 |
Complete MCPS Form
W4-MW-507
Employee’s Withholding Allowance Certificate.
 |
|
Send the form to
the Employee and Retiree Service Center. |
| |
Note:
Changing an address does not change state and local
jurisdictions for income tax withholding. You may
also want to examine your dependents and filing
status
|
|
To add new dependent(s).
Cancel current coverage if signing up for family
through spouse’s coverage. Coverage for your
child (birth/adoption) is not automatic through
MCPS. If you enroll your child within 60 days,
he/she will be covered retroactively from birth.
Please note: This must be done within 60 days
of birth or adoption or you will have to wait until
the next open enrollment to obtain insurance
coverage for the new child. If you obtain coverage
through your spouse's insurance plan, MCPS coverage
will not be effective.
|
|
Complete MCPS Form
455-20 Employee
Benefit Plan Enrollment. Social security
number is required.
|
|
Send a copy of each
child’s birth certificate to the Employee
and Retiree Service Center.
|
| |
Note:
MUST BE DONE WITHIN 60 days of birth or adoption
of the child(ren), or next Open Enrollment period.
You should receive your updated cards within 30
days by mail.
|
|
Complete MCPS Form
455-20 Employee
Benefit Plan Enrollment, Section VI
|
|
Send the form to
the Employee and Retiree Service Center.
|
|
Complete ERSC Form
514
Optional
Dependent Life Enrollment Form.
|
|
Send the form to
the Employee and Retiree Service Center. |
| |
Note:
MUST BE DONE WITHIN 60 days of birth or adoption
of child(ren) or next Open Enrollment period subject
of evidence of insurability.
|
|
Complete ERSC Form
300
Flexible
Spending Account Election Form.
|
|
Send the form to
the Employee and Retiree Service Center. |
| |
Note:
MUST BE DONE WITHIN 60 days of birth or adoption
of child(ren). Cannot be used for expenses incurred
prior to first contribution date.
|
|
Complete MCPS Form
455-5,
Designation of
Beneficiary/Beneficiaries for the County and Form
MSR004 for the State
Retirement and Pension System of Maryland.
|
|
Send the both forms to
the Employee and Retiree Service Center, 7361
Calhoun Place, Ste 190, Rockville, MD 20855.
|
|
|
|
Keep copies of all
forms. Do not send any original documents, such
as a birth certificate or social security card.
|
|
Don’t forget
to forward copies of the Social Security Cards and
Birth Certificate(s) of your child(ren) to the Employee
and Retiree Service Center.
|
|
Make sure all leave
(short and/or long term) request forms with required
documentation are on file in the Employee and Retiree
Service Center.
|
|
Get some rest. You
deserve it! |
|
|
