This checklist is designed to help you through some of the important steps in planning for retirement. As you
make the transition to retirement, we recommend that you do the following to avoid a gap in your benefits:
Attend TXClass PN400: “Retiring from UT Austin” Date Completed: _________
This session provides an overview of retiree insurance enrollment, eligibility, premium billing and
payment, Social Security, Medicare and coordination with UT insurance, returning to work after
retirement, and getting started with TRS or ORP. Session is offered the 2nd Wednesday every month.
Register online at https://utdirect.utexas.edu/txclass/index.WBX.
UT Retiree Insurance Enrollment Date Completed: _________
Your insurance will not automatically continue when you retire. You must complete and submit forms
to Human Resource Service Center (HRSC) prior to your retirement date (submit 31 days prior is
preferred). For eligibility and enrollment information, see “Retiree Insurance Benefit Overview,”
Submit to HRSC:
Insurance Enrollment/Change for Retirees
Dependent Information form & copy of proof of relationship document
(form and proof document required if adding a dependent not previously covered)
Automatic Payment Request Authorization (optional)
Copy of TRS 30, Application for Service Retirement (TRS participants only)
ORP Declaration of Retirement (ORP participants only)
**These forms are also available online at http://www.utexas.edu/hr/retiree/forms
Group Term Life Conversion Date Completed: _________
If converting coverage greater than $50,000 to Individual Whole Life, contact HRSC for an application
no later than 31 days after your retirement date. Information and premiums at
http://www.fdl-life.com/ut/lang_en/employees/employees.htm, or phone 800-538-0379.
Long Term Care Date Completed: _________
Contact CNA at 888-825-0353 or https://www.ltcbenefits.com/Home.asp no later than 31 days after
your retirement date to request a direct billing to your home address.
Personal Information Date Completed: _________
Before you retire, ensure your address and emergency contact information is current via UT Direct at
https://utdirect.utexas.edu/pnbiog or submit Personal Information Update form to HRSC.
Beneficiary Designation Date Completed: _________
Complete the secure online beneficiary designation form for your UT Group Term Life Benefits. Log in
to My UT Benefits with your EID and password: www.utsystem.edu/benefits/myutbenefits.
Turn Unused Annual Leave into Retirement Savings Date Completed: _________
You may defer any portion (up to maximum annual contribution limit) of your unused annual leave
(vacation) and floating holiday to a UTSaver 457(b) DCP. No federal income tax will be withheld from
the amount deferred, only Medicare and SS. To participate, submit a Purchase/Change Agreement
form to HRSC before your last day of employment. Information and form available online:
Medicare (available at age 65 or younger if due to a disability) Date Completed: _________
Contact the Social Security Administration (SSA) at least 3 months before you need benefits to begin.
Enroll in Medicare Parts A and B at www.medicare.gov or phone 800-772-1213.
If over age 65 when you apply, request forms CMS-40B and CMS-L564. Take form CMS-L564 to Human
Resource Service Center to complete.
Social Security Benefits (available at age 62 or older) Date Completed: _________
Contact the SSA about 3 months before the date you want your benefits to start. Apply online at
www.ssa.gov , visit any Social Security office or phone 800-772-1213.
Teacher Retirement System (TRS Members Only) Date Completed: _________
Contact TRS at www.trs.state.tx.us, or phone 512-542-6400, 6 months prior to retirement (preferred)
to allow sufficient time for completion of TRS required forms.
Optional Retirement Program (ORP Participants Only) Date Completed: _________
Contact your ORP provider or financial advisor 3 months before retirement to review distribution
options and beneficiary designations.
For a list of current “Approved Providers”, go to www.utretirement.utsystem.edu.
• Contact HRSC just prior your retirement date to request a Vesting/Termination Status Form
be sent to your ORP provider(s) after your last paycheck is issued.
UTSaver Program (prior or current participants only) Date Completed: _________
Participants of UTSaver TSA 403(b) and UTSaver DCP 457(b) should contact their provider or financial advisor at
least 3 months before retirement to review distribution options and beneficiary designations. For a list of
current “Approved Providers”, go to www.utretirement.utsystem.edu.
Cancel current UTSaver participation as of 1st of month following employment separation.
Human Resource Service Center
Fax: 512-232-3524; phone: 512-471-4772
Campus Mail Address: HRSC, J5600
U.S. Mail Address: P.O. Box V, Austin, TX 78713
Location: North Office Building A, 2nd Floor Lobby
101 E. 27th St., Austin, TX 78713