UDM Logo

Additional Benefits Forms

For more specific information and questions pertaining to your individual situation, you can email us at HR@udmercy.edu.  Someone will always be happy to assist you with all your questions and/or concerns.Health_Care_Credit_2011-12_revised.pdfHealth Care Credit 2011-12 MemoHealth Care Credit 2011-12 Memo/www.udmercy.edu/hr/benefits/forms/pdf/Health_Care_Credit_2011-12_revised.pdf35963HCC_Waiver_Form.pdfHealth Care Credit Waiver FormHealth Care Credit Waiver Form/www.udmercy.edu/hr/benefits/forms/pdf/HCC_Waiver_Form.pdf68538Hap Senior Plus Enrollment Form.pdfHAP Senior Plus Enrollment FormHAP Senior Plus Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/Hap Senior Plus Enrollment Form.pdf199082AETNA CHANGE FORM.PDFAETNA Change FormAETNA Change Form/www.udmercy.edu/hr/benefits/forms/pdf/AETNA CHANGE FORM.PDF167068aetna_rx.pdfAETNA Medicare Rx Plan Enrollment FormAETNA Medicare Rx Plan Enrollment Form/www.udmercy.edu/hr/benefits/forms/pdf/aetna_rx.pdf160592UDM_LobgTermDisability.pdfUDM Long Term Care Insurance Program InstructionsUDM Long Term Care Insurance Program Instructions/www.udmercy.edu/hr/benefits/forms/pdf/UDM_LobgTermDisability.pdf3641299/www.udmercy.edu/hr/benefits/forms/pdf/formsforms