Current Employees

• Benefits
• Benefits Forms
  • Access-A-Ride Enrollment Form
  • Transit Benefits Enrollment Form
  • Transit Benefit Park-N-Ride Enrollment Form
• Benefits Orientation – CET (LAGCC)
• Benefits Orientation – Full-Time Civil Service (LAGCC)
• Benefits Orientation – Classified Hourly & College Assistant (LAGCC)
• Benefits Orientation – Instructional Staff (LAGCC)

Health Care
Health Maintenance Organization (HMO) Providers

As of January 1, 2024, the Empire BlueCross BlueShield and Empire BlueCross names are Anthem Blue Cross and Blue Shield and Anthem Blue Cross.

POS, EPO, PPO Providers
Point Of Service (POS), Exclusive Provider Organizations (EPO) & Participating Provider Organizations (PPO) Indemnity Plans

• COBRA Continuation Enrollment – Welfare Fund Full-Time
• COBRA form, Notice of Rights and Rates
• College Assistants Health Insurance Benefits Informational Sheet (LAGCC)
• Flexible Spending Accounts
• Health Benefits Application (LAGCC)
• Health and PSC Change of Status (LAGCC)
• Office of Labor Relations (OLR) NYC Health Benefits Program
• Young Adult Option Through Age 29 (NYS Law chapter 240)

Pension Plans

Request

• Change of Name and/or Address (LAGCC)
• CUNYfirst Self-Service Address Change (LAGCC)
• CUNYfirst Self-Service Name Change (LAGCC)
• Employee Request For Reasonable Accommodation Form
• Employee Verification Request Form (LAGCC)
• Executive Council Authorization For Position Form (LAGCC)
• Gender Change Request Form (LAGCC)
• POI Position Request Information Sheet (LAGCC)
• PRC Request Form (LAGCC)
• Preferred Name Request Form (LAGCC)
• Promotion Request Form – Adjunct Associate Professor and Adjunct Professor (LAGCC)
• Recommendation for Appointment (LAGCC)
• Reports Request Form (LAGCC)
• Request for Placement on Transfer Roster
• Tuition Waiver Request

Tax Forms

• CUNY TDA/403B Salary Reduction Agreement
• CUNY Universal Availability Notice
• Non-US Person Tax Compliance Notification Sheet
• Residency Status for Tax Purpose Data Request Form (LAGCC)

Work Forms

• Adjunct Workload Form
• Annual Performance Evaluation Classroom Instructional Staff (LAGCC)
• Application for Multiple Position for Non-Teaching Instructional Staff
• Civil Service Evaluation Form – (Dynamic Form) (LAGCC)
• Classified Managerial – Performance Accountability Assessment – (Dynamic Form) (LAGCC)
• College Laboratory Technology Performance Evaluation Form (CLT) (LAGCC)
• CUNY – HEO Assignment Differential
• CUNY – HEO Reclassification
• CUNY – HEO Workload Concerns
• Faculty Major College Contribution Form – (Dynamic Form) (LAGCC)
• HEO Performance Evaluation Form – (Dynamic Form) (LAGCC)
• HEO Series/CLT Compensatory/Overtime Authorization Form and Report (LAGCC)
• Report of External Employment for Classified Staff
• Multiple Position Report Form for Full-Time Faculty
• Multiple Position Report Form for Non-Teaching Instructional Staff
• Observation Form (LAGCC)
• Post Observation Form (LAGCC)
• Public Safety Performance Appraisal
• WC Accident Description Codes
• Worker’s Compensation Claimant Information
• WC DP2002
• WC Employee Statement
• WC Supervisor Report
• WC Witness Statement

• Instructional Staff Handbook (LAGCC)
• Adjunct Handbook (LAGCC)
• Executive Salary and Compensation Plan (LAGCC)

A dedicated space has been established on campus for nursing parents. Rooms C350 and MB60 are now available to all employees and students who have a current college ID and submit the reservation date/time using the Reservation Calendar.

Lactation Room Reservation

• CUNY Policy on Acceptable Use of Digital Assets and Resources (updated “CUNY Computer Use Policy”)
• Drugs and Alcohol Policy
• Executive Compensation Plan (LAGCC)
• Lactation Room Policy and Procedures
• Military Leave and Benefits Coverage
• Policies and Procedures On Nondiscrimination and Sexual Harassment
• Procedures Concerning Sexual Assault, Stalking and Domestic, and Intimate Partner Violence Against Students
• Reasonable Accommodations and Academic Adjustments
• Risks and Consequences of Drug and Alcohol Use
• Sexual Misconduct Policy /Student’s Bill of Rights Policy
• Student & Employee Requests for Name and Gender Changes
• Time Off for Religious Observance
• Time to Vote on Election Day
• Workplace Violence Policy and Prevention Program- 2012

• Environmental Health and Safety Guide (LAGCC)
• Personnel Review Committee Policies and Procedures (LAGCC)
• President’s Reaffirmation of Diversity/Equal Opportunity/Affirmative Action (LAGCC)

• Professional Development & Learning
• Have It Your Way! Create a Customized Leadership Development Program That Works (LAGCC)
• Intro To Position Management
• A Partner in the Work Life Cycle of an Employee (LAGCC)
• Multiple Position Policy (LAGCC)
• Performance Management (LAGCC)

• CUNY Information Security
• Cybersecurity Training Course
• Employee Sexual Misconduct Prevention and Response Course Training (ESPARC)
• Workplace Violence Prevention Training (WVP)

• Employment History Request Form – Pension (LAGCC)
• New York City Retirement System (NYCERS)
• Phased Retirement Summary
• Phased Retirement Application – Faculty
• Phased Retirement Application – Professional Staff
• Application for Retirement Leave of Absence (TRAVIA)
• Retiree Email Form
• Retirement Guidelines (LAGCC)
• TIAA
• Teachers Retirement System (TRS)

• HR Assist (LAGCC)
• PR Assist (LAGCC)
• Advance Approval of Leave Form (LAGCC)
• Application for Child Care Leave of Absence (Unpaid) – Classified Staff Only
• Application for Child Care Leave of Absence (Unpaid) – Instructional Staff Only
• Application for Scholar Incentive Award
• Application for Terminal Leave
• Application To Donate Leave
• Application To Receive Leave
• Application To Change Donation or Withdraw
• Application To Donate Dedicated Leave
• Application To Receive Dedicated Leave
• Certification for Serious Injury or Illness of a Current Service Member – Military Family Leave
• Certification for Serious Injury or Illness of a Veteran – Military Caregiver Leave
• Certification of Qualifying Exigency For Military Family Leave
• CUNY Dedicated Sick Leave Program
• CUNY Policy on Family & Medical Leave Act
• CUNY Remote Work Agreement
• Excess Annual Leave Usage Form (LAGCC)
• Family and Medical Leave Request Form
• Family And Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Employee’s Serious Health Condition
• Family And Medical Leave Act (FMLA) Certification of Family Relationship
• Family And Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Family Member’s Serious Health Condition
• Fellowship Leave Application
• Fitness for Duty Certification
• Library Reassignment Form
• Non-FMLA Medical Leave Application
• Non-FMLA Fitness For Duty Certification
• NYS – Paid Family Leave
• NYC – Paid Family Leave – Opt-Out Form
• Paid Parental Leave Form 
• Paid Parental Leave Bridge Election Form (LAGCC)
• Partial Leave of Absence With Partial Pay
• Special Leave of Absence Without Pay
• TIC – Paid Family Leave – Care for Family Member Application
• TIC – Paid Family Leave – Military Application
• TIC – Paid Family Leave – Bonding Application

Union Contacts

• Labor Contracts
• PSC Domestic Partnership (DP)
• PSC Enrollment

• Municipal Credit Union
• Research Foundation
• CUNY Graduate Center
• The City University of NY (CUNY)
• Domestic Partnership Enrollment Information
• 529 College Savings Plan
• City of New York’s 401(k) Retirement Plan (Available Only to Community College Employees)
• NYS Deferred Compensation Plan 457(b)
• Flexible Spending Accounts Information