Related Forms - Benefits
Visit the VCU Human Resources forms page for a full list of forms (by category).
Health care and wellness forms
Blue Card Blue Shield Global Core International claim
Blue View Vision Out-of-Network 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)
Retirement forms
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)
Optional Retirement Plan Document (PDF)
Post offer self identification (PDF)
TDA automatic enroll opt out (Word)
Virginia Retirement System Defined Contribution Plans