Miscellaneous Forms and Documents

• Accidental Death & Dismemberment Beneficiary (PDF)
• Personal Information Change Form (PDF)
• Affidavit for Dependent Eligibility and Tax Status (PDF)
• Disabled Dependent Certification (PDF)
• Minnesota Life Life Insurance Beneficiary Form (PDF)
• USM UNUM Life Beneficiary (PDF)
• First Report of Injury Packet (PDF)
• 2013 Payroll Deduction Schedule (regular) (PDF)

Reimbursements:

• Connect Your Care Claim Form (DOC)
• Connect Your Care Dependant Care Account (DOC)

Retirement:

• Summary of Pension Reform

              Changes Effective 7/1/11(PDF)

• State Retirement Agency Newsletter (PDF)
• Supplemental Retirement Information (PDF)
• State Pre-Retirement Planning Seminar Registration Form
• Optional Retirement Program Performance Report (PDF)

Insurance Plans and Forms:

• Lecturers Health Insurance Process (PDF)
• Group Benefits Information for Direct Pay Employees(PDF))
• Premium Rates FY 2013 (Direct Pay- Contingent, Part-Time Faculty, COBRA) (PDF)
• Premium Rates FY 2013 (Regular and Retirees) - With Subsidies Medical, Prescription, Dental, Metlife, and AD&D(PDF)
• Premium Rates FY 2013 (Regular and Retirees) - No Subsidies
• USM UNUM Term Life and Long-Term Disability Enrollment Form (PDF)
• USM UNUM Long-Term Disability Plan Highlights (PDF)

Tuition Remission:

• Tuition Remission Deadlines (PDF)
• Tuition Remission Form and Affidavit for Taxability (PDF)
• Tuition Remission Guidelines (PDF)
• Tuition Remission for Contingent II (DOC)

Related Links:

• Supplemental Benefits
• Internal Revenue Service
• Social Security
• State of Maryland Benefits          
• State of Maryland Central Payroll
• Unemployment
• State Employees Credit Union (SECU)

Related Links Continued:

• Fidelity
• Maryland State Retirement Agency
• TIAA-CREF
• Nationwide
• UNUM Term Life and Long-Term Disability