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Employee Benefits

Open Enrollment 2015

Employee Benefits Information and Open Enrollment Guide

Mandatory Open Enrollment Forms

Benefit - Forms, Brochures, Guides, and Websites


Accidental Death & Dismemberment Insurance

Beneficiary Update

CalPERS Health Forms and Guides

CalPERS Health Plan Websites

CalPERS Long Term Health Care

Long Term Care
Select: Long Term Care

CalPERS Service Credit

Deferred Compensation Forms

CalPERS 401k and 457 Plan Comparison Sheet
MassMutual 457 and 401k Comparison Sheet

CalPERS Forms

CalPERS 401(k) Account Transfer - Contact Personnel
CalPERS 401(k) Contribution Change Form
CalPERS 401k New Enrollment with Beneficiary Form
CalPERS 457 Account Transfer - Contact Personnel
CalPERS 457 Contribution Change Form
CalPERS 457 New Enrollment form requires Beneficiary Form

Beneficiary changes
CalPERS 401(k) Beneficiary Change Form
CalPERS 457 Beneficiary Change Form


CalPERS 401(k) Loan -Verify Loan Justification prior to Submitting to Personnel
CalPERS 401(k) Loan Justification Form - Loan Justification
CalPERS 401(k) Distribution - Contact Personnel
CalPERS 457 Emergency Withdrawal Request - Contact Personnel
CalPERS 457 In-Service Withdrawal Request - Contact Personnel
CalPERS Hardship Distribution Request - Contact Personnel

MassMutual Forms

MassMutual 401(k) Contribution Change Form
MassMutual 401k New Enrollment with Beneficiary Form
MassMutual 401(k) Installment Payment Change Request Form - Contact Personnel
MassMutual 401(k) Death Benefit Request - Contact Personnel
MassMutual 401(k) and 457 Spousal Consent Form
MassMutual 457 Contribution Change Form
MassMutual 457 New Enrollment with Beneficiary Form
MassMutual 457 Pre-Retirement Catch-Up Form - Contact Personnel
MassMutual Rollover Submission Form - Contact Personnel

Beneficiary changes
MassMutual 401(k) Beneficiary Form
MassMutual 457 Beneficiary Form
MassMutual 401k and 457 Spousal Consent Form

MassMutual 401(k) Loan - Contact Personnel
MassMutual Benefit payment request - Contact Personnel
MassMutual In Service Withdrawal Request - Contact Personnel
MassMutual Installment Payment Request - Contact Personnel
MassMutual Withdrawal Form - Contact Personnel

Deferred Compensation Websites

Dental Insurance

Employee Assistance Program

FSA (Flex Spending Accounts) - WageWorks Dependant Care Forms Medical Reimbursement and Tahoe Rural Health Subsidy

Supplemental Life Insurance