Browse the most current versions of the insurance and retirement benefits forms.

Insurance

Accounting

Affordable Care Act (ACA)

COBRA

Dental care

Employer

Health insurance

Life insurance

Long term disability

MoneyPlus

Notice of election

Other forms

Prescription benefits

Vision care

Retirement

1000 Series

  • 1100 Enrollment Form (All Systems)
  • 1102 Beneficiary Form - Beneficiary Designation, Contingent Beneficiary (All Systems)
  • 1103 Beneficiary/Trustee Designation Form (All Systems)
  • 1104 Election of Non-Membership
  • 1106 State Optional Retirement Program (ORP) Active Incidental Death Benefit Beneficiary Form (South Carolina Retirement System)
  • 1107 Employer Certification of Police Officers Retirement System (PORS) Eligibility
  • 1113 Certification of Trust (All Systems)
  • 1162 State Optional Retirement Program (State ORP) Notice of Termination or Change
  • 1221 Standard Retirement Quarterly Report (South Carolina Retirement System, Police Officers Retirement System)
  • 1222 Standard Retirement Quarterly Report - Class I Employer (South Carolina Retirement System, Police Officers Retirement System)
  • 1223 Adjustment to Quarterly Payroll Report (South Carolina Retirement System, Police Officers Retirement System)
  • 1224 Supplemental Service Report (South Carolina Retirement System, Police Officers Retirement System)
  • 1226 ACH Debit Authorization
  • 1227 Supplemental Contribution Report
  • 1239 Name/Address Change Form
  • 1286 EES Electronic Payment Authorization Agreement
  • 1340 Fiscal Year Contribution Rates
  • 1341 Due Date Calendar

2000 Series

  • 2101 Request for Service Purchase Cost (All Systems)
  • 2122 Request for Public/Educational Service Verification
  • 2130 Request for ORP Service Verification (Applies to ORP service in South Carolina only.)
  • 2140 General Assembly Retirement System Special Contributing Member Election
  • 2209 Service Purchase Salary Verification
  • 2390 Service Purchase Payment Options (All Systems)
  • 2391 Service Purchase Federal Address List

3000 Series

  • 3227A Requirements for a Participant to Revoke Election to Participate
  • 3228 Employer Resolution on Tax Deferred Payroll Deductions for Installment Purchase
  • 3229 Installment Service Purchase Remittance

4000 Series

  • 4101 Refund Request (South Carolina Retirement System, Police Officers Retirement System)
  • 4257 Certification of Nonexistent Trust (All Systems)

6000 Series

  • 6100 Request for Retirement Benefit Estimate (All Systems)
  • 6101G General Assembly Retirement System Application for Service Retirement Benefits
  • 6101J Judges and Solicitors' Retirement System Application for Service Retirement Benefits
  • 6101N SCNG Service Retirement Application
  • 6101P Police Officers Retirement System Application for Service Retirement Benefits
  • 6101S South Carolina Retirement System Application for Service Retirement Benefits
  • 6151P Police Officers Retirement System Application for Disability Retirement
  • 6151S South Carolina Retirement System Application for Disability Retirement
  • 6251 Member's Disability Report
  • 6253 Employer's Disability Employment Status Report
  • 6254 Employer's Description of Disability Applicant's Job
  • 6255 Authorization for Release of Information
  • 6291 Administrative Appeal Disability Report
  • 6302 Retiring Member's Service Application Checklist
  • 6352 Retiring Member's Disability Applications Checklist
  • 6500 Employer Eligibility Determination Request
  • 6501 Employer Resolution and Application (SCRS)
  • 6501P Employer Resolution and Application (PORS)
  • 6502 Application to Append Coverage for Incidental Death Benefit (SCRS)
  • 6502P Application to Append Coverage for Incidental Death Benefit, Accidental Death Program and/or Firefighters Coverage (PORS)
  • 6503 Electronic Employer Services (EES) Employer Confidentiality Agreement
  • 6504 Electronic Employer Services (EES) Authorizing Contact Designation/Agreement
  • 6505 Electronic Employer Services (EES) Designated Agent Confidentiality Agreement

7000 Series

  • 7100 48-Month Rule Request to Terminate Benefits and Return to Active Service
  • 7101 Request for 48-Month Rule Eligibility
  • 7201 Retired Member Change of Beneficiary (South Carolina Retirement System, Police Officers Retirement System)
  • 7201G Retired Member Change of Beneficiary Form (GARS)
  • 7202 Withholding Certificate for Monthly Benefit Payments
  • 7204 Direct Deposit Authorization
  • 7213 Authorized Representative Form
  • 7214 School Resource Officer Critical Needs Certification
  • 7217 Termination of Retired Member Working Under Earnings Limit
  • 7218 12-Month Break-in-Service Exemption Certification
  • 7500 Teacher and Employee Retention Incentive (TERI) Payout Election Form
  • 7700 Deduction Form, Public Safety Officer Insurance Payment Program - EIP Only
  • 7701 Deduction Form, Public Safety Officer Insurance Payment Program - Non-EIP
  • 7800 Deferred benefit Account (JSRS) Payout Form

Death

Employer

Enrollment

GARS

Installment

JSRS

Leaving covered employment

PORS

Public safety

Refund

Retirement - disability

Retirement - service

Returning to covered employment

SCRS

Service purchase

State ORP

Trust certification