to Health Care Assistance Plan forms and policies.
- Health Care Plan Document (2016)
- HealthScope Medical/other Reimbursement Form
- HealthScope Medical/other Reimbursement Form (Alternative method)
- Express Scripts Reimbursement Form
In-between, Short-term Medical/Individual Health Coverage—non HCAP covered employees.
With access to healthcare coverage available through the Federal Healthcare Exchange, short term and individual medical plans are no longer being offered through Adventist Risk Management. Please click on the link below for additional information and instructions on how to enroll.
International Personal Medical Coverage while Traveling (Not for University group travel)
Adventist Risk Management, along with IMG's (Medical Insurance without Boundaries), offers, for purchase, a full-service approach, providing international medical insurance products—includes servicing vacationers, those working or living abroad for short or extended periods, people traveling frequently between countries, and those who maintain multiple countries of residence. To meet all of these needs, IMG developed a comprehensive range of major medical, life, dental and disability products that can be tailored to meet your needs.
Short Term Travel
Mission Trips or other travel on an approved activity of the University or church, and/or a denominational employee (or retiree) on a business trip or vacation, this coverage is for you. Search the website Travel Hub for your type of needed coverage.