Health Care 

Universal Enrollment Form (Enrollments/changes for Highmark, enrollment only for GHP)

GHP Change Form (All changes to current GHP coverage)

GHP Dependent Certification Form 

Dental 

UCCI Enrollment Form 

Dependent Certification Form 

Life Insurance 

Life Coverage Change Form

Beneficiary/Name Change Request

Flexible Spending Account 

Claim Form 

Direct Deposit Change Form 

VBA Program

Enrollment Form

Request a Benefit Form

Retirement Program 

Administrative & Faculty Salary Reduction Form 

Support Staff Salary Reduction Form 

Casual Salary Reduction Form 

Tuition Benefit 

Tuition Remission Form (tuition at Bucknell)

Tuition Exchange/Grant Form (dependent children only)

Informal Tuition At Susquehanna University Form (faculty and staff only)

Health Advocate 

HIPAA Authorization Form 

Spousal Equivalents 

Spousal Equivalent Packet 

Relocation

Moving Expense Reimbursement form

Moving Expense Guidelines