Benefits Forms

Dental and Vision​

Domestic Partnership and Common Law Marriage

Flexible Spending Accounts

Submit claims online or download forms directly from the secure Flexible Spending Account page in the Penn Benefits Enrollment System.

Life Insurance

Medical, Prescription, and Behavioral Health

Phased Staff Retirement

Time Off

Short Term Disability and Family Medical Leave

Basic, Matching, and Supplemental Retirement Annuity Plans

Visiting Scholars