{"id":18676,"date":"2020-01-20T16:19:35","date_gmt":"2020-01-20T21:19:35","guid":{"rendered":"https:\/\/www.rochester.edu\/human-resources\/?page_id=18676"},"modified":"2026-07-09T10:32:49","modified_gmt":"2026-07-09T14:32:49","slug":"retiree-forms-tools-resources","status":"publish","type":"page","link":"https:\/\/www.rochester.edu\/human-resources\/benefits\/retiree-benefits-resources\/retiree-forms-tools-resources\/","title":{"rendered":"Retiree Forms, Tools &#038; Resources"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":6,"featured_media":0,"parent":9186,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"page-templates\/one-column.php","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-18676","page","type-page","status-publish","hentry"],"acf":{"lead_in":"","display_title":"","subtitle":"","call_to_action":"","hero_image_placement":"no_image","hero_media":"images","hero_pattern_option":"","hero_video":"","hero_image_landing":"","hero_image_landing_two":"","hero_image_landing_three":"","content_modules_above":[{"acf_fc_layout":"text","anchor":"","css_class":"","title":"","content":"If you're a current retiree or are in the planning stages, the following resources, tools, and links might be helpful to you.\r\n<h2>2026 retiree benefit information<\/h2>\r\n<h3>Non-Medicare eligible retirees<\/h3>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2023\/10\/open-enrollment-highlights-retiree.pdf\">Non-Medicare Eligible Retiree Highlights <\/a><\/li>\r\n \t<li><a class=\"external-link\" title=\"Follow link\" href=\"https:\/\/www.rochester.edu\/human-resources\/benefits\/retiree-benefits-resources\/retiree-health-care-rates\/\" target=\"_blank\" rel=\"nofollow noopener\">Retiree rates<\/a><\/li>\r\n<\/ul>\r\n<h3>Medicare-eligible retirees<\/h3>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-over-65-retiree-newsletter.pdf\">Medicare Eligible Retiree Newsletter <\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-hra-guide.pdf\">HRA guide<\/a><\/li>\r\n<\/ul>\r\n<h2>Retirement forms<\/h2>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2020\/12\/New-Website-Retirement-Checklist-12.11.20.pdf\">Retiree Checklist<\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-qualifying-event-form.pdf\">Retiree Qualifying Life Event\/Change Form<\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2020\/12\/Service-Credit-4R_12.11.2020.pdf\">4R Prior Credit Form<\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2020\/12\/Service-Credit-5R_12.11.2020.pdf\">5R Prior Credit Form<\/a><\/li>\r\n<\/ul>\r\n<h2>Tools<\/h2>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2021\/01\/ScenarioExamplesforRetirees.pdf\">Scenarios - HRA and Eligibility<\/a><\/li>\r\n<\/ul>\r\n<h2>2025 retiree benefit information<\/h2>\r\n<h3>Non-Medicare eligible retirees<\/h3>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-retiree-highlights.pdf\">Non-Medicare Eligible Retiree Highlights <\/a><\/li>\r\n \t<li><a class=\"external-link\" title=\"Follow link\" href=\"https:\/\/www.rochester.edu\/human-resources\/benefits\/retiree-benefits-resources\/retiree-health-care-rates\/\" target=\"_blank\" rel=\"nofollow noopener\">Retiree rates<\/a><\/li>\r\n<\/ul>\r\n<h3>Medicare-eligible retirees<\/h3>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-over-65-retiree-newsletter.pdf\">Medicare Eligible Retiree Newsletter <\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-hra-guide.pdf\">HRA guide<\/a><\/li>\r\n<\/ul>\r\n<h2>Retirement forms<\/h2>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2025\/10\/2026-qualifying-event-form.pdf\">Retiree Qualifying Life Event\/Change Form<\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2020\/12\/Service-Credit-4R_12.11.2020.pdf\">4R Prior Credit Form<\/a><\/li>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2020\/12\/Service-Credit-5R_12.11.2020.pdf\">5R Prior Credit Form<\/a><\/li>\r\n<\/ul>\r\n<h2>Tools<\/h2>\r\n<ul>\r\n \t<li><a class=\"u-link-pdf\" href=\"https:\/\/www.rochester.edu\/human-resources\/wp-content\/uploads\/2021\/01\/ScenarioExamplesforRetirees.pdf\">Scenarios - HRA and Eligibility<\/a><\/li>\r\n<\/ul>\r\n<h2>Informational sessions<\/h2>\r\nWe offer monthly webinars to help you understand the retirement process. These sessions are most helpful for employees who are six months to a year from their anticipated retirement date.\r\n\r\n<a class=\"button button--blue\" href=\"https:\/\/www.rochester.edu\/working\/hr\/benefits\/events\/\">Find an informational session<\/a>\r\n<h2>External resources<\/h2>\r\n<ul>\r\n \t<li><a class=\"u-link-external\" href=\"https:\/\/my.viabenefits.com\/UniversityofRochester\">Via Benefits University-sponsored marketplace<\/a><\/li>\r\n \t<li><a class=\"u-link-external\" href=\"https:\/\/www.medicare.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare<\/a><\/li>\r\n \t<li><a class=\"u-link-external\" href=\"https:\/\/www.medicareinteractive.org\/get-answers\/coordinating-medicare-with-other-types-of-insurance\/job-based-insurance-and-medicare\/health-savings-accounts-hsas-and-medicare\" target=\"_blank\" rel=\"noopener noreferrer\">HSA and Medicare<\/a><\/li>\r\n \t<li><a class=\"u-link-external\" href=\"https:\/\/www.ssa.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">Social Security<\/a><\/li>\r\n \t<li><a class=\"u-link-external\" href=\"https:\/\/www.tiaa.org\/public\/tcm\/rochester\" target=\"_blank\" rel=\"noopener noreferrer\">TIAA<\/a><\/li>\r\n<\/ul>","background_color":"#ffffff","width":"width-medium"}],"sidebar":"show__sidebar","sidebar_feed":"menu_select","menu":"316","page_links":null,"sub_menu":"816","content_modules":null},"yoast_head":"<title>Retiree Forms | Office of Human Resources | University of Rochester<\/title>\n<meta name=\"description\" content=\"Resources and relevant form paperwork for University of Rochester retirees, including a retiree change forms, and more.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.rochester.edu\/human-resources\/benefits\/retiree-benefits-resources\/retiree-forms-tools-resources\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta 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