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BALTIMORE COUNTY PUBLIC SCHOOLS RETIREE BENEFITS ENROLLMENT/CHANGE APPLICATION 87 PLEASE PRINT RETURN COMPLETED FORM TO: Baltimore County Public Schools, Office of Retiree Benefits 6901 N. Charles

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How to fill out bcps retirees39 enrollmentchange form

How to fill out the BCPS Retirees' Enrollment Change Form:

01

Start by downloading or obtaining a copy of the BCPS Retirees' Enrollment Change Form. This form is usually available on the BCPS website or through your retirement benefits administrator.

02

Begin by filling out personal information details on the form. This may include your full name, date of birth, social security number, and contact information. Ensure that all the information provided is accurate and up-to-date.

03

Indicate the type of enrollment change you want to make. This can include adding or removing dependents, changing healthcare plans, updating contact information, or any other changes related to your retirement benefits.

04

Provide the necessary information regarding the changes you want to make. For example, if you are adding a dependent, include their full name, date of birth, and relationship to you. If you are changing healthcare plans, specify which plan you wish to switch to and provide any required supporting documentation.

05

Review the form for completeness and accuracy. Double-check all the information you have provided to ensure that it is correct and matches any supporting documentation you may be including.

06

Sign and date the form. This confirms that you have provided accurate information and that you authorize the requested enrollment change.

07

Submit the completed form as per the instructions provided. This may involve mailing it to the appropriate BCPS office or submitting it electronically through an online portal. Be sure to follow the designated submission method to ensure that your enrollment change request is processed promptly.

Who needs the BCPS Retirees' Enrollment Change Form?

The BCPS Retirees' Enrollment Change Form is specifically designed for retired employees of BCPS (Baltimore County Public Schools) who wish to make changes to their healthcare or retirement benefits enrollment. Any retired BCPS employee who wants to add or remove dependents, update personal information, or change healthcare plans will need to complete this form. It is essential to keep these benefits up to date and in line with any changes in personal circumstances.

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