FormsStaff → Benefits

Staff

Benefits
Acknowledgement of Medicare Enrollment Requirements for All Disability Retirees32 K
455-14
Application for Lump Sum (De minimis) Retirement Distribution72 K
455-26
Attending Physician's Statement112 K
455-25
Change in Personal Information for MCPS Employees462 K
445-1A
Designation of Beneficiary/Beneficiaries426 K
455-5
Employee Benefit Plan Enrollment166 K
455-20
Flexible Spending Account Calendar Year 2022 Election87 K
450-3
MCEA Unit Member Moving Pay (Article 21.F) Verification Form82 K
430-52
MCPS Retirement, Section 403(b) Leave Payout Contribution Agreement80 K
455-28
MCPS Retirement, Section 457(b) Leave Payout Contribution Agreement81 K
455-29
Membership Information Montgomery County Public Schools Employee Pension System434 K
455-3
Optional Dependent Term Life Insurance103 K
450-2
Optional Employee Term Life Insurance100 K
450-1
PACS TIMESHEET Lunch/Recess Coverage (SEIU Only)73 K
430-15
PACS TIMESHEET Missed Duty-Free Lunch (MCEA Only)70 K
430-14
Preliminary Application for Disabiity Benefit89 K
455-23
Request for COVID Sick Leave49 K
430-1C
Request for Estimate of Retirement Benefits63 K
455-2A
Request for Leave under the Maryland Healthy Working Families Act811 K
430-1B
Request for Refund of MCPS Prepaid Benefits68 K
455-4
Retiree Benefit Plan Enrollment137 K
455-22
Retiree Benefit Plan Enrollment - FOR NEW RETIREES ONLY182 K
455-22R
Statement of Disability and Medical Release82 K
455-24
Student Debt Relief Fund for SEIU Local 500 Bargaining Unit Members 93 K
442-1
Transfer of Cumulative Sick Leave97 K
430-62