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 form Life Insurance Beneficiary Form and the Salary, Annual and Sick Leave Beneficiary Form. These forms are now digital and changes can be made online. If inquiring about Retirement or 457 Deferred Compensation beneficiary forms, please contact the Retirement Department (MCERP). Participants that have a MassMutual 457 plan through the union, please contact Keir Richter, 410.207.3070 or [email protected]. Keep a copy with the employee's/retiree's paperwork and send the original to Executive Office Building, Office of Human Resources, 101 Monroe Street, 7th floor Rockville, Maryland 20850.

If unable to print form, Online users may submit a request by clicking on the "Create Service Request" button below. Please complete all 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.