Benefits

Insurance and Claim Forms:

Affidavits for Domestic Partners

Dental Claim _^(Aetna)

COVID Test Pharmacy Benefit Claim Form

Health Savings Account (HSA) Payroll Deduction Form

Injury/Incident Report

Life Insurance Beneficiary Designation

Medical Flexible Spending Account Claim Form

Dependent Care Claim Form

Medical Claim _^(Aetna)

Vision Claim _^(Aetna)

Non-Insurance Related Benefits:

Computer Purchase Agreement

Education Assistance

Leave of Absence Request

Privacy of Medical Information:

Authorization to Release _^(Aetna)

HIPAA Privacy Notice

Additional Forms:

Enrollment Change & Flexible Spending Account Forms

Employment

Recruitment:

• Request to Fill a Position
• Position Description – Create or edit a position description in the PageUp library

Hiring:

• Staff Hiring Form – used to communicate the need to onboard a staff member – this means anyone that is not currently on the staff payroll
• related – Staff Hiring Form User Guide
• related – Personnel Action Due Date Calendar 2025 | 2026
• related – Employee Onboarding Guide

Changes to Current Staff:

• Current Staff Action Form – used to communicate updates to currently employed individuals
• related – Current Staff Action Form User Guide
• related – Personnel Action Due Date Calendar 2025 | 2026
• related – List of Labor Orgs (by department)

Ending Employment:

• End of Employment Notification – used to communicate when an individual will no longer be employed by Bates
• related – End of Employment Nofitication User Guide

For Employees:

• Employee Name and Campus Address Change Form – Employees only – students contact records@bates.edu for changes
• Remote Work Agreement (Updated July 2022)

Payroll

Biweekly – Staff Time Sheet

Biweekly – Student Time Sheet

Monthly – Staff Time Sheet

Direct Deposit Information

W-4 Form – Federal Income Tax Withholding

W-4 Form – State of Maine Income Tax Withholding