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Benefits Forms
- Retiree Medical (UnitedHealthcare) Claim Form (PDF)
- Retiree Benefits Enrollment Form
- Retiree Medicare Cross Over Enrollment Form
- Retiree Medicare Part B Request fpr Employment Information Form
- Point-of-Service Plan (UnitedHealthcare) Claim Form (PDF)
- UnitedHealthcare Foreign Providers Claim Form (PDF)
- UnitedHealthcare Dependent Eligibility Beyond Age Limit Due to Disability (PDF)
- Dental (MetLife) Claim Form (PDF)
- Dental (MetLife) Reimbursement Direct Deposit Form (PDF)
- Important Information about Covering Dependents on Your NYU Plans
- VSP Out-of-Network Reimbursement Form
- Social Security Number/Medicare Coordination Form
- Life Insurance Enrollment Form Codes 100, 102, 103 (PDF)
- Life Insurance Enrollment Form Codes 104, 106, 107 Non-Union (PDF)
- Life Insurance Enrollment Form Code 107 SGT (PDF)
- Life Insurance Enrollment Form Code 107 PRG (PDF)
- Life Insurance Enrollment Form Code 107 Local 810 (PDF)
- Life Insurance Medical History Statement for NY Residents (PDF)
- Life Insurance Beneficiary Designation Form
- Life Insurance - Application for Conversion of Group Insurance (PDF)
- Life Insurance Claim Form for Beneficiary Benefits (PDF)
- Retirement Plan Enrollment and Investment Selection (PDF)
- STDA Salary Reduction Agreement and Investment Selection Form (PDF)
- 457(b) Salary Deferral Agreement and Investment Selection Form (PDF)
- 457(b) How to Enroll - TIAA-CREF (PDF)
- 457(b) How to Enroll - Vanguard (PDF)
- TIAA-CREF How to Enroll Online (PDF)
- TIAA-CREF Designation of Beneficiary Form - NYU Retirement Plans (PDF)
- TIAA-CREF Direct Transfer/Rollover Authorization to TIAA-CREF (PDF)
- TIAA-CREF Retirement & Supplemental Tax-Deferred Annuity Plans Enrollment Form (PDF)
- TIAA-CREF Supplemental Tax-Deferred Annuity Plan Enrollment Form (PDF)
- TIAA-CREF Notice of Name Change Form (PDF)
- Vanguard Asset Transfer Authorization (PDF)
- Vanguard Designation of Beneficiary Form (PDF)
- Vanguard Distribution Request/Direct Rollover (PDF)
- Vanguard Enrollment/Change/Beneficiary Designation Form - NYU Retirement Plans (PDF)
- Vanguard Enrollment/Change/Beneficiary Designation Form - 457(b) (PDF)
- Vanguard In-Service Withdrawal Request (PDF)
- Adjusted Work Schedule for Classes (PDF)
- Graduate Student Assistantships Tuition Award Application (PDF)
- Local 3882 Tuition Reimbursement 20% (PDF)
- Portable Tuition for Dependents - Current Employee (PDF)
- Portable Tuition for Dependents - Retiree and Former Employee (PDF)
- Tuition Remission - Retiree and Former Full Time NYU Employees (PDF)
- Tuition Remission 100% for Job Related Non-Credit SCPS Courses (PDF)
- Tuition Remission Application for Non-Credit SCPS Courses (PDF)
- Job Relatedness for Employee Graduate Tuition Remission Tax Form (PDF)
Bone Density Screening, Yoga, Walking Program
This month, stay healthy to the bone by participating in the bone health and integrity analysis screening, attending a yoga class, reviewing a webinar on healthy eating, joining colleagues for a walking session, and registering for a complimentary hearing screening. And take care of your financial health by exploring investment options and strategies.
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