Benefits Forms
Most forms here are in PDF format. To get a current copy of the Adobe Acrobat Reader, for any platform, go to the Reader home page.
Please, contact Human Resources if you encounter any access barriers, challenges or require the content in another format to fully access the information at hrs@boisestate.edu or (208) 426-1616.
Forms
- Beneficiary Form – Basic Life
- Beneficiary Designation Form for Minors
- Beneficiary & Voluntary Term Life Enrollment
- WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
- Certification of Health Care Provider for Family Member’s Serious Health Condition
- Health and Wellness Release Time
- Health Insurance Enrollment Form – Blue Cross
- Idaho Health Savings Account (HSA) Enrollment Form – Navia
- Idaho Flexible Savings Account (FSA) Enrollment Form – Navia
- Idaho Flexible Spending Claim Form – Navia
- PERSI: Beneficiary Designation (RS – 115)
- PERSI: Request for Base Plan Account Withdrawal (RS – 108)
- Premium Only Plan Election Form
- Optional Retirement Plan Selection Form
- Shared Leave Donation
- Shared Leave Request Form
- Supplemental Retirement Account (SRA) Authorization Form (PDF)
- VSP Out-of-Network claim form
- WH-381 Notice of Eligibility and Rights & Responsibilities