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Employee Handbooks

Office of Human Resources: Employee Benefits Links to forms



Most forms are in fillable pdf. (What is pdf?)
Search for a specific form by keyword in the Find window: Control-F

Health Insurance

Health Insurance Enrollment Form for Active Employees

COVA Care Plan

     Anthem Claim Form

     Medco Prescription Drug Reimbursement Form

     Medco Prescriptions By Mail Order Form

     Medco FAX Prescriptions Form

COVA HealthAware

Cova HealthAware Website


Virginia Retirement System

VRS Retirement for Members

VRS Beneficiary Designation Form

Application to Purchase Prior Service

Agreement for Salary Reduction to Purchase Service Credit

Authorization for After-Tax Payroll Deduction to Purchase Service Credit

Request for Review of Membership Records

Request for Estimate of Service Retirement Benefits

Optional Retirement System

Election to Participate - ORP for Higher Education

Termination Certification Form - ORP for Higher Education

ORP Health Insurance Credit Employer Certification of Service

Basic and Optional Group Life Insurance

Optional Group Life Insurance Enrollment Form

Evidence of Insurability Form

Change Form for Optional Group Life Insurance Plan

VRS Beneficiary Designation Form

Deferred Compensation - 457 Plan


Tax Sheltered Annuities

Salary Reduction Agreement - 403(b) Plan

Cash Match Agreement


Administrative and Teaching Faculty Leave Request Form 1-2010

Request for Family and Medical Leave