Action or Update
Forms
Supporting Documents
Address Change
Retiree Change of Address Request Form Rev 4/07
N/A
Birth or Adoption of a child
Life Insurance Beneficiary Designation Form 190 Retiree Medical Enrollment Form 5608
Birth or Adoption Certificate
Death of a Retiree/Spouse or Dependent
Life Insurance Beneficiary Designation Form 190 Retiree Medical Enrollment Form 5608 Completion of checklist*
Death Certificate
Divorce
Divorce Decree
Marriage
Marriage Certificate
Checklist for death of a retiree/spouse or dependent
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