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Enrollment Forms
The forms and brochures below are provided as PDF documents for completion and printing. The documents will open in an Adobe Acrobat Reader window. Physically sign all forms give to the campus Benefits Administrator. Remember to keep copies of the forms.
Enrollment in the ORP is effective on the first day of the pay period following receipt of all completed enrollment forms by your college's Benefits Administrator. This is also the insurance start date for group life and long-term disability insurances.
Forms to Complete
- Insurance Enrollment and Beneficiary Change Form (.PDF)
- ORP Enrollment/Change Form (.PDF)
- Notice on Social Security: Form SSA-1945 (.PDF)
- Request for Return of Accumulated Deductions Form (also called the SERS Request for Withdrawal Form, which is required if assets will be transferred from the SERS to the new ORP account. SERS funds may be transferred at any time.) (.PDF)
The ORP legislation allows for two to four Providers, which the Board of Higher Education is responsible for overseeing.
Participants must also select a Provider using the application links below or the enrollment kits from the campus Benefits Administrator. The enrollment kits contain detailed information about the Providers’ ORP accounts; investments; expenses; fees and services.
Contact the college Benefits Administrator or the ORP Plan Administrator with questions.
Related Links
ORP information for campus benefits administrators [For Institutions]