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1111 East Main Street
Richmond, VA 23219
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Administrative Offices
1200 East Main Street
Richmond, VA 23219

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member Group Life Insurance Forms
Form #DescriptionLast
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ALL Minnesota Life/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.
opens web page
VRS-2 Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
01/2014 opens pdf 180kb
VRS-2A Designation of Beneficiary - Continuation 12/2014 opens pdf 148kb
VRS-11A Employer Certification of Basic Group Life Insurance Coverage Under Workforce Transition Act 02/2011 opens pdf 29kb
VRS-11C Employer Certification of VRS Basic Group Life Insurance Coverage Under the Transitional Benefits Program 02/2011 opens pdf 29kb
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