Benefit Forms and Materials

DPAs are responsible for maintaining materials such as forms, brochures, and publications for employees in their department.  To simplify ordering of materials, DPAs may obtain some forms by downloading them directly from forms and publications at  At Your Service.   However, many forms, brochures and publications can be ordered through the Fulfillment House.  There is no cost to departments for ordering through the Fulfillment House and it usually takes only three days to receive the items you ordered.  

DPAs may want to have on hand the following items for new employees.

The items below are available through the Fulfillment House.

• Your Group Insurance Plans (item #2001)
• Medical Plan Summary-2002 (item #2100)
• Summary Plan Description for Retirement, DCP, 403b Plan (item #1001)

To Set Up a Fulfillment House Account

• Go to the Fulfillment House web site: apps.kpcorp.com/ucbenefits.
• Enter your user ID and password. (Note: The user ID and password are the same.)  
• Type your one-time shipping information.

To Place an Order

• Click on "Order Materials" and make your selection.
• You can preview your order by clicking on "Preview Order."  
• Once your order is correct, click on "Submit Order."
• Retain the Order ID for future reference.
• You will receive an e-mail from K/P Corporation as to when your order will be shipped.

To Check the Status of an Order

• Go to the Main Menu, click on "Check Order Status” or you can either enter your Order ID or you can see a list of all the orders you have placed.
• Make your choice and then click "Go" to view the detailed order and shipment information.

When hiring new employees, departments will need to provide the employee with the following forms.

• Pin Authorization (UPAY 874) Available through the Fulfillment House
• Employment Eligibility Verification (I-9) Available through the Fulfillment House
• Demographic Data Transmittal (U5605) Available through the Fulfillment House
• BELI Assign or Reassign (UPAY 726) Available through the Fulfillment House
• Withholding Allowance Certificate (UC W-4/DE 4) Available through the Storehouse
• Surepay Payroll Earnings Distribution Form (UPAY 702) Available through the Storehouse
• State Oath Of Allegiance and Patient Agreement (UPAY 585) Available through the Payroll Office web site

Address

1160 University Avenue, Suite B
Riverside, CA 92521