Forms

In order to ensure the timely processing of your request, please read the entire form and instructions before completing and return the completed form to the address indicated. Forms that are not received in “good order” will be returned.

Enrollment

Enrollment can now be completed online. For more information on enrollment eligibility and to get started, please refer to the Enrollment section of this website.

As part of the online enrollment process, you will need to designate a beneficiary to ensure that death benefits under the Plan are paid to the individual(s) of your choice.

Once enrolled, you should periodically review your plan beneficiary designation(s) and determine whether any changes are appropriate. This is especially true if you have a life change event (e.g., marriage, birth of a child, divorce or death). You can review/edit your beneficiary designations online if you register for online account access.

It is important to note that with respect to the beneficiary(ies) you have designated:

If you have a change in status, your designation is not necessarily updated automatically. For example, depending on the governing state law, if your spouse is your beneficiary and you get divorced, your ex-spouse may remain your Plan beneficiary until you make a change to your designation.
The beneficiary you designate under the Plan is separate from any designation you may have made under the City’s pension plan or group life coverage.

If you are designating a Trust as a beneficiary, an Affidavit of Trust is required to be completed and included with your beneficiary designation form.

If you do not designate a beneficiary under the 457 Plan, in the event of your death, benefits will be paid to your estate. Please refer to the 457 Plan Overview section of this website for specifics.

Other Forms

PARTICIPATION AGREEMENT FORM – FINAL PAYCHECK ONLY – This form should be returned to your Human Resources Department.

Catch-up FAQ’s, Instructions and Application – This form provides information on the catch-up elections available under the plan.

Incoming Rollover Acknowledgement Form – In order to rollover benefits into the Plan, the City requires that you complete an Acknowledgment Form. If you are rolling assets into your Voya plan account, you will need to complete a Voya form as well. We have a team of rollover specialists available to assist you with the exchange/rollover process. Please contact your local Voya representative.

Qualified Domestic Relations Order – The procedures that will be used for processing Qualified Domestic Relations Orders and a sample order.

Unforeseeable Emergency Withdrawal Request / Voya Participant – A participant must call the Customer Service at (800) 584-6001 and speak with a CSA who will provide the withdrawal request package. For the eligible reasons If a participant experiences a financial hardship that cannot be relieved by other financial means (insurance, liquidation of assets, and cessation of deferrals into the Plan) and meets the requirements of the Internal Revenue Code and the Plan, a request for withdrawal under this option may be authorized.