Employer Website
EZLink logo  Navigator
VRS Logo Tuesday, November 19, 2019
Print Page

All forms are fillable and ready for download and printing. VRS accepts all forms by mail or fax. Fax to: 804-786-9718. If on deadline when faxing a form, please call or email to alert VRS of its pending arrival. VRS does not accept forms via email, which is not a secure form of communication.

employer Group Life Insurance Forms
Form #DescriptionLast UpdatedDownload
ALL Securian Financial/VRS Life Insurance Forms:
VRS-31, VRS-32, VRS-35, VRS-37, VRS-38, VRS-39, VRS-39A, VRS-39R and
VRS Certificate of Life Insurance.
VRS-2 Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
09/2019
VRS-2A Designation of Beneficiary - Continuation 09/2019
VRS-11A Employer Certification of Basic Group Life Insurance Coverage Under Workforce Transition Act 02/2011
VRS-11C Employer Certification of VRS Basic Group Life Insurance Coverage Under the Transitional Benefits Program 02/2011

Additional Resources

Top