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Tuition Benefit Forms

Service Credit Form
At the University of Rochester, the service requirement for the tuition benefits plan may be met by service at another college, university or U of R affiliated teaching hospital, as well as service at a member of the controlled group of the University that offered a tuition benefit plan for which the faculty or staff member was eligible. To receive credit for such prior service, please complete this form.

Employee Tuition Waiver
Complete and submit this form to the Office of Total Rewards (TuitionBenefits@UR.rochester.edu) if you are taking courses at the University of Rochester.

Employee Tuition Reimbursement
Complete and submit this form to the Office of Total Rewards (TuitionBenefits@UR.rochester.edu) if you are taking courses at an outside college/university.

Employee Reimbursement of Professional Certification/Recertification Exams
Complete and submit this form to the Office of Total Rewards (TuitionBenefits@UR.rochester.edu) if you are taking a certification/recertification exam.

Dependent Children Tuition Waiver
Apply online by logging into HRMS using your Net ID and follow the path "Self Service > Benefits > Tuition > Apply-Dependent Tuition Waiver"


YOUR Benefits Extras Forms

If you are covered under one of the University Health Care Plans and the VSP Vision Care Plan, you may be eligible for additional reimbursement for qualified vision expenses. The benefits offered through the University Health Care Plans and VSP may be used in conjunction with one another for the same service or purchase.

At the point of service, ask your provider if they are able to process the claim through your VSP plan as well as your Excellus/Aetna Health Care Plan. If they are only able to process through your VSP plan at the point of service, you may use a claim form below to submit for additional reimbursement from your health care TPA (Excellus or Aetna).

Aetna Claim Form
Excellus Claim Form