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Human Resources

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  • Human Resources
  • HR Staff - Who to Call
  • Benefits and Paid Time Off
  • Compensation
  • Emergency Resources for Employees
  • Employee Handbooks and Code of Policies
  • Employee Recognition
  • Employment
  • FMLA, Extended Leaves, ADA and Worker's Compensation
  • Forms
    • Employment Forms
    • Benefits Forms
    • Retiree Forms
  • Learning and Development
  • PATH
  • Programs and Events
  • Wellness
  • Work/Life Initiatives
  • Preparing to Retire
  • Retirees
Home Human Resources Forms Benefits Forms

Benefits Forms

Health Insurance

  • Aetna Medical Claim Form
  • Vision Claim Form

Dental Insurance

  • Dental Claim Form

Voluntary Vision

  • Vision Claim Form (for out of network providers)

Flexible Spending Accounts

  • For all other forms go to http://www.flex-admin.com/participants/forms/

Life Insurance

  • Evidence of Insurability Form
  • Group Life Conversion Privilege Form

Supplemental Life Insurance

  • Evidence of Insurability Form
  • Group Term Life Insurance Portability Election Form
  • Group Life Conversion Privilege Form

Retirement Savings Plan

  • Certificate for Hardship Withdrawal
  • Prior Hours Verification Form

Time Off, Leaves and Disability

  • FMLA Request
  • Parental Leave Notification
  • Workers' Compensation Treatment Acknowledgement Form

Work/Life

  • Dual Career Intake
  • Faculty Meeting Childcare
  • Emergency Back-Up Care Reimbursement
  • Weight Watchers Payment Agreement

Domestic Partner Benefits

  • Declaration of Domestic Partnership
  • Declaration of Tax Dependent Status
  • Declaration of Termination of Domestic Partnership



  • Employment Forms
  • Benefits Forms
  • Retiree Forms

Contact Information

  • Office Hours:

    Monday          8:30 a.m. - 4:30 p.m.
    Tuesday          9:30 a.m. - 4:30 p.m.
    Wednesday,    8:30 a.m. - 4:30 p.m.
    Thursday        11:00 a.m. - 4:30 p.m.
    Friday             8:30 a.m. - 4:30 p.m.

  • Employment:
    Individuals seeking employment may visit our Employment Opportunities page under Job Seekers.
  • Mailing Address:
    Human Resources
    204 W. Washington Street
    Washington and Lee University
    Lexington, Virginia 24450

    humanresources@wlu.edu
    (540) 458-8920
    Fax: (540) 458-8060

  • Physical Address:
    2 S Main Street
    Lexington, VA 24450
Washington and Lee University
204 W. Washington St. Lexington VA 24450 540-458-8400
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