Affidavits/Declarations

Deferred Compensation

Disability Insurance

Employee Health Benefits - CalPERS Plans

Employee Health Benefits - County Plans

Flexible Spending Accounts - FSA

Leave Balance Cash-Outs

Life Insurance - Lincoln

Life Insurance - Standard

Miscellaneous

Retiree Health Benefits

Retirement

Retirement Publications

After Tax Benefit Plan Election Form

Affidavit of Marriage (County)

Affidavit of Marriage (HBSD-1965) (CalPERS)

Affidavit of Parent-Child Relationship (HBD-40) (CalPERS)

Declaration of Tax Dependent Status

Nationwide Asset Transfer Out Request

Nationwide Beneficiary Change Form

Nationwide Distribution Request Form

Nationwide Incoming Assets Form

Nationwide Request For Purchase of Service Credit

Nationwide Unforeseeable Emergency Distribution Application

VALIC 401(a) Money Purchase Distribution Request Form

VALIC 401A Systematic Withdrawal Form

VALIC 457 Systematic Withdrawal Form

VALIC Administrative Change Form

VALIC CalPERS Service Credit Transfer Form

VALIC Unforeseeable Emergency Withdrawal Form

VALIC Distribution Request Form

VALIC Beneficiary Designation Form

VALIC Transfer In/Rollover Form

VALIC Intra Plan Transfer Out

Deferred Compensation Change Form

Standard Long Term Disability Claim Form

Standard Life Long Term Disability (LTD) Certificate

Sedgewick/VPA Disability Forms

2011 Benefit Election Form

2011 CalPERS Health Plan Enrollment Form (HBD-12)

2011 CalPERS Mini Guide

2012 Benefit Election Form

2012 CalPERS Mini Guide

Affidavit of Parent-Child Relationship (HBD-40)

Affidavits/Declarations

Medical Report for Disabled Dependent Benefit (HBD-34)

Questionnaire for Disabled Dependent Benefit (HBD-98)

Statement of Financial Responsiblity for Domestic Partner Health Benefits (HBD-108)

Zip Code Election (HBD-109)

2011 Annual Enrollment Guide

2011 Annual Enrollment Mini Guide

2011 Benefit Election Form

2012 Active Annual Enrollment Guide

2012 Active Annual Enrollment Mini Guide

2012 Benefit Election Form

Affidavits/Declarations

Health Net HMO - EOA: Evidence of Coverage - EOC

Health Net PPO: Evidence of Coverage - EOC

Kaiser Permanente: Evidence of Coverage - EOC

Medical Eye Services Claim Form

Medical report for Disabled Dependent Benefits

Member Questionnaire for Disabled Dependent Benefits

Retiree Health Benefits Forms

Statement of Financial Liability for Domestic Partner Health Benefits

VSP Out-of-Network Claim Form

ASIFlex Website

One-Time Pre-Retirement Leave Cash-Out (LIUNA & SEIU only)

One-Time Pre-Retirement Leave Cash-Out (Management)

Basic Life Insurance Certificate (SEIU & LIUNA)

Beneficiary Designation Form

BeneficiaryConnect Services

Claim Form

Conversion Form

Evidence of Insurability

Group Insurance Enrollment Form

Portability Form

Portability/Conversion Summary

Supplemental Life Insurance Certificate

Travel/Connect Services

Basic Life Certificate of Coverage (DDAA, LEMU, MCU, RSA-PS)

Beneficiary/Change Form

Claim Form

Conversion Application

Evidence of Insurability (EOI)

Life Insurance Certificate

Long Term Disability (LTD) Benefits FAQ

Long Term Disability (LTD) Certificate of Coverage

Portability Application

Request for Conversion Information

Supplemental Certificate of Coverage

Supplemental Insurance Enrollment Form

Supplemental Life Benefits Summary

Employee Services Forms

Leave Forms

Wellness Program

Rideshare Registration

Transportation Expense Prog. Enrollment Form

Transportation Expense Prog. Reimbursement Form

2011 Annual Enrollment Guide

2011 Benefit Election Form

2012 Kaiser Senior Advantage Enrollment Form

2012 Retiree Annual Enrollment Guide

2012 Retiree Benefit Election Form (BEF)

Health Net Disenrollment Form

Request to Cancel Benefits

SCAN Disenrollment Form

SCAN Enrollment Form

2012 Retiree Annual Enrollment Guide

2012 Retiree Benefit Election Form (BEF)

401(a) Beneficiary Designation Form

401(a) Money Purchase Plan Election Form

CalPERS Beneficiary Designation Form

CalPERS Plan-to-Plan Certification Form

CalPERS Service Retirement Election Application

COBRA Enrollment Form

Final Check Deferral of Leave Balance Accruals

Request for Additional Retirement Service Credit Form

Retiree Address Change Form

Retirement Plans

VEBA Account Change Form

VEBA Claim Form

VEBA Spouse/Dependent Information Form

VEBA Systematic Premium Reimbursement Form

Post Employment Program Election Form (Mgmt, Conf, Unrep, DDAA & LEMU only)

Post Employment Program Election Form (LIUNA & SEIU Only)

CalPERS Pub 12 Service Credit Purchase Options

CalPERS Pub 16 When You Change Retirement Systems/Reciprocity

CalPERS Pub 33 Employment After Retirement

CalPERS Pub 35 Disability Retirement Election Application

CalPERS Pub 37 Reinstatement From Retirement

CalPERS Pub 43 Service Retirement Election Application

CalPERS Pub 8 Local Miscellaneous Benefits

CalPERS Pub 9 Local Safety Benefits

Post Employment Program (PEP) Brochure MCU, DDAA, LEMU, PR7, PD7

Post Employment Program (PEP) Brochure SEIU, LIUNA

Post Employment Program Changes (LIUNA, SEIU)

Retirement Plans [CalPERS, 401(a), 457(b), PEP, Social Security]