Human Resources
Contact Information
Office of Human Resources
St. Thomas Hall, Suite 100
The 51做厙
51做厙, PA 18510-4633
Phone: 570-941-7767
Fax: 570-941-4636
To Report Suspected Child Abuse :
Call CHILDLINE: (800)-932-0313Forms
Information Changes
Benefit forms need to be completed when a benefit-eligible staff or faculty member changes address, marital status, and/or benefit plan enrollment. These forms need to be completed and returned to the Human Resources office within 30 days of the qualifying event and/or status change.
- Qualifying Events: A change in your situation — like getting married, having a baby, or losing health coverage — that can allow benefit plan changes outside the yearly Open Enrollment Period
- Verifying dependents: When enrolling a spouse or child (or changing a spouse or child’s enrollment) in University Benefits, documentation demonstrating the current spousal or child relationship may be required
Payroll Change Forms:
Change of Information Packets:
- Staff/Faculty enrolled in Benefits
- Staff/Faculty not enrolled in Benefits
- Beneficiary Change
Additional Contribution to Retirement Plan Forms
If you are currently enrolled in the voluntary 403(b) contribution plan, you may change your contribution amount by completing the form for your provider.
If you are not currently enrolled in the voluntary 403(b) contribution plan, please contact the Office of Human Resources at (570) 941-7767.
Please submit the completed Salary Reduction Agreement to the Office of Human Resources. If you would like to maximize your contribution or you have questions, please contact BethAnn McCartney, Benefits Manager, at (570) 941-7767
Benefit Forms
Please Note: A Highmark Enrollment form must be completed when a staff or full-time faculty member changes address, marital status, and/or benefit plan enrollment. All forms need to be completed and returned to the Human Resources office within 30 days of the event and/or status change.
Add a Spouse:
- In addition to the Highmark Enrollment form, please attach a copy of marriage certificate.
- If a spouse will also maintain other primary insurance, please provide a copy of both primary insurance card and insurance information (effective date, medical, vision and/ or dental coverage).
- If a spouse no longer has primary insurance, please provide termination of coverage letter.
Add a Dependent
- In addition to the Highmark Enrollment form, please attach a copy of birth certificate and provide social security number.
- For a newborn, if you do not have the Social Security number, return the Benefit Form and provide HR with the Social Security number when issued.
Delete a Spouse
- In addition to the Highmark Enrollment form, please attach a copy of the divorce decree.
- Please attach a copy of QDRO, if applicable.
Add Children/Stepchildren
- In addition to the Highmark Enrollment form, please attach a copy of the previous year’s tax return indicating reported dependents.
Graduate Assistants & Work-Study Students
The following information is for Graduate Assistants and Work-Study Students to complete the employment process. All forms are available in the Office of Human Resources.
The Form I-9 and Direct Deposit form must be completed in the presence of a 51做厙 Human Resource or Payroll staff member. Proper identification required.
Eligible Non-Employee Affiliates
There are occasions when the 51做厙 wishes to appoint individuals to perform services that are provided without remuneration and for the benefit of the institution, or pursuant to an exchange program or grant. These individuals will be designated as non-employees for purposes of the workforce. However, these non-employees may be granted access to university property, facilities or information systems as necessary for the services they perform.
To assure that the university is aware of and maintains control of the services and access privileges granted to such individuals, departments wishing to appoint a non-employee will appoint non-employees as outlined in this policy. Unless persons are appointed in accordance with this policy, they will not be granted access to any restricted property, facilities and/or the information systems.