Making Benefits Changes
Employees newly hired and/or newly appointed into a position which provides a greater level of benefits eligibility, should use the UC At Your Service website (AYSO) enrollment application to take enrollment actions.
The UPAY 850 Form should only be used when employees have a mid-year “Family Status Change” that results in a qualifying event (marriage, birth, divorce, etc.), an involuntary loss of coverage (ILOC), or when employees receive approval on a Statement of Health Application. They should submit a completed UPAY 850 form to Payroll within the 31 day PIE to initiate a benefit change. This type of change cannot be completed through the AYSO enrollment application.
Employees applying for Disability Insurance or Life Insurance outside of a PIE should follow the Statement of Health Enrollment Instructions.
All UPAY 850s should be sent directly to Payroll, via e-fax 415-920-2512 or email: Payrollbenefits@ucsf.edu. Payroll will process the forms within five business days of receipt.
After submitting a UPAY 850 to Payroll, employees may verify their enrollment status by logging into AYSO and selecting, “Current Enrollments” from the Health & Welfare menu.
Employees who need to access services fairly soon after making a change, should follow the steps to expediting eligibility, once they can see the change under "Current Enrollments" on AYSO
Employees with questions or employees who would like a consultation regarding benefit changes should contact the HR Specialty Center Benefits Office hotline at 415-476-1400 or firstname.lastname@example.org.