Member
Enrollment Form
This
form must be completed for:
Every new employee
Every rehired employee
Any name change
Any transfers to your department
Any change in status (example:
change from a permanent to on-call position)
This
form gives the Plan pertinent information on the member including
the designated beneficiary. The
death benefit for an active member's named beneficiary will be a
lifetime monthly annuity if the member should die while an active
employee. There are
specific rules on who can be a beneficiary.
A beneficiary can be named as follows:
-
If
you are married, the beneficiary must be your spouse.
-
If
you do not have a spouse but have children under age 21, they will
automatically receive the benefit until they reach age 21.
-
If
you are unmarried and do not have children under age 21, you can
name anyone as your beneficiary.
-
Only
one beneficiary can be named.
-
The
beneficiary cannot be your estate/trust.
-
You
cannot name a contingency beneficiary.
Leave
Without Pay Form
This
form should be completed for any employee who is on temporary leave
without pay.
Employee
Separation Form
This
form must be completed for every person who is in a permanent or
temporary position and eligible for fringe benefits who has
terminated employment for whatever reason other than a transfer to
another City agency. DO
NOT complete this form if an employee is in an ON-CALL position.
Change
of Beneficiary Form
If
an active member wants to change their beneficiary, this form should
be used. It is
important that beneficiary information is kept current. Any life
change such as marriage, divorce or death of a spouse might impact
who the member wants as their designated beneficiary.
The form must be notarized.
If you have questions, please e-mail Membership
Services.
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