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Deferred Compensation: Forms

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401(k) Enrollment and/or changes - for online enrollment or changes to the 401(k) plan 

SEND ALL FORMS TO:  Benefits & Retirement
                                              600 Henley Street
                                              Suite #115
                                              Knoxville, TN 37996-4115

401K Auto Enrollment: for new hires after July 1, 2014.

Notice to State Employees: Effective July 1, 2014, all changes to 401(k) & 457 Deferred Compensation plans can be made on the Empower Retirement website by visiting https://participant.empower-retirement.com/. Once you have logged in to your account, go to the Transactions menu and select "Change Paycheck Contribution."
You may also call KeyTalk® at (800) 922-7772 and speak with a representative to make the change for you.

Not Enrolled?
If you are eligible to enroll in the Program but have not done so, take advantage of this benefit in the new year! Within the next few weeks, you will receive an invitation to enroll, along with your Personal Identification Number (PIN), in the mail. To learn more about the Program, visit the website at highlights.

 

403(b) Plan

403(b) New Enrollment/Changes  - for new enrollment (contact your vendor choice for Membership form) and changes to the 403b plan - 403(b) Company list

To change your investment allocations, please contact your 403(b) provider. 403(b) Company forms are available on their websites. Some of the forms are available here.

TIAA-CREF - ORP - for online access to the ORP or 403b accounts to enroll or change account information

VALIC - ORP for online access to the ORP or 403b accounts to enroll or change account information

VOYA - ORP - for online access to the ORP or 403b accounts to enroll or change account information

 

Termination

401(k)-457 Deferral of Lump Sum Annual Leave
Agreement for Deferral of Lump Sum Annual Leave
(Both Forms are required)

403(b) Deferral of Lump Sum Annual Leave
Agreement for Deferral of Lump Sum Annual Leave
(Both Forms are required)


*Contact 403b company (Ameriprise, Fidelity, ING, TIAA-CREF, VALIC) for forms*

TIAA-CREF- Guide to Online Withdrawals for 403b plans

Retirement

Distribution Request for 401(k) OR 457 Plans - for total or partial lump sum withdrawals or rollovers out of the plan please contact Empower Retirement at (800) 922-7772 option 2 or local Nashville at (615) 244-1030.  

 Automated Minimum Distribution Request for 401(k) Plan- for retirees over age 70 1/2 who want to set up future withdrawals at the minimum level IRS permit. 

457 Plan Automated Minimum Distribution Request - for retirees over age 70 1/2 who want to set up future withdrawals at the minimum level IRS permits

Forms for Retirees

401(k) Death Benefit Claim Form
401(k) Withholding Certificate  - to change the amount withheld for taxes after distributions have begun.
401(k) Authorization for Direct Deposit 401(k) - to authorize direct deposit of your periodic or minimum distribution payments to your checking or savings account

457 Death Benefit Claim Form
457 Withholding Certificate - to change the amount withheld for taxes after distributions have begun.
457 Authorization for Direct Deposit - to authorize direct deposit of your periodic or minimum distribution payments to your checking or savings account

AboUT You 

RESOURCES:

Campus/Institute Contacts:
Chattanooga   
Family Practice- Chatt. 
Health Science Center  
Knoxville Area    
Martin   
UTSI    
UT Memorial Hospital

SEND FORMS TO:
Deferred Compensation (401k, 457, 403b) Forms:
     Total Rewards/ Benefits & Retirement Office
     600 Henley St, #115
     Knoxville, TN  37996-4115

Insurance Forms:
     Insurance & Retirement
     P115 Andy Holt Tower
     1331 Circle Park
     Knoxville, TN  37996-0100

Retirement Forms:
     Total Rewards/ Benefits & Retirement Office
     600 Henley St, #115
     Knoxville, TN  37996-4115

Other Links:
Deferred Compensation (State site)
Deferred Compensation (Empower Retirement site)
Optional Retirement Program (ORP State site)
Tennessee Consolidated Retirement System (TCRS State site)
Office of Personnel Management- OPM (CSRS & FERS)