This form is to be used only by separating or retiring employees electing to defer all or a portion of their vacation and/or sick payout.
Requests for establishment of a new 403(b), changes in payroll deduction amounts or changes in vendors are handled through Fidelity Netbenefits.
By completing this online form, Payroll Operations will be advised of your 403(b) deferral election. The completion of this form WILL NOT result in the establishment of a 403(b) account with your chosen provider.
If you complete this form and have not established a 403(b) account as of the date your deferral is processed, your deferral will be directed to Fidelity Investments and invested in the Fidelity default investment fund.
If you have a 403(b) with an approved vendor (Fidelity, AXA-Equitable, TIAA or Voya only):
Complete and submit this Salary Reduction Agreement form no later than the first of the month in which your payout will be processed. If the form is not submitted in a timely manner, your deferral will not be processed and cannot be resubmitted.
If you DO NOT have a 403(b) established with an approved vendor and this will be YOUR FIRST deferral:
The university has four 403(b) providers available to you. Visit Bearcats Landing for a list of approved providers along with contact information. In order to establish an account, you must access Fidelity Netbenefits and select your 403(b) vendor.
Your account must be established and this form submitted no later than the first of the month in which your payout contribution will occur. If you complete this form and have not established an account via the Netbenefits site, your deferral will be directed to Fidelity Investments and invested in the Fidelity default investment fund.
This form cannot be used to enroll in or make changes to the Ohio Public Employees Deferred Compensation plan. Please contact Ohio Public Employees Deferred Compensation directly at 1 (877) 644-6457.
This form cannot be used to make a change to your Alternative Retirement Plan vendor election.
This is an online form; completing and submitting it will result in the requested change provided all other requirements are met.
By typing in your name in the Employee Signature field, you are authorizing a change in our records. If you wish to retain a copy of the completed form, please print a copy BEFORE submitting it. Please email benefits@uc.edu if you have questions.
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