Do you need to change beneficiaries? Add or remove dependents? Update payment information?
Retiree Medical & Dental Plan Change Forms
- For Retirees of Local 88, Non-Represented, ONA, JCSS, IBEW, Physicians, and Painters (pdf)
- For Retirees of MCCDA, DSA, FOPPO, IUOE, and Prosecuting Attorneys (pdf)
Other Required Forms:
- Affidavit of Marriage or Domestic Partnership (pdf)
- Required if adding a spouse/domestic partner