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Retiree - Names of Beneficiaries

Because of HIPPA regulations and the Office of Human Resources (OHR) policies, OHR does not provide the names listed on Beneficiary Forms. To ensure that the names on Beneficiary Forms are current, complete a new form and submit it to OHR. The Life Insurance Beneficiary Forms are available on the Office of Human Resources website. Remember to place a copy of the forms with other important legal documentation.

If unable to print form, Online users may submit a request by clicking on the "Create Service Request" button below. Please complete all of the fields in the Contact Information section, provide the requestor's address in the Service/Incident Address information section and provide a brief description of the request in the Brief Description field.

Find more information from the following link(s):
To speak with a Customer Service Representative, please call 311 during business hours.