Insurance Forms

Claim Forms

• UT Select Medical  
• UT Select Prescription
• UT Dental Select
• UT FLEX (PDF)

Beneficiary Designation Forms

• Group Term Life
• Teacher Retirement System of Texas (for active employees)
• Teacher Retirement System of Texas (for retired employees)

Other Important Forms

• Medco by Mail Order Form (PDF)
• UT FLEX Direct Deposit Authorization Form (PDF)