Address/Name Change
Affidavit for Domestic Partnership and Domestic Partner’s Dependents
Dependent Child Affidavit
Disability Dependent Certification Form
Enrollment Forms July 2009 - June 2010:
HEARTS Form
HIPAA Authorization Form
HIPAA Certificate IRS Worksheet to Determine Dependent SupportMail Order Prescription Brochure and Form
Met Life AD & D Plan Beneficiary Designation Form
Met Life Life Insurance Beneficiary Designation Form
Met Life Statement of Health Form (147KB)
Notice of Creditable Coverage July 2008 - June 2009
Notice of Creditable Coverage July 2009 - June 2010
Optional Retirement Program Handbook for Retiree Health Benefits
Optional Retirement Program Retiree Health Benefits Enrollment Packet
State Notification of Medicare Information