Human Resources: Forms

Human Resources Forms

Separation Checklist
for Employees Leaving the Employment of Syracuse University

Notification: Notify your department as soon as you are aware of your separation. It is recommended that you give two pay periods notification.
Property: Return all University property to your department or facility including all borrowed materials, ID cards, access cards, purchasing cards, Bank of America cards, keys, technical equipment (phones, laptop computers, PDA's, pagers, two-way radios, etc.) and all other University owned property.
Address Change: Confirm/update your home address and phone number on MySlice so that benefit, COBRA, mail, and tax statements are sent to the correct mailing address.
Benefits:
1. Medical, Dental, and Flexible Spending Accounts: According to the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), medical, dental, and flexible spending account benefits are available upon separation. COBRA extends to eligible employees and their enrolled dependents the right to continue plan coverage for a specified period of time at their own expense and at full cost. The COBRA notification will be sent to the home address listed in MySlice within 44 days of your date of separation from the University. The COBRA coverage will be effective the first day you are no longer benefits eligible. You may cancel COBRA at anytime. A few important notes about COBRA:
  1. You can only participate in the plans you were enrolled in on the date of separation from the University.
  2. If COBRA is not elected, medical, dental, and flexible spending account coverage will cease the day of separation. You will have until April 30 of the following year to submit receipts to Excellus Benefit Services for reimbursement from your Flexible Spending Account for expenses that occurred prior to your separation date. Use the online copy of the reimbursement form.
  3. Please note that regardless of your date of separation from the University, the entire benefit premium for that pay period will be deducted from your paycheck. The premium will not be pro-rated and no reimbursement will be granted.
2. Long Term Disability Insurance: You will be mailed paperwork from The Standard pertaining to converting your coverage to an individual policy if you were enrolled in this benefit as an active employee.
3. MetLife Life Insurance:
  1. Non-retirees: You will be mailed paperwork from MetLife pertaining to converting your coverage to an individual policy. For additional information or if you would like to change your beneficiaries, please contact Metlife at 877-275-6387.
  2. Retirees: If you are retiring, you will not have to convert your SU-sponsored insurance policy to an individual policy. Your coverage will remain intact but will be reduced to $3,000. If you would like to change your beneficiaries, please contact the Human Resource department at 315-443-4042.
4. MetLife Auto and Home Insurance: To continue this coverage, contact MetLife at 315- 656-2982.
5. John Hancock Long Term Care Insurance: To continue this coverage, contact John Hancock Insurance at 888-588-7716..
6. TIAA-CREF Retirement Account: All University and voluntary contributions to your TIAA-CREF account will cease as of the date of separation from the University. The account itself remains intact and you can manage it through a TIAA-CREF representative. Call 800-842-2776 or visit the TIAA-CREF website for further information.
Payroll:
1. Timesheets: Submit your final timesheet to the person in your department responsible for Payroll Input.
2. Final paychecks: Your final pay will be automatically deposited if you have electronic deposit. For other arrangements, contact the Payroll department at 315-443-4042 or hrservic@syr.edu.
3. Other paycheck Deductions: For loan payments, child support, etc., contact your financial institution or appropriate source to make payment arrangements.
4. W-2 Forms: To ensure receipt of Form W-2 for income tax purposes, provide Payroll with a current and correct home mailing address. Confirm/update your home address and phone number on MySlice. If the W-2 is not received by January 31, contact the Payroll Office at 315-443-4042 or payroll@syr.edu.
Vacation Pay: Only unused vacation time will be paid in the last paycheck for the balance of vacation hours accrued and not used. Accrued but unused Personal Business, Floating Holidays, and Sick Time will not be paid out.
Parking: Return parking permits, proxy cards, and service passes to the Parking Office on the date of separation from the University.
Outstanding Debts: Any outstanding debts to the University must be paid out upon separation (i.e. Parking, library, other fees)
Retirement: If you are retiring, contact the Human Resources Service Center at 315-443-4042 or hrservic@syr.edu for further information regarding retirement benefits.