Empower 401k Plans

• 401k Plan Highlights
• 401k Beneficiary Designation Form
• 401k Address & Name Change Form
• 401k Goalmaker Election Form
• 401k Request for Disbursement
• 401k Request for Hardship Form
• 401k Service Credit Purchase Form

Empower 457  Plans

• 457 Plan Highlights
• 457 Beneficiary Designation Form
• 457 Address & Name Change Form
• 457 Request for Disbursement
• 457 Service Credit Purchase Form
• 457 Instructions for Rollover Pre-Approval
• Retire-Termination Brochure

• 457(b) Deferred Compensation Plan Information

AFLAC Supplemental Insurance

• AFLAC Cancellation Form

County – Health, Dental, Vision, Rates, Hartford Life

• Health, Dental and Vision Enrollment Form/Change Form
• Health Equity HSA Form
• Cigna Dental Claim Form
• UNUM Life Insurance – County Enrollment & Change Form
• Life Insurance Overview

FSA-COBRA- The Employers Association

• FSA and DCA Claim Form
• FSA and DCA Status Change Form 2020
• TEA Flexible Spending Brochure
• TEA COBRA Notification of New Hire or Qual Event Notice

Hartford Supplemental Life

• County Benefit Hartford Life Conversion
• Hartford Life Supplemental Form
• Hartford Supplemental PHA
• Hartford Supplemental Portability Life Form

General Forms

• Employment Expectations
• Pay Codes, Benefit Codes and Deduction Codes

NC Association of Rescue and EMS

• NC Rescue Scholarships
• North Carolina Association of Rescue and EMS Information

NC Retirement and Firemen’s and Rescue Squad Pension Forms

• Designating Beneficiary for Retirement Sys Refund of Contributions & Death Benefit – Form 2FR
• Firemen’s and Rescue Squad Workers Pension Beneficiary Form
• Retirement Benefits Handbook

Other Agency Forms

• Funeral Announcement
• Dedicated Coverage Form