HOME // SEPARATION

Quick Links

Forms

Notice of Final Deposit and Request for Refund Form (TRS6)

Sick Leave Pool Voluntary Contribution Form

Vacation/Leave Deferral Form

UT Police Department Separation Form

Decommissioning Policy

Request for Safety Records

 

 

Separation Process

The following information has been developed to assist faculty and staff as well as department personnel in identifying all applicable steps that should be taken prior to an individual separating from the University of Texas Health Science Center at San Antonio. In addition, you will find resources, links, and points of contact to complete this important process.

 

Mandatory Requirements for Separation

 

Benefits & Payroll Information

Click on any of the links below to view more detailed information about your benefits and final paycheck upon separation from the UT Health Science Center. When you click the link, text will appear on your screen. To suppress the information, click the link again and the text will be hidden from view.

 

COBRA

COBRA is the continuation of group medical, dental, and vision insurance coverage. If you lose eligibility for UT System insurance coverage, the institution will offer you and your covered dependents the option to continue medical, dental, and/or vision insurance without having to submit evidence of good health.

 

Your insurance coverage via UT System will continue through the end of the month in which you separate from the institution. You may only continue the coverage that you and your dependents have at the time you or your dependents lose eligibility.

 

After your insurance coverage terminates, the Office of Human Resources will mail you a COBRA Election Notice, which typically occurs on the fifth business day of the month following your separation date. Please review your address information in Employee Self-Service to ensure it is current.

 

Note: There is a 60-day deadline to submit your completed COBRA Application to continue coverage. Initial payment must be made in full no later than 45 days after the date of your election.

 

Monthly COBRA Premium Rates - Effective September 1, 2014 through August 31, 2015

Life Insurance & Long-Term Disability - Dearborn National

Life Insurance - Dearborn National

You may be eligible to continue your Life Insurance with Dearborn National if you lose UT System insurance coverage. If you are interested in continuation of coverage, you have 31 days from the date you lose coverage to request and complete the Term Life Insurance Forms.

Application for Conversion

If you are enrolled in basic or voluntary term life insurance with Dearborn National, you and your covered dependents may convert the group term life coverage to an individual whole life policy with the insurance company, regardless of your current health. You and your dependents are eligible for conversion even if you retire from the institution.

 

To convert your life insurance, review the following steps:

  • Complete Part 2 of the Application to Convert Group Term Life Insurance and submit to ben-admin@uthscsa.edu within 31 calendar days of the date you lose coverage. The application includes a Premium Calculation Worksheet.
  • The Benefits Department will complete Part 1 of the application and will return the application to you.
  • Upon receipt of the completed application, mail the application and payment directly to Dearborn National.

Application for Portability

If you are enrolled in voluntary term life coverage with Dearborn National, you and your covered dependents may elect to continue term life coverage through portability. You and your dependents must have been insured for at least one year. Portability is not an individual policy and does not have a cash value. Portability rates increase as you age, in five-year increments. This coverage may continue until you or your spouse reach age 65 or your spouse or dependent children no longer meet the definition of a spouse or dependent child. You and your covered dependents are not eligible for portability if you have elected conversion or if you retire from the institution.

  • Complete Part 2 of the Application for Portability and submit the application to ben-admin@uthscsa.edu within 31 calendar days of the date you lose coverage. The application includes a Portability Premium Calculation Worksheet.
  • The Benefits Department will complete Part 1 of the application and return the application to you.
  • Upon receipt of the completed application, mail the application and payment directly to Dearborn National.

More information about Conversion and Portability is available in the Group Term Life Certificate or Dearborn National's website.

 

Long-Term Disability (LTD) - Dearborn National

You may be eligible to continue your LTD with Dearborn National if you lose UT System insurance coverage.If you are interested in continuation of coverage, you have 31 days from the date you lose coverage to request and complete the Long-Term Disability Forms.

 

If you are enrolled in LTD insurance, you may be able to convert the coverage to an individual policy. You are not eligible to continue LTD coverage if you (a) retire from the institution, (b) you have not been insured for at least 12 consecutive months under the policy, or (c) you are disabled under the terms of the policy.

 

To convert your LTD, review the following steps:

  • Send an e-mail to ben-admin@uthscsa.edu within 31 days of the date you lose coverage. The Benefits Department will complete and send you the Employer Questionnaire.
  • Determine your premium using the Conversion Premium Calculator.
  • Review the Conversion Enrollment Kit for details and complete the Conversion Application on the last page of the Enrollment Kit.
  • Upon receipt of the questionnaire from the Benefits Department, mail the questionnaire and the application, along with payment, directly to the address noted on the application.

 

Life Insurance & Long-Term Disability - The Standard

Life Insurance - The Standard Insurance Company

You may be eligible to continue your life insurance with The Standard Insurance Company if you lose UT System's insurance coverage. If you are interested in continuation of coverage, you have 31 days from the date you lose coverage to request and complete the required forms listed below.

Application for Conversion

If you are enrolled in voluntary term life insurance with The Standard, you and your covered dependents may convert the group term life coverage to an individual whole life policy with the insurance company, regardless of your current health. You and your dependents are eligible for conversion even if you retire from the institution.

 

To convert your life insurance, review the following steps:

Application for Portability

If you are enrolled in voluntary term life coverage with The Standard, you and your covered dependents may elect to continue term life and accidental death and dismemberment coverage through portability. You and your dependents must have been insured for at least one year. Portability is not an individual policy and does not have a cash value. Portability rates increase as you age. This coverage may continue until you or your spouse reach age 65 or your spouse or dependent children no longer meet the definition of a spouse or dependent child. You and your covered dependents are not eligible for portability if you have elected conversion or if you retire from the institution.

 

To port your life insurance, review the following steps:

  • Complete the Portability of Insurance Application within 31 days of the date you lose coverage. Please carefully read the instructions on page one of the application. Note, you will need to submit your first payment along with the application.

  • Send the Employer Statement, which is page six of the application, to the Benefits Department at ben-admin@uthscsa.edu. The statement will be completed by Benefits and returned to you via e-mail.
  • Upon receipt of the completed application, mail the application and payment directly to The Standard. Note, a premium calculation worksheet is on page two of the application.

More information about Conversion and Portability is available in The Guide to Converting or Porting Life Insurance.


Long-Term Disability (LTD) – The Standard Insurance Company

You may be eligible to continue your LTD with The Standard Insurance Company by converting your coverage to an individual policy.

You are not eligible to continue LTD coverage if you

(a) retire from the institution,

(b) you have not been insured for at least 12 consecutive months under the policy, or

(c) you are disabled under the terms of the policy. If you are interested in continuation of coverage, you have 31 days from the date you lose coverage to request and complete the LTD Forms.

 

To convert your LTD:

  • Complete the Request for Long Term Disability Conversion Materials Form and mail it to The Standard. They will subsequently send you the required materials and forms via e-mail or U.S. Mail.
  • Upon receipt of the LTD conversion kit, there are two forms included in the kit that should be completed.
    • Employer Questionnaire Form – To be completed by the Benefits Team
    • Employee Conversion Application – To be completed by the Employee
  • Send the Employer Questionnaire Form to the Benefits Department for completion at ben-admin@uthscsa.edu.
  • Upon receipt of the completed Employer Questionnaire Form from the Benefits Department, mail both forms and your payment directly to The Standard Insurance Company.

Long-Term Care

Long-Term Care (LTC) - CNA

If you are enrolled in Long-Term Care insurance, you may continue coverage with CNA through direct home billing. Direct home billing will not change your premium rate. Other covered family members may continue their direct home billing. To avoid cancellation of coverage, please contact CNA directly at 1-888-825-0353 within 60 days of the date you lose coverage.

 

Final Paycheck

Employees paid on a monthly basis will receive their final paycheck on either the 1st or the 10th of the month, depending on separation date.

 

Final checks for employees paid hourly will be processed in the next semi-monthly pay cycle.

 

If you participate in direct deposit, you will receive your final paycheck via that method. Otherwise, your check will be sent to you via U.S. mail. To ensure your check is sent to the correct address, you should review/update your address information using Employee Self Service or by sending an e-mail to hr-admin@uthscsa.edu.

Note: If your final paycheck, upon separation, is not sufficient to cover your monthly benefits deductions, then the full amount of the deductions will be deducted from your lump-sum check containing your leave accruals.

 

If you are not eligible to receive a lump-sum check and still owe for your deductions, it is your responsibility to contact Payroll to remit final payment.

 

For more information, see Vacation and Personal Leave.

 

If you have questions, please contact your department or Payroll Services at pay-admin@uthscsa.edu or 210-562-6315.

Vacation and Personal Leave

If you have been employed for at least six continuous months, you will receive a lump-sum payment for any unused vacation leave balances. You will be paid for any unused personal leave regardless of state service. Lump-sum checks are issued on or around the 20th day of the month following your termination date.

 

Your department is responsible for reporting any leave taken in your final month of employment through the DRS timekeeping system. Leave checks are normally generated on the 20th day of the month after your separation month. If you participate in direct deposit, you will receive your leave balance check via that method. Otherwise, your check will be sent to you via U.S. mail.

 

Note: If you transfer employment to another Texas State agency without a break in service, you will not receive a lump-sum payment for your unused vacation leave balance. Instead, your vacation leave balance will be transferred to your new state agency employer. It is the employee's responsibility to ensure the balance is transferred. You will, however, receive a lump-sum payment for your personal leave balance.

 

You have the option to defer all or a portion of your unused vacation balance into the UT Saver 457(b) Deferred Compensation Plan (DCP). To elect this option, complete the Vacation Leave Deferral Form and submit to the Benefits Department at ben-admin@uthscsa.edu.

The form must be submitted prior to the last day of employment.

 

For more information, click the following link: http://www.utretirement.utsystem.edu/UTSaver457b_defer.htm

Sick Leave & Holiday Time

Any accrued sick leave or holiday time will not be paid upon your separation from UT Health Science Center. Sick leave, however, will be reinstated if you are employed by another state agency within 12 months of your separation provided there is a 30 day break in service.

Sick Leave Pool

The sick leave pool is intended to help current employees in the event of a catastrophic, life-threatening illness or injury that results in all leave balances being exhausted and causes a loss of compensation.

 

Employees who separate from the institution may voluntarily contribute one or more days of their own sick leave hours to the sick leave pool. Contributions to the pool must be in increments of 8 hours. Sick leave hours that are contributed to the sick leave pool may not be restored under any circumstances upon return to employment with our institution or any other state agency.

 

If you wish to contribute hours to the sick leave pool, you will need to complete the Sick Leave Pool Voluntary Contribution Form.

 

For questions about the Sick Leave Pool, please send an e-mail to HR-LeaveAdmin@uthscsa.edu.

Teacher Retirement System (TRS)

Participants in TRS are vested after 5 years of state service and may receive a retirement annuity provided that the TRS retirement criteria have been met.

 

Note: In the event you are retiring from the Health Science Center, you will need to schedule an appointment with a Benefits Advisor to go over your retirement options. Please contact a Benefits Advisor at 210-567-2600.

 

Upon your separation from UT Health Science Center, you may choose from one of the following options regarding your account with TRS:

  1. You may leave your funds with TRS.
  2. You may request a refund of your contributions or transfer funds into another retirement account. A withdrawal will result in a mandatory 20% income tax being withheld. If you are under the age of 59 1/2, an additional 10% early withdrawal penalty may be imposed by the IRS. Deposits will be refunded approximately 60-90 days following your completion of the Notice of Final Deposit and Request for Refund Form (TRS6).
  3. You may elect a direct rollover to another retirement account. No taxes or penalties will be imposed.

If you elect options 2 or 3 above, you are required to complete a Notice of Final Deposit and Request for Refund Form (TRS6) and have it notarized. Forms can be notarized at local banks, post offices, or UPS Stores. Check with your department to determine what Notary Public services are available on campus.

 

After notarizing the form, mail the form directly to Teachers Retirement System at :

Teachers Retirement System

1000 Red River Street

Austin, Texas 78701-2698

For additional information, contact TRS at 800-223-8778 or visit the TRS website at http://www.trs.state.tx.us/.

Optional Retirement Program (ORP)

Upon your separation from UT Health Science Center, you may choose from one of the following options regarding your ORP account:

  1. You may leave your funds with your designated ORP vendor.
  2. You may request a refund of your contributions or transfer funds into another qualified retirement account. If you are vested in the plan, you will have access to both employee and employer contributions. A withdrawal will result in a mandatory 20% income tax being withheld. If you are under the age of 59 1/2, an additional 10% early withdrawal penalty may be imposed by the IRS. Please contact your ORP vendor for details on the timeframe of your refund.
  3. You may elect a direct rollover to another qualified retirement account. No taxes or penalties will be imposed.

If you elect options 2 or 3 above, send an e-mail to the Benefits Department at ben-admin@uthscsa.edu to request a Vesting/Termination Letter. This letter is necessary for you to provide to your designated ORP vendor to be used with transactions relative to your account after separation.

 

The Benefits Department will either e-mail or mail the completed letter to the current e-mail address or U.S. mail address on file after your final paycheck has been issued.

UT Saver Tax Sheltered Annuity Plan (TSA) & UT Saver Deferred Compensation Plan (DCP)

If you are a participant in a TSA or DCP, please contact your designated vendor regarding the continuance or distribution of your account(s) or you can send an e-mail to the Benefits Department at ben-admin@uthscsa.edu to request a Vesting/Termination letter.

 

Contact Information

Office of Human Resources

ben-admin@uthscsa.edu

210-567-2600

 

Office of Payroll Services

pay-admin@uthscsa.edu

210-562-6315