Medical, Dental and Vision Forms  

New Employees will enroll in PWCS Medical, Dental &Vision plans online through ESS

For Mid-Year Change Forms and Premium Information Visit the PWCS Benefits Intranet Page


Medical/Dental/Vision Claim Forms

For Anthem  out-of-network claim forms, log into your account on the Anthem Website

For Delta Dental  out-of-network  claim forms, log into your account on the Delta Dental website

For Vision Service Plan (VSP)  out-of-network claim forms, log into your account on the VSP website

Flexible Benefit Program Forms

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Visit the PWCS Intranet Page for Flexible Spending Enrollment forms

For Flexible Spending Claim forms or online claims submission, log into your account at the P&A Group website.  


Virginia Retirement System Forms

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PWCS Forms

pwcs logoPayroll Forms - (Direct Deposit Forms, Tax Withholding Forms, Etc.)
HR Forms

Retirement Opportunity Program (ROP)

Updated ROP forms coming soon!
  • Work Assignment Completion Record (PDF)
  • ROP Time Sheet (PDF)
  • Participation/Work Assignment Request (PDF)


Lincoln Financial Group Forms

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Changes to your 403(b) contributions and beneficiaries are now done either online or by contacting Lincoln Financial directly. 

Time & Leave Forms

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 For PWCS Leave forms, visit the PWCS Benefits Intranet Page.



Standard Long Term Disability Forms

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Tuition Reimbursement Forms

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Please note - tuition reimbursement requests must be submitted as soon after registration for approval. We do NOT accept initial requests for reimbursement once the class is over.


For Tuition reimbursement forms, please visit the PWCS Benefits Intranet page. Requires PWCS Login ID and password.