Benefits

Faculty Terminating Employment

If you are terminating your employment with Virginia Commonwealth University (VCU), below is important information for your review and action concerning the status of your current benefits.  You can pick up an employment termination packet from VCU Human Resources - Lindsey House Quick Stop at 600 West Franklin Street.  You can also print the forms as needed from the list below.

 Note: You will Adobe Reader to access some of the forms and documents on these pages. You can obtain a free copy of Adobe Reader at the Adobe Reader Assistance Page.  

• Employer Certification of Eligibility for Conversion Privilege

You may convert your group life insurance to an individual whole life policy with Minnesota Life.  If you wish to convert your policy without a medical questionnaire, complete and return this form within 31 days of your employment termination date.  This form is not available on line.  Please contact Minnesota Life at 1-800-441-2258 or VCU Human Resources (Lindsey House Quick Stop) for a copy of this form. 

• Notification of Conversion Privilege and Application

If you participate in the VCU Faculty Optional Retirement Plan (ORP) or the voluntary Long-Term Disability (LTD) Plan through TIAA-CREF, you may convert your LTD plan to an individual policy.  If you wish to convert your policy, complete and return the application form within 31 days of your employment termination date.  The application form is not available online.  Please contact VCU Human Resources (Lindsey House Quick Stop) if you wish to convert to an individual policy.  

• VRS Factsheet

If you are a member of the Virginia Retirement System (VRS), you may request a refund of your retirement contributions, rollover your contributions to a qualified retirement plan, or keep them with the VRS.  The enclosed fact sheet provides information on your options and the tax consequences of taking a distribution.

• VRS Refund Request

If you want a refund, complete and return this form to request a refund or rollover of your VRS contributions.  You must include a copy of your Social Security card or other official document that shows your Social Security number.

• VRS Address Declaration for Inactive Members

If you want your retirement contributions to remain with VRS, complete and return this form.

• Savings Bond Cancellation

If you currently participate in the U.S. Savings Bonds Program, contact the National Bond and Trust Company (NBT), VCU's third-party vendor, at 1-800-426-9314 or visit the NBT website at http://www.nbtco.com/.

• Personal Data Form  Word version

Complete and return this form only for a change of address.

• Faculty Exit Survey

Complete and return this form to the VCU Office of EEO/AA Services at P. O. Box 843022, Richmond, VA 23284-3022.  The survey form is not available online.  Please contact VCU Human Resources (Lindsey House Quick Stop) for a copy of this form.  

Please return the completed HR forms to VCU Human Resources - Lindsey House Quick Stop at  600 West Franklin Street. 

If you have questions or need additional information, contact us at (804) 827-1770 or by email. 

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