Get Virginia Retirement Forms

Filling out the Virginia Retirement Forms online is an essential step for participants seeking a health insurance credit through their retirement plans. This guide provides a clear and supportive approach to ensure that you complete the form accurately and efficiently.

Follow the steps to complete the Virginia Retirement Forms successfully.

1. Use the ‘Get Form’ button to access the Virginia Retirement Forms and open them in the editor for completion.
2. In Part A, enter the participant’s information, including their name, address, birth date, and daytime phone number. Choose the appropriate status indicating whether they are an ORP/ARP retiree or a long-term disability recipient.
3. For Medicare coverage, check 'Yes' if applicable. Provide the effective date of Medicare Part B and the monthly premium amount.
4. Proceed to Part B if the participant has other health, dental, vision, or prescription drug insurance. Fill in the insurance policy details, specifying the plan name and membership type.
5. Enter the premium payment details, including how often premiums are paid, the amount per payment, the retiree’s portion, and the effective date of the premium.
6. In Part C, certify the retirement plan details if the participant is an ORP/ARP retiree, including the name of the plan, distribution dates, and service duration.
7. If the participant is a long-term disability recipient, provide relevant information about the disability start date, service duration, and vendor details.
8. Complete the employer certification section by providing the authorized signature, title, and contact information.
9. Finally, the participant must sign and date the form to confirm they will report any changes regarding their health insurance coverage.
10. After filling out all required fields, save your changes. You can then download, print, or share the completed form as necessary.

Start filling out your Virginia Retirement Forms online today to ensure you receive the health insurance credit you're entitled to.