Life Event? Update these forms
Certain "life events" can impact your coverage or benefits in CalPERS programs. Please refer to the following list for more details.
Please fill out the forms below and return to HR
Employee Emergency Information Sheet
Health Enrollment:
- CalPERS Health Enrollment Form - must be done within 60 days of life event
- Corresponding Cafeteria Plan Form
Dental Enrollment:
Vision Enrollment:
(SRFA employees not eligible)
Life Insurance:
(for regular employees, greater than 75% FTE)
- Voluntary Life Insurance Application (to purchase coverage for spouse, up to 50% of employee coverage) - must be done within 30 days of life date
- Beneficiary Designation form (for Basic and/or Voluntary Life Insurance)
457 Deferred Comp Beneficiary Designation Forms:
Marin County Employees' Retirement Association:
- MCERA Beneficiary Change Form (for regular employees, greater than 75% FTE)
- MCERA Name Change Form
PARS:
- PARS Beneficiary Change Form (for part-time & fixed-term employees, less than 75% FTE)