ARE YOUR DEPENDENTS FOR INSURANCE COVERAGE AND
BENEFICIARY DESIGNATIONS IN ORDER?

We want to be sure that you are aware of the processes in place for changing your dependent coverage and beneficiary designations. We hope the following information will be helpful.

Insurance Coverage For New Dependents

In the event of marriage, birth of a child, adoption, return to school, or other life event, you must add eligible dependents to your insurance coverage within 31 days of the event. Failure to add the dependent(s) within the required 31 day time period will result in your having to wait until the next open enrollment period to initiate coverage. Appropriate documentation (i.e., marriage certificate, birth certificate, adoption papers, proof of enrollment in school) must be provided to the MI HR Service Center whenever a dependent is added. (Secretary of State and Attorney General Employees should submit documentation to their respective HR Office.) If appropriate documentation is not provided, coverage will be revoked.

If you experience a family status change such as a divorce or spouse’s loss of employment (if they previously carried insurance benefits for your family), you may be eligible to elect or change insurance coverage outside of the open enrollment period provided that such election is made within 31 days of the event that caused the status change.

Beneficiary Designations

Defined Benefit Retirement Plan (This plan is limited to all vested employees hired prior to March 31, 1997, unless the employee elected to transfer to the Defined Contribution Plan.)

1.	You may designate a spouse, child, parent, brother, sister, or grandchild to receive your retirement benefit in the event of your death prior to retirement. If you are married and no designation is on file, the monthly retirement benefit will automatically go to your spouse. However, it is recommended that you file a beneficiary designation form with the Office of Retirement Services even if you are naming your spouse as the beneficiary.
2.	If you are unmarried and do not have a beneficiary designation form on file, upon your death your monthly retirement benefit will be paid to your dependent children but will stop when your youngest child reaches age 18. If you have no dependent children under age 18, no retirement benefit will be payable. In order for a child or other eligible family member to receive lifetime benefits, it is imperative that you file a Defined Benefit Beneficiary Designation form with the Office of Retirement Services.
3.	When designating a defined benefit beneficiary, you may designate only one person to receive your retirement benefits (i.e., you cannot list several children, or more than one person.)
4.	If you are married and wish to name someone other than your spouse as your beneficiary, your spouse must sign off on the beneficiary designation form.

If you are unsure of your current beneficiary designation, you may contact the Office of Retirement Services (ORS) at ORSCustomerService@michigan.gov or 800-381-5111 to learn that information or you may simply submit a new beneficiary designation form.

Defined Benefit Plan beneficiary designation forms are available through MI HR Self-Service under “Employee”, “Benefits”, “Beneficiary”, “Print Beneficiary Forms”, then click on form “R400G” (Defined Benefit form). Forms are also available from the ORS website at http://www.michigan.gov/ors. Mail the completed form to the Office of Retirement Services at the address at the top of the form.

Defined Contribution Retirement Plan/Deferred Compensation 401(k) & 457
Forms to change beneficiary designations for the Defined Contribution Retirement Plan, 401(k) or 457 deferred compensation plans are available via MI HR Self-Service or you may contact CitiStreet at 800-748-6128. To obtain a form via Self-Service, click on “Employee”, “Benefits”, “Beneficiary”, “Print Beneficiary Forms”, “CitiStreet 457”. Forms must be mailed directly to CitiStreet at the address on the form.

Final Compensation, Life Insurance, Accidental Duty Death Insurance
Beneficiaries may be designated on-line in self-service, or by completing forms available from your office of human resources or the Civil Service website under MDCS Forms. To enter beneficiaries in Self-Service, go to “Employee”, “Benefits”, “Beneficiaries.” Beneficiary designations entered online will replace those previously filed on paper. If you elect to file a paper form, it must be submitted to your office of human resources.

Accidental Death & Dismemberment Insurance
Forms are available on the Department of Civil Service website at: http://www.jcwalters.com/som.html, user name = som, pswd = state. Then, click on the “Forms” button at the top of the page. Forms are also available from your Office of Human Resources. The completed form must be returned to your Office of Human Resources.

Please contact your human resources representative or the MI HR Service Center, if you have any questions.

MI HR Service Center
Phone: 877-766-6447
TDD 517-241-8046
7:00am to 6:00pm Monday - Friday, except holidays
FAX: 517-241-5892
P.O. Box 30002
Lansing MI 48909