Human Resources
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Contact Information
Office of Human Resources
St. Thomas Hall, Suite 100
The University of Scranton
Scranton, PA 18510-4633
Phone: 570-941-7767
Fax: 570-941-4636
To Report Suspected Child Abuse :
Call CHILDLINE: (800)-932-0313Forms to Process 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
Required Form for all changes:
- Human Resources Information Change Form (required for all address changes)
- Residency Certification Form (required for all address changes)
- Health Plan Forms
- Highmark BlueCross Health Plan Enrollment/Change Form
- United Concordia Enrollment/Change Form
- Premium Conversion Plan Document
- (This form authorizes The University of Scranton on how to deduct, pre or post-tax, your portion of the premium from your pay.)
- Retirement Forms (complete the form for your retirement plan)
- Transamerica Information Change Form or
- TIAA-CREF Address Change Form (if applicable)
Optional Forms, dependent upon the change:
- Federal Withholding Form W-4 (only if you are changing your status and exemptions)
- Cigna Life Insurance (ONLY if changing beneficiary)
- Life Insurance Beneficiary Form
- Cigna Voluntary Life Insurance Beneficiary Form (ONLY if purchasing additional life insurance coverage)
- Retirement Forms (complete the form for your retirement plan)
- Additional Benefits (only complete if currently enrolled)
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