Benefits & Leave Forms

Lincoln Financial

• Lincoln Financial Disability Evidence of Insurability Form
• Lincoln Financial Disability Claim Form
• Lincoln Financial Disability Enrollment Form

The Standard

• The Standard Enrollment/Change Form
• The Standard Medical Statement Form
• The Standard Disability Claim Packet

MetLife

• MetLife Dental Domestic Partner Enrollment Form
• MetLife Dental Affidavit of Domestic Partner

• FSA Claims Information

Mandatory and supplemental retirement elections are managed electronically through ConnectCarolina. To enroll, terminate or submit changes to your mandatory and/or supplemental retirement plans:

1. Log in to ConnectCarolina
2. Choose Self Service from the drop-down menu at the top
3. Choose the My Benefits tile
4. Choose Benefits Enrollment on the left
5. Select Mandatory Retirement Plan OR Supplemental Retirement Plans

If you want to retire from TSERS or the ORP, please send an email to benefits@unc.edu indicating your name and PID. You can request that a Benefits Consultant reach out to you.

Please see the Leave Forms section below for additional information and training resources.

Resources

Employee Training | To assist employees with navigating the new process for submitting leave attachments online, an Employee User Guide and training video have been created to demonstrate how to submit and view leave attachments in ConnectCarolina.

• Leave Attachment – Employee User Guide
• Employee Training Video: Leave Attachment – Employee User Guide CH

HR Rep Training | To assist HR Reps with navigating the new process for submitting employee leave attachments online, an HR Rep User Guide and training video have been created to demonstrate how to submit leave attachments in ConnectCarolina on an employee’s behalf.

• Leave Attachment – HR Rep User Guide
• HR Rep Training Video: Leave Attachment – HR Rep User Guide

Please feel free to reach out to your assigned HR Leave Consultant with any questions or for additional assistance.
 

Leave Forms

Below are links to the leave forms with the type of attachment that should be used to submit the form in ConnectCarolina by going to SelfService > My Benefits > Leave > Submit a Leave Document.

Note: Employees can use ConnectCarolina to submit types of leave attachments other than the ones listed below (for example, birth or adoption documentation). For a comprehensive list of leave document attachment types, please review the “File Attachment Description” section of user guides linked above.

There may be times that you have to obtain forms directly from the benefit plan vendor. Here are links to certain vendor websites:

• NCFlex Benefit Plan Forms
• Teachers’ and State Employees’ Retirement System Forms
• State Health Plan of North Carolina