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  • COVID-19
    • Freeze
    • Return to campus
      • Sample scenario
    • Telework learning opportunities
    • Working parents
  • Careers at VCU
    • Executive search team
      • Executive search team services
      • Leadership searches
        • Director of sustainability
        • Director of finance
        • Provost and senior vice president for academic affairs
        • Director for adult and non-traditional student services
        • Senior associate dean, school of business
        • Director of admissions operations
        • Executive director, faculty human resources
        • Chief research information officer, school of medicine
        • Senior Curator
      • Recent placements
        • Associate dean of business and administration
        • Chief operating officer
        • Assistant vice president for capital assets and real estate
        • Director of parking and transportation
        • Director of planning and design
        • Executive director of academic HR
        • Presidential administrative specialist
        • Senior strategic writer
      • Work with us
    • Veterans
    • Hiring individuals with disabilities
    • Annual report
  • New employees
    • Checklists
    • New employee orientation
    • New faculty resources
    • Your first day and beyond
    • Employee training and policy review
    • Remote new employee learning plan
  • Current employees
    • Benefits
      • A-Z list of benefits
        • Deferred compensation plan
        • Disability insurance
        • Flexible spending accounts
        • Health benefits
          • Health coverage premium holiday
        • Life insurance
        • Long-term care insurance
        • Purchase of prior service
        • Retirement
          • Planning resources
          • Optional retirement plan
          • Virginia Retirement System
          • Individual counseling
        • Tax-deferred annuity and cash match programs
        • Tuition benefit
        • Unemployment compensation
        • Workers' compensation
          • FAQ's
          • Report an illness or injury
          • Contacts and resources
      • Faculty benefits
      • Clinical faculty benefits
      • University and Academic Professional benefits
      • Classified staff benefits
      • Adjunct, postdoc, wage
      • Enroll in benefits
      • Changing your benefits
      • Benefits upon separation
      • Glossary of terms
      • Forms and documents
      • Benefits FAQ
      • Contact Benefits
    • Career development
      • Career communities
        • Career Development Collaborative career community
        • Communications career community
        • Development career community
        • Finance and Procurement career community
        • HR career community
        • Information Technology career community
        • Leadership career community
        • Legal, Audit and Compliance career community
        • Library Services career community
        • Research career community
        • Student Services career community
      • Growing your career
      • Leadership development
      • Learning opportunities
      • Tuition benefit
      • Career development planning
    • Call Me By My Name project
    • Code of Conduct
    • Compensation (Pay)
    • Employee health
    • Employee relations
      • Contact Employee Relations
    • Employment verification
    • Paydays and holidays
    • Great Place enrollment
      • FAQs
    • Information systems
      • myVCU
      • Talent@VCU
      • VCU RealTime
    • Interfaith holiday calendar
    • Learning and development
    • Leave
      • University and Academic Professionals
      • Converting to a University and Academic Professional
      • Classified staff
      • Faculty 12-month
      • Faculty 9 and 10-month
      • Faculty 9, 10 and 12-month
      • General leave policies
    • Payroll
    • Performance management
    • Recognition and awards
      • Annual service recognition celebration
      • Distinguished faculty awards
      • Dorris Douglas Budd Award
      • Great place, Great people
      • Governor's awards
      • President's awards
      • Recognize a colleague
        • Recent recognitions
          • 2019 archive
          • 2018 archive
          • 2017 archive
          • 2016 archive
          • 2015 archive
    • Service and support tool
    • Timekeeping
    • Work/Life
      • Alternative work arrangements
      • CommonHealth and Wellness
      • Commonwealth of Virginia Campaign (CVC)
      • Community service
      • Employee discounts
        • Employee discount codes
      • Family resources
      • Financial fitness
      • Flu clinics
      • Grief and loss
      • LGBT resources
      • Moving and relocation
      • Tobacco cessation
      • Weight Watchers (WW)
      • Contact work, life and well-being
  • Managers and HR
  • Policies
  • Forms
  • Contact
    • HR departments and staff listing
    • HR contacts for schools and units
    • HR Advisory Committee
  1. Human Resources
  2. Current employees
  3. Benefits
  4. Forms and documents

Related Forms - Benefits

Visit the VCU Human Resources forms page for a full list of forms (by category). 

Healthcare and wellness forms

Anthem claim

Aetna claim

Blue Card Blue Shield Global Core International claim 

Blue View Vision Out-of-Network claim 

Delta Dental claim

Employee health documentation request (Word)

Flexible Spending Account (FSA) claim form (health care & dependent care)

Health benefits and flexible spending enrollment 

Health benefits and flexible spending enrollment (DocuSign version)

Health insurance program appeal

Physician selection (Word version) 

Physician Selection Form (DocuSign version)

Prescription drug exception

 

Retirement forms

Beneficiary designation 

Deferred Compensation VRS Retirement One Time Deferral (PDF)

Election of retirement plan (PDF)

Election of retirement plan (DocuSign version)

Employee certification form for purchase of VRS service credit (PDF)

Fidelity investments

ICMA-RC

Optional Retirement Plan Document (PDF)

Post offer self identification (PDF)

TDA Plan Document (PDF)

TDA automatic enroll opt out (Word)

TIAA

Virginia Retirement System (VRS) forms

VRS beneficiary designation

VRS member benefit profile error report

  • A-Z list of benefits
  • Faculty benefits
  • Clinical faculty benefits
  • University and Academic Professional benefits
  • Classified staff benefits
  • Adjunct, postdoc, wage
  • Enroll in benefits
  • Changing your benefits
  • Benefits upon separation
  • Glossary of terms
  • Forms and documents
  • Benefits FAQ
  • Contact Benefits

Contact Human Resources

Benefits | Communications | Compensation | Compliance |
Employee Relations | VCU HR forms | HR Consultants | Learning and Development | Operations | Policies | Work/Life | HR Organizational Chart | HR staff listing | VCUHealth

(804) 828-0177 (Voice)
(800) 828-1120 (TDD)
AA/EOE

HR Welcome Center

The HR Welcome Center on Belvidere Street is a one-stop shop for HR related questions and transactions.‌ Walk-ins are not accepted at this time. Please contact VCU HR through email at askhr@vcu.edu or call 804-828-0177 and we will be happy to assist you.

Virginia Commonwealth University
Human Resources
Lindsey House | 600 West Franklin Street | Box 842511
Richmond, VA 23284-2511
Email: askhr@vcu.edu

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