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, please complete a new Life Insurance Beneficiary Form and the Salary, Annual and Sick Leave Beneficiary Form, available online at the link below.

If inquiring about Retirement or 457 Deferred Compensation beneficiary forms (Fidelity or Empower), please contact the Retirement Division in the Department of Finance at [email protected].

If unable to print form, create a service request and the Health Insurance Team will mail a paper copy to your home. Keep a copy of the completed form with your paperwork and send the original to Executive Office Building, Office of Human Resources, 101 Monroe Street, 7th floor, Rockville, Maryland 20850.