City of Riverside, California - Human Resources Benefits

:: Benefit Forms

Anthem Blue Cross Forms

Kaiser Permanente

Delta Dental

Deferred Compensation Forms

Great West Deferred Compensation Forms
Alternate Payee Distribution Form Automated Minimum Distribution Beneficiary Designation Catch-Up Application Form Change Form Death Benefit Claim Form (Benefitted) Distribution/Direct Rollover/Transfer	Electronic Fund Transfer ACH Form Enrollment/Application Form Incoming Transfer/Direct Rollover Loan Payment Change Request Participant Distribution Guide Suitability Profile Unforeseeable Emergency Withdrawal Request
ICMA Deferred Compensation Forms
401(a) Enrollment Form 401(a) Loan Packet 401(a) Plan Change Form 401(a) Withdrawal Packet 457 Co-Provider Transfer Form 457 Enrollment/Change Form 457 Withdrawal Packet Beneficiary Claim Packet Beneficiary Designation Catch-Up Provision Packet	Direct Deposit Emergency Withdrawal Packet Loan Packet Payment Schedule Change 457/401 Service Credit Buyback Packet Special Tax Notice Transfer Out ICMA Transfer To ICMA Transfer Packet W4-P
Public Agency Retirement Services (PARS) Deferred Compensation Forms
PARS Distribution Form	Designation of Beneficiary Form

Leave Forms

Flexible Spending Plan Forms

Life Insurance/Long Term Disability

Retirement

Vision Service Plan (VSP)

QUESTIONS?

Contact the
Human Resources Department

Telephone: (951) 826-5639
Fax: (951) 826-2421
Email: Citybenefits@riversideca.gov

Monday-Friday . . . 8am-5pm PDT