Benefit Forms

*Open PDF forms in Adobe Acrobat to enable fillable form features disabled when viewing PDF in a browsers.  If you do not have Adobe Acrobat, it is available from Terpware under Design & Production

Use the search box to narrow the listing of forms or use the drop down filters to view forms by a category.

TypeFormDownload
HealthContract RenewalPDF
HealthAddress/Name ChangeOnline
Flexible Spending Account (FSA)P&A Group Claim Form (Dependent Daycare and Healthcare)Download
State Retirement Pension (SRP)Pension Enrollment Form (Faculty / Exempt)PDF | E-Sign
State Retirement Pension (SRP)Pension Enrollment Form (Nonexempt)PDF | E-Sign
State Retirement Pension (SRP)Pension Pre-Retirement ChecklistDownload
Supplemental Retirement Account (SRA)Maryland Supplemental Retirement Plans 401 / 457b / 403b Rollover FormOnline
Supplemental Retirement Account (SRA)Maryland Supplemental Retirement Plan 401k / 457b / 403b Change FormOnline
Supplemental Retirement Account (SRA)Maryland Supplemental Retirement Plan 401k / 457b / 403b Enrollment FormOnline
Supplemental Retirement Account (SRA)403b TIAA (SRA) Enrollment / Deduction Change FormDownload
Supplemental Retirement Account (SRA)457b TIAA (SRA) Enrollment / Deduction Change FormDownload
Supplemental Retirement Account (SRA)403b TIAA (ROTH) Enrollment /Change FormDownload
Supplemental Retirement Account (SRA)403b Fidelity (SRA) Enrollment / Deduction Change FormDownload
Supplemental Retirement Account (SRA)457b Fidelity (SRA) Enrollment / Deduction Change FormDownload
Supplemental Retirement Account (SRA)403b Fidelity (ROTH) Enrollment / Download
Optional Retirement Program (ORP)ORP Enrollment FormsPDF | E-Sign
Optional Retirement Program (ORP)Checklist of ORP Pre-Retirement Action ItemsDownload
Life/DisabilityState of Maryland MetLife EnrollmentSPS Login
Life/DisabilityState of Maryland MetLife Evidence of InsurabilityMailed to Employee by MetLife
Life/DisabilityState of Maryland MetLife Beneficiary DesignationDownload
Life/DisabilityState of Maryland MetLife PortalLogin
Life/DisabilityUSM MetLife Enrollment PortalOnline
Life/DisabilityUSM MetLife Evidence of InsurabilityOnline
Life/DisabilityUSM MetLife Beneficiary DesignationOnline
Employment ContractContingent I (Health Benefits Eligible)Download
Employment ContractContingent I (Not Eligible for Health Benefits)Download
Employment ContractContingent II Nonexempt (Health Benefits Eligible)Online
Employment ContractContingent II Nonexempt (Not Eligible for Health Benefits)Online
Employment ContractContingent II Exempt (Health Benefits Eligible)Online
Employment ContractContingent II Exempt (Not Eligible for Health Benefits)Online