I haven't fully pulled this all apart, but here's a little information for those that want to dive in.

In order to provide 3D positioning and orientation of elements in VR mode, they must be created in a dialog.

3DMODE="3" -- or 2
3DSCALE="0.0053 0.0053 0.0053"
3DALIGNMENT="NORTH"
3DPOSITION="0 0 3"
3DORIENTATION="-0.707 0 0 -0.707"
3DANCHOROFFSET="-0.2094 0.22 0"

reallyactive="NO" -- not sure if related to 3D, but new to me

In-game examples:
HUD.chatlayerdialog
HUD.radarleftlayer
HUD.radarrightlayer
HUD.statuslayerdialog