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MaPS Forms

Submitted by ipthomps on Tue, 09/11/2012 - 1:59pm

Submitted by 21232f297a57a5a... on Tue, 07/01/2014 - 1:10pm

Note: Electronic forms must be saved to your desktop prior to editing and then sent to the designated area.

Employee Forms

Agreements

Form Description
Employee Confidentiality Agreement An agreement to uphold confidentiality of HR data for any employee whom accesses HR records as a function of the duties of their job. The agreement should be signed by anyone with access to confidential HR data and information.

Benefits & Pensions

Form Description
Alberta Blue Cross

Health Services Claim
Health Spending Account Claim
Travel Claim

Health & Dental Benefits Changes – please submit to Human Resources for processing

Links directly to the Alberta Blue Cross website. Staff can print the most commonly used claim forms for reimbursement of health and dental care expenses.

Alberta Health Care Insurance

AHC0102 – Application for Alberta Health Care Insurance Plan Coverage

AHC0199 – Employee Group Commencement and Termination for Alberta Health Care Insurance Coverage

Links directly to the Alberta Health and Wellness website where staff can access information as well as forms to apply for Alberta Health Care, add and/or delete dependents, register a change of address etc.

MaPS Basic and Voluntary Accidental Death and Dismemberment (AD&D) - Beneficiary Designation

MaPS Basic and Optional Group Life Insurance - Beneficiary Designation

UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form

To be filled out by Management and Professional Staff

All Sections of these forms should be completed as it will replace any prior designations.

NOTE: If you have Voluntary Employee AD&D coverage or Optional Employee Life Insurance and leave Section 3 of the forms blank, the beneficiary will be your Estate.

Voluntary Critical Illness Form  For more information on this program CLICK HERE
Wellness Spending Account Claim Form All Wellness Spending Account claims are made using this form. The claim form outlines allowable expenses as well as any exclusions.

Leaves/ Time Off

Form Description
Time Off Request Form This form is completed by the staff member for all paid or unpaid leaves including: vacation, maternity, parental,adoption, unpaid leave of absence and apprenticeship leave.

Personal Information

Form Description

Payroll Deadline Calendar and Tax Forms

Direct Deposit Information JobAid Your direct deposit information is now available through Employee Self Service. The job aid found here will take you step-by-step through the process. Log-in to the MY U OF C portal, then go to My Records - Employment Records - Employee Self Service, and follow the job aid instructions from there.

Performance Management (Goal Setting)

Form Description
Goal Setting Template Used by MaPS employees to assist in setting goals in preparation for performance related discussions. For more information please visit the Performance Management Website.

Tuition Support

Form Description

Academic Courses

Tuition Support Program Registration for Academic Courses

Continuing Education Courses

Tuition Support Program Registration for Continuing Education Courses

Forms used when a staff member or eligible dependent is registering in academic and/or Cont Ed courses offered through the University of Calgary programs.

The Academic Tuition Support form will not be available after the fee deadline.

Submitted by 21232f297a57a5a... on Thu, 06/26/2014 - 5:12pm

Administrator Forms

Recruitment and Onboarding

Form Description
Recruitment
Job Profile A description of a position’s tasks, duties and responsibilities. Specific details of the purpose of the position; the accountabilities for which the incumbent will be held responsible. Should describe how the position will demonstrate stated characteristics/accountabilities. (i.e “leadership” is defined and supported by actual duties related to this job).
Position Control Form Used to request a new position, modify existing position or inactivate a position.
Reference Check Form - Template This form provides you with a standardized reference checking format and a formal reference tracking tool.
Eligibility For Removal Allowance - MaPS Staff Use this form when you are relocating a new MaPS employee.
General Associate, Associate Limited Access Relationships A General Associate or an Associate - Limited Access is a person who is not part of the workforce but who is still of interest to the organization (e.g. Consultants, Volunteers).
Onboarding
Onboarding Checklist - New Hire Provides a comprehensive list of the steps involved in facilitating the new employee orientation and mainstreaming process.

Onboarding Checklist - Hiring Manager/Onboarding Coordinator

Provides a comprehensive onboarding list of the steps for the Hiring Manager and the Onboarding Coordinator.
Employee Confidentiality Agreement An agreement to uphold confidentiality of HR data for any employee whom accesses HR records as a function of the duties of their job. The agreement should be signed by anyone with access to confidential HR data and information.

Revenue Canada

R105 – Application for Exemption from Income Tax and CPP for Non-Residents
TD1(E) – Personal Tax Credits Return
TD1 (AB) – Personal Tax Credits Return - Alberta
TD4 – Declaration of Exemption - Employment at a Special Work Site

Compensation

Form Description
Acting Incumbency Used when an AUPE staff member performs the majority of the responsibilities of a more senior position for one day or more, they are entitled to a 5 per cent premium, as per Article 26. Acting incumbency payments for Support Staff are administered on the employees time sheet.

Visit the Finance Services Payroll site to access other forms related to compensation.

Performance Management for Support Staff Direct Reports

Form Description
Support Staff:
Mid-Probation Review Used to review the overall performance of a staff member at the mid-point of their probationary period. The mid-probationary review and job profile will assist with the probation discussion, to note any changes or improvements that have occurred or are necessary.
Probation Review Used to review the overall performance of a staff member prior to the completion of their probationary period. The probationary review and job profile will assist with the probation discussion, to note any changes or improvements that have occurred or are necessary.
Mid-Year Review Used to guide an informal discussion; providing an opportunity for feedback and revisit goals and learning & development plans to identify progression and support initiatives.
Annual Review Used to review the overall performance, related to accountabilities and core competencies of a staff member on an annual basis. Manager and staff member discuss; accomplishments/developmental activities, situational factors, setting of goals and learning & development plan.

MaPS Performance Reviews are conducted within the PeopleSoft Performance Management system. For more information on this process, visit this page and select "performance management"

Termination and Retirement

Form Description
FOIP Reference Sign Off FOIP Reference Sign Off – Used to consent the release of information such as attendance, performance or salary history in a written or verbal reference.

Manual Timesheets

Manual time sheets should only be used by departmental timekeepers or employees/managers who need to submit time that is more than two pay periods old. All employees should enter time via Employee Self Service in the same time period in which the work was completed. Manual times heets are only used when Self Service time entry is not an option.

Visit the Finance Services Payroll site to access the manual time sheets.

Life Events

Submitted by 21232f297a57a5a... on Wed, 06/25/2014 - 4:24pm

List of relevant forms:

Please click on the Life Event or required change below for further information. Send completed form(s) to Human Resources for processing (4th Floor, MacKimmie tower). Alberta Health & Wellness Notice of Change forms must be sent directly to Alberta Health & Wellness.

Addition / Deletion of Dependent

Eligible dependents include unmarried, unemployed dependent children under the age of 21 or; if over the age of 21 but less than age 25, they must be attending an accredited educational institution, college or university on a full-time basis. Children of a common-law spouse may be covered if they are living with you.

Benefit Eligibility What do I do
Alberta Health Care Within 31 days of event Complete Notice of Change Form. It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.
Extended Health and Dental Within 31 days of event Complete Benefit Change Form to add or delete a child.

* If change is not received by Human Resources within 31 days of event, then the change will be processed the first of the following pay period in which the change was received.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Over-Age Dependent Declaration

Unmarried dependent child between the ages of 21 and 25 in full-time attendance at an accredited educational institution, college or university.

Benefit Eligibility What do I do
Alberta Health Care When child turns 21 year of age and/or prior to September 1 each year Complete Notice of Change Form (only if student is not covered by you).

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental When child turns 21 year of age prior to September 1 each year Complete Overage Dependent Declaration Form and forward to Human Resources (4th floor, MacKimmie Tower).
Optional Child Life Insurance (Over-age Dependent) When disabled child turns 21 year of age evidence of insurability is required to continue coverage under the plan. Contact totalrewards@ucalgary.ca to obtain Application for Over-Age Disabled Dependent Coverage form.

Cost of medical examination is the responsibility of the employee.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Marriage

Within 31 days of your date of marriage, please complete a Benefit Change Form. Completion of the form will facilitate the change of your name (if applicable), addition of your spouse to your Health and Dental plans, as well as designate your spouse as beneficiary for your Life Insurance, Accidental Death & Dismemberment and Pension plans.

NOTE: If the Benefits Change Form is received after the 31 day grace period, your spouse will be added to your Health and Dental Plans the first of the following pay period in which the forms are received.

Benefit Eligibility What do I do
Alberta Health Care Within 31 days of date of marriage Complete Alberta Health and Wellness Notice of Change Form.

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental Within 31 days of date of marriage Complete Benefit Change Form to have your spouse added your health & dental plans.
Life Insurance Within 31 days of date of marriage Complete Benefit Change Form to have your spouse named as beneficiary for both your Basic and Optional Life Insurance.
Accidental Death & Dismemberment Within 31 days of date of marriage Complete Benefit Change Form to have your spouse named as beneficiary for both your Basic and Optional AD & D.
Pension Plan Within 31 days of date of marriage Complete UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form.
Name Change Within 31 days of date of marriage Complete Benefit Change Form to change your name.
Change of Address Within 31 days of date of marriage Complete Benefit Change Form to change your address.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Domestic Partnership

For your Domestic Partner to be eligible for addition to your Health and Dental plans you must have cohabited continuously for a minimum of 12 months. Completion of the Benefit Change Form will facilitate the addition of your Domestic Partner to your Health and Dental plans as well as provide you the opportunity to designate your Domestic Partner as beneficiary for your Life Insurance and Pension plans. Both you and your partner will be required to complete a Domestic Partner Declaration.

NOTE: If the Benefit Change Form is received after the 31 day grace period, your spouse will be added to your Health and Dental Plans the first day of the following pay period in which the forms are received.

Benefit Eligibility What do I do
Alberta Health Care First of the month following 3 years of cohabitation Complete Alberta Health and Wellness Notice of Change Form.

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental 1 year from date of cohabitation Complete Benefit Change Form to have your partner added to your health and dental plans.
Life Insurance At staff member’s discretion Complete Benefit Change Form to have your partner named as beneficiary for both your Basic and Optional Life Insurance plans.
Accidental Death & Dismemberment At staff member’s discretion Complete Benefit Change Form to have your partner named as beneficiary for both your Basic and Optional AD&D.
Pension Plan Following 3 years cohabitation Complete UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form.
Change of Address If required Complete Benefit Change Form to change your address.
Establishing the Partnership Mandatory Complete Domestic Partner Declaration Form. Forward to Human Resources (4th floor, MacKimmie Tower).

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Separation

At time of separation you may choose to remove your partner from your Health and Dental plans as well a re-designate your beneficiary for your Life Insurance plan. Your spouse can not be removed as beneficiary of your pension plan until your divorce is finalized.

Benefit When What do I do
Alberta Health Care At plan holder’s discretion Complete Alberta Health & Wellness Notice of Change Form.

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental At staff member’s discretion Complete Benefit Change Form to delete spouse from health and dental plans.

There is no requirement to remove your spouse from the plans during the period of separation. Only at time of divorce must the ex-spouse be removed.

Life Insurance At staff member’s discretion Complete Benefit Change Form to re-designate your beneficiary for both your Basic and Optional Life Insurance.
Accidental Death & Dismemberment At staff member’s discretion Complete Benefit Change Form to re-designate your beneficiary for both your Basic and Optional AD&D.
Pension Plan During separation or up to date of divorce Your spouse remains your beneficiary until your divorce is final.

A Matrimonial Property Order (MPO) or Consent Order is required by the plan administrator to split pension benefits upon marital breakdown. A draft order should be provided to Buck Consultants for review to ensure it complies with pension legislation and plan regulations. You, your spouse and legal representatives should contact Buck Consultants at: 1-866-709-2092 (toll-free).

Change of Address As required Complete Benefit Change Form to change your address.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Divorce

Once your divorce is finalized, your former spouse is no longer eligible for coverage under the University of Calgary’s Extended Health and Dental or any Optional Spouse Insurance (LIfe, AD&D, CI).

Benefit When What do I do
Alberta Health Care Once divorce is finalized Complete Alberta Health and Wellness Notice of Change Form.

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental Once divorce is finalized Complete the Benefit Change Form to have former spouse removed from your Health and Dental plans.
Life Insurance At staff member’s discretion Complete Benefit Change Form to have your former spouse removed as beneficiary for both your Basic and Optional Life Insurance (provided there is no requirement for them to remain a beneficiary).
Accidental Death & Dismemberment At staff member’s discretion Complete Benefit Change Form to have your former spouse removed as beneficiary for both your Basic and Optional AD&D (provided there is no requirement for them to remain a beneficiary).
Pension Plan After divorce is finalized Complete UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form and provide a certified true copy of the front page of your Divorce Decree.

Ensure that the final Matrimonial Property Order or Consent Order, signed by the Court is sent to Buck Consultants at:

155 Wellington Street West
Suite 3000
Toronto, Ontario M5V 3H1
1-866-709-2092 (toll free)

Name Change As required Complete the Benefit Change Form to change your name.
Change of Address As required Complete the Benefit Change Form to change your address.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Change of Beneficiary

You must complete a Benefit Change Form to change the named beneficiary for your Basic and/or Optional Life Insurance, and Accidental Death and Dismemberment Plans.

Complete a UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form to make changes to a named beneficiary for the Universities Academic Pension Plan.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Death of Eligible Dependent and/or Beneficiary

We all face losses throughout our life. When the loss is the death of someone close to us, the grieving process can affect both our home and work life. The Staff Wellness Centre offers information and resources to help employees and their families during the time of a loss. For information and support please contact: Staff Wellness Centre.

Benefit When What do I do
Alberta Health Care At earliest convenience Complete Alberta Health and Wellness Notice of Change Form.

It is the staff member’s responsibility to send the completed form directly to Alberta Health and Wellness.

Extended Health and Dental At earliest convenience Complete Benefit Change Form.
Life Insurance or Optional Life At earliest convenience Complete Benefit Change Form.
Accidental Death & Dismemberment or Voluntary  Accidental Death & Dismemberment At earliest convenience Complete Benefit Change Form.
Pension Plan (UAPP) At earliest convenience Complete a UAPP Declaration of Spouse and Designation of Non-Spouse Beneficiary Form for death of either a spouse or alternate beneficiary.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Approaching Age 65

This section provides staff with information about what happens to your benefits when you turn age 65.

Staff members age 65 and older, who continue to work in an eligible employment category, continue to participate in the University’s group benefit plans, except for Long term Disability.

Coverage continues for Extended Health and Dental, Flexible Spending Account, Group Life Insurance and Accidental Death & Dismemberment for you and your eligible dependents. Please review the following, which outlines benefit changes and other important information.

Benefit Plan Changes
Alberta Health and Wellness Alberta Health and Wellness will contact you 6 months prior to your 65th birthday regarding application for Alberta Blue Cross Senior’s Benefits.
Extended Health and Dental The Provincial Alberta Blue Cross Senior’s Plan (ABC) will become first payer when having prescriptions filled. You will be required to present both the ABC Senior’s card and ABC University group ID card when you or your eligible family members access services from the pharmacy and/or dentist.
Canada Pension Plan (CPP) You have the option of applying for benefits to commence any time after age 60. Applications for CPP should be made 6 months prior to the date of commencement. For more information and application forms, refer to the CPP website http://www.servicecanada.gc.ca/eng/services/pensions/cpp/retirement/index.shtml.

If you elect to commence receipt of CPP benefits, it is important that you provide the Payroll Office with a copy of the confirmation letter received from the Canada Pension Plan.

If you continue working while receiving CPP pension:

  • age 60 to 65: CPP contributions are mandatory and additional CPP pension accrues
  • age 65 to 70: CPP contributions continue and additional CPP pension accrues unless file a form with the Canada Revenue Agency (provide a copy to the University's Payroll Services) found on CPP website http://www.servicecanada.gc.ca/eng/services/pensions/cpp/prb/index.shtml
  • Over age 70: CPP contributions stop and no additional CPP pension accrues
Old Age Security (OAS) You are entitled to receive Old Age Security in addition to CPP at age 65 regardless of whether or not employment continues. OAS can be delayed for up to 5 years in exchange for an increased amount. For information and application forms, refer to the OAS website http://www.servicecanada.gc.ca/eng/services/pensions/oas/pension/index.shtml.
Optional Life Insurance Coverage ceases when the staff member or spouse, as applicable, reaches age 75 or retirement, whichever is earlier.
Long Term Disability Insurance Coverage ceases six months prior to the staff member’s 65th birthday.
Pension Plan You are not required to retire at age 65. However, when you have elected a retirement date you should submit a letter of resignation to your supervisor. Written notification of your election to retire should be provided approximately 4 months prior to an elected retirement date.

For more information regarding retirement: Management & Professional Staff Retirement Booklet.

For more information on Life Events, or the completion of any of these forms, contact the Integrated Service Centre at 220-5932.

Pension Estimates/Retirement

Staff considering retirement can obtain pension estimates by accessing the retirement planner available on the UAPP website at www.uapp.ca. The following summary shows how to access the UAPP retirement planner: How to Access UAPP Statements and Retirement Planner.

Staff who are also entitled to benefits from the Public Service Pension Plan through Combined Pensionable Service, can obtain pension estimates from Alberta Pensions Services. Contact information is available at www.pspp.ca.

Staff members are eligible to retire with an immediate pension from the Universities Academic Pension Plan if they are over 55 and have accumulated 2 or more years of pensionable service. Written notification to the direct manager must be provided 4 months prior to the chosen retirement date. A retirement options package will be mailed approximately 1 to 2 months prior to the elected retirement date. More information regarding preparing for retirement and retirement process:

Staff who are also entitled to benefits from the Public Service Pension Plan through Combined Pensionable Service, will be provided with an application form for that plan approximately 2 to 3 months prior to the elected retirement date.

At retirement, group benefit coverage ceases. However, there are a number of benefits and privileges available to retired staff. Further details can be found on the following link: Management & Professional Staff Retirement Booklet.

For more information contact the Integrated Service Centre at 220-5932.

Benefits and Pension at Termination of Employment

Benefit Coverage Ceases/Additional Information
Extended Health and Dental On date of termination. Any claim incurred up to the date of termination should be submitted to ABC as soon as possible and no later than 90 days from the date of termination.

Alberta Blue Cross offers individual health and dental coverage. For more information contact
Alberta Blue Cross.

Life Insurance - Basic and Optional Life Insurance – Conversion Privilege

Your University of Calgary group coverage through Manulife ceases on your termination or retirement date.  Within 31 days of termination of the University group coverage, a Conversion Privilege (for both Basic and Optional coverage) is available to convert an individual policy without medical evidence of insurability.  Please contact Manulife Financial at 1-888-626-8543 directly for any questions regarding the available conversion options or on how to apply for the conversion. 

If you die during the conversion period, Manulife will pay the maximum amount that you were eligible to convert as a death benefit to your beneficiary.

The Life Insurance rates are provided on the application form unless you are over 65 in which case please contact Manulife.

In order to apply for the Conversion Privilege, please complete sections 2 and 3 of the Manulife Group Insurance - Application for Conversion and send your completed form to:

Human Resources
Attn: Benefits
MacKimmie Tower, 4th Floor

The Benefits team will complete section 1 and return the form to the employee via Canada Post to the employee's current home address on file. Please ensure your mailing address is up to date and accurate.

Child Optional Life Insurance On date of termination.
Accidental Death & Dismemberment Accidental Death and Dismemberment (AD&D) – Conversion Privilege

Group coverage ceases on date of termination or retirement. Within 31 days of termination of the University’s group coverage a conversion privilege (for both Basic and Optional coverage) is available, provided you are under age 70.  Please contact SSQ Financial Group directly for any questions regarding the application for the conversion.

In order to apply for the Conversion Privilege, please complete Part II of the Group Accident Insurance Conversion Notice and send completed form to:

Human Resources
Attn: Benefits
MacKimmie Library Tower, 4th Floor

The Benefits team will complete Part I and return the form to the employee via Canada Post to the employee's current home address on file. Please ensure your mailing address is up to date and accurate.

Long Term Disability Ceases on termination or retirement date, or 6 months prior to your 65th birthday, whichever comes first.
Universities Academic Pension Plan (UAPP) Purchase of eligible previous or leave service would need to be completed within 30 days of termination. Contact an HR Pension Advisor immediately at (403)220-5461 for information and related deadlines. Purchase of eligible service immediately prior to termination will delay production of termination options package(s).

Within 6 to 8 weeks after the last day of employment, Buck Consultants will provide an options package directly to the member. Please ensure your current address is provided on PeopleSoft.”

Flexible Spending Account On the date of termination.

Claims for eligible expenses must be submitted to Alberta Blue Cross within 90 days of termination. Receipts must be dated prior to date of termination.

For more information contact the Integrated Service Centre at 220-5932.