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

  

 PlanProvider Name / Address Change Marital Status /
Dependent Change 
Beneficiary Change 
Medical,
Dental &
Vision
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 InsuranceStandard 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 LifeComplete Member Information Change Form Update Beneficiaries
Complete Member Information Change Form 

Complete Member Information Change Form
PERS I, II, III
PSERS 
Department of Retirement
Systems 
No further action -
Finance will update 
Update Beneficiaries DRS Beneficiary Designation Form 
W-4IRS No further action Complete W-4 Form Not applicable 
Flexible Spending Account 
(Voluntary)
Navia Benefit SolutionsEmail 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 
(Voluntary) 
MissionSquare (Formerly ICMA)
Log into your account at MissionSquare Retirement.
Follow prompts or call MissionSquare at 800-669-7400.
Empower
(Formerly MassMutual)
Log into your account at Empower
If accessing for the first time, use your SSN as your user name and "108941" as your temporary PIN; or call Empower at 855-756-4738. 
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.