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Benefits Forms

Having trouble finding what you’re looking for? Please try using the search bar at the top of the page, or contact our office at 410-455-2337 to speak with an HR representative.

General

Change of Name/Address Process

Tuition Remission

Tuition Remission (now online!)

Health Benefits

Benefit Enrollment is online in the SPS Workday System

Plan Year 2019 Retiree Enrollment Form
Plan Year 2020 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 

Disability

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

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)