Currently, all documents are in PDF format. Adobe Acrobat Reader is required to view them. 
401(k) Incoming Rollover - for making rollovers into the 401(k) plan
457 New Enrollment
457 Incoming Rollover - for making rollovers into the 457 plan
457 Catch-Up If you are within 3 years of normal retirement age and wish to utilize the special catch-up please call Great West at 1-800-922-7772 and select option 2.
403(b) New Enrollment - contact your vendor choice for Membership form - 403(b) Company list
To change your investment allocations, please contact Great West at 1-800-922-7772 or use their online Account Access.
401(k) Salary Reduction Agreement - Change deduction amount
401(k) Beneficiary Designation Form - for naming or changing your 401(k) beneficiary.
401(k) Participant Change Request - for name or address changes
401(k) Loan Request
401(k) Hardship Withdrawal Request
To change your investment allocations, please contact Great West at 1-800-922-7772 or use their online Account Access.
457 Salary Reduction Agreement - Change deduction amount
457 Beneficiary Designation Form - for naming or changing your 457 beneficiary.
457 Participant Change Request - for name or address changes
457 Hardship Withdrawal Request
To participate in the 457 Standard Catch-Up contact the Benefits & Retirement Office to see if you qualify. 865-974-8765
To change your investment allocations, please contact your 403(b) provider.
403(b) SRA Change 403(b) - Change deduction amount
403(b) Company forms are available on their websites. Some of the forms are available here.
401(k)-457 Deferral of Lump Sum Annual Leave
Agreement for Deferral of Lump Sum Annual Leave
(Both Forms are required)
401(k) Distribution/Withdrawal Request
457 Distribution/Withdrawal Request
(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*
401(k) Plan Distribution Request - or total or partial lump sum withdrawals or rollovers out of the plan please contact Great West at (800) 922-7772 option 2 or local Nashville at (615) 244-1030.
401(k) 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.
Distribution Request for 457 Plan - for total or partial lump sum withdrawals or rollovers out of the plan please contact Great West at (800) 922-7772 option 2 or local Nashville at (615) 244-1030.
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
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
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 (Great West site)
Optional Retirement Program (ORP State site)
Tennessee Consolidated Retirement System (TCRS State site)
Office of Personnel Management- OPM (CSRS & FERS)
