Benefit Forms

General

• Personal Information Change Form

Tuition Remission

• Tuition Remission Form

Health Benefits

• Regular Staus Health Benefits Enrollment Form 2021
• Regular Status Health Benefits Enrollment Form 2022
• Contractual Health Benefits Enrollment Form 2021
• Contractual Health Benefits Enrollment Form 2022
• Retiree Health Benefits Enrollment Form
• Direct Pay Health Benefits Enrollment Form
• Disabled Dependent Children
• Health Insurance Portability & Accountability Act
• Notification of Termination for Benefits
• Guide To Your Health Benefits 2021
• Guide To Your Health Benefits 2022
• 2021 Wellness Activities
• 2022 Wellness Activities

Maryland Healthy Working Families Act

• Sick and Safe Leave

Life Insurance/Disability

• Life Insurance
• Long Term Disability
• Accidental Death & Dismemberment

Flexible Spending Account

• Flexible Spending Account (FSA)

Leave

• Leave

Retirement

• Maryland State Retirement and Pension Enrollment Form (Faculty/Exempt Staff)
• Maryland State Retirement and Pension Enrollment Form (Non-Exempt Staff)
• Optional Retirement Program (ORP) Enrollment Form (Exempt Staff)
• Choosing a Retirement Plan
• Retirement Plans At-a-Glance

Supplemental Retirement Account

• Maryland Supplemental Retirement Plan 401k / 457b / 403b Enrollment Form
• Maryland Supplemental Retirement Plans 401k /457b /403b Rollover Form
• Maryland Supplemental Retirement Plan 401k / 457b / 403b Change Form
• TIAA-CREF 403 (b)
• TIAA-CREF 457 (b)
• Fidelity 403 (b)
• Fidelity 457 (b)

Reference Material

• Health/Prescription/Dental Life Insurance Rates 2021
• Health/Prescription/Dental/ Life Insurance Rates 2022
• Condensed Benefits Overview - Regular Exempt Employees
• Condensed Benefits Overview - Regular Non-Exempt Employees
• Condensed Benefits Overview - Contingent II

Having trouble finding what you're looking for? Please contact any Human Resources Team Member for assistance.