Employee Status Changes

Status Changes
Change in Marital Status? Name? New Baby? Child no longer a dependent? New address?
These changes affect your benefits and failure to notify Human Resources could result in payments by you for ineligible services. Marital or dependent status changes must be submitted to Human Resources within 30 days of the qualifying event.

Notifying Human Resources
Step 1: Complete an Name/Address/Phone/Emergency Contact Change Form OR for all other changes a Notice of Change to Benefits Form. 
Step 2: Locate your group below and identify any additional action required. 
Step 3: Return all completed forms to Human Resources.
  1. Master
  2. Local 17
  3. WSNA
  4. Deputy Sheriff's Guild
  5. IBU
  6. Corrections Deputies
  7. Unrepresented
 Plan Provider  Name / Address Change  Marital Status /
Dependent Change 
Beneficiary Change 
Dental &
Teamsters  Contact Teamsters at 360-734-7780 or log into your account  Complete Participant Data Form if adding spouse or dependent  

Notify your HR Rep if dropping a spouse/dependent.
Not applicable
Life Insurance Standard Life  No further action -
HR will update 
Update Beneficiaries - if enrolled in additional Voluntary life insurance complete Enrollment/Change Form  Standard Life
Beneficiary Designation Form
Life Insurance  Teamsters Life Complete Member Information Change Form  Update Beneficiaries
Complete Member Information Change Form 

Complete Member Information Change Form
Department of Retirement
No further action -
Finance will update 
Update Beneficiaries  DRS Beneficiary Designation Form 
W-4 IRS  No further action  Complete W-4 Form  Not applicable 
Flexible Spending Account 
Navia Benefit Solutions Email or call
800-669-3539 or update on your next claim form 
Complete Flex-Plan
Change in Status Form
Not applicable 
Deferred Compensation
457 Account 
ICMA  Log into your account at ICMA Retirement Services.
Select "Personal Information" under the "Manage my Account" tab, follow prompts or call ICMA at 800-669-7400.
Mass Mutual/Hartford Log into your account at MassMutual Retirement Services
If accessing for the first time, use your SSN as your user name and "108941" as your temporary PIN; or call Mass Mutual / Hartford at 800-528-9009. 
Health Savings Account
(Voluntary for QHDHP Plan only)
 Optum Bank  Log into your account at Optum Bank.
 Select "Profile Summary" under your name at the top, follow prompts or call Optum at 877-470-1771.