The COVID-19 Utility Municipal Relief Program can now provide more than one payment to utility customers with overdue utility bills that have experienced economic hardship due to the pandemic. Please contact Utility Billing Customer Service at 757-516-1001 for more information.
Forms
Health, Dental, Vision and Pharmacy
- 2021 - 2022 TLC Enrollment Form
- 2021 - 2022 TLC Personal Data Change Form
- Prescription drug claim form
- Home delivery order form
Flexible Spending Account (FSA)
- Employee authorization for payroll deduction to health savings account
- Address change form
- Account maintenance form
- Benefits card election form
- Direct deposit form
- FSA Enrollment form
- FSA Dependent care reimbursement form
- FSA Medical reimbursement claim form
- HSA Individual enrollment form
- Limited FSA medical reimbursement claim form
- Status change form