Medical & Dental • Premium Surcharges • Long Term Disability • Life Insurance
Health Savings Account • Flexible Spending Account • PERS/TRS Retirement
Washington State Retirement Plan • Voluntary Investment Plans
Medical & Dental
Premium Payment Plan Election/Change
Valid Dependent Verification Documents – required if adding a spouse/state registered domestic partner and/or children.
Dependent Eligibility Worksheet
Flexible Spending Account (FSA)
Dependent Care Assistance Program (DCAP)
2018 FSA & DCAP Enrollment Form
FSA & DCAP Change Form Allows you to make changes to an account for qualifying events.
FSA Direct Deposit Authorization/Flexi-Card Enrollment
Recurring Day Care Claim Instruction Guide
FSA/DCAP Claim Form
Health Savings Account (HSA)
Public Employees Retirement Plan (PERS)/Teachers Retirement Plan (TRS)
Member Information Form (for Civil Service, Bargaining Unit and Hourly)
Higher Education Employees Plan 3 Investment Program Form (for Faculty and Administrative Professional)
Plan 3 Change of Investment Program: Choose between the Washington State Investment Board (WSIB) and the Self-Directed Investment Programs.
Name & Address Change : To be completed by inactive members, retirees and beneficiaries receiving benefits. Active members update your address through MyWSU account.
Washington State University Retirement Plan (WSURP), TIAA
How To Enroll Online Guide
10% Increased Contribution: At any time following your 50th birthday you may elect to increase your contribution rate to 10%.
Paper Enrollment Form: Use this form to enroll by mail. Use the How to Enroll Online Guide above to enroll online.
VEBA Enrollment Form
Change of Name: Use this form to update your name on your retirement account. Return completed form to address noted on top of form.
Beneficiary Change via TIAA website: Update your beneficiaries online.
Voluntary Investment Plans
2018 Salary Reduction Agreement: Use this form to designate your desired contribution for the TIAA-CREF Voluntary Investment Plan
Deferred Compensation Participation Agreement: Use this form to designate your desired contribution for the Deferred Compensation Program (DCP).