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Benefits Forms

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Change of Name/Address Process

Tuition Remission & Reimbursement

Tuition Remission 
Tuition Reimbursement

Health Benefits

Effective January 1, 2019 Enrollment will be online through the SPS Workday System which will replace most forms.

Plan Year 2019 Regular Employee Enrollment Form
Plan Year 2019 Direct Pay PT-Contractual/COBRA/LAW Enrollment Form
Plan Year 2019 Contractual/Variable Enrollment Form
Plan Year 2019 Retiree Enrollment Form
HIPPA Authorization Form
CHIP Acknowledgement 

Affidavit/Dependent/Certification Forms

Disabled Dependent Certification Form 
Affidavit for Dependent Eligibility and Tax Status 

Life Insurance

Beneficiary Form for UNUM Term Life Insurance 
MetLife Insurance Beneficiary Form or Beneficiary change online
UNUM Term Life Enrollment Form 


UNUM Long Term Disability Enrollment Form 
UNUM Claim for Income Protection Benefits 

Accidental Death & Dismemberment

MetLife Accidental Death & Dismemberment Beneficiary Form or Beneficiary Change online

Flexible Spending Account

Flexible Spending Account Log-in
Flexible Spending Claim Form


Leave forms are available here.

Retirement Forms

Retirement Plan Selection Form
ORP Retiree Health Benefits Handbook 
ORP Retiree Forms Packet 
Pension Retiree Checklist
ORP Retiree Checklist 

Supplemental Retirement Account Forms

SRP Supplemental Retirement EZ Enrollment Form 
MSRP Supplemental Retirement Plans Deferral Change Form 
TIAA-CREF 403 (b) 
Fidelity 403 (b) 
TIAA-CREF 457 (b) 
Fidelity 457 (b)