The forms listed below can be used for retirees to change their information, designate a beneficiary, update insurance benefits, and more.
Use this form to inform ERSRI about your Domestic Partnership or the termination of a Domestic Partnership.
Use this Beneficiary Designation Form to tell ERSRI who you would like to name as your primary and contingent beneficiaries or to make beneficiary updates.
Use IRS form W-4P if you would like to change the amount of federal taxes withheld from your monthly pension payment. Note: ERSRI payees can also update this information using the ERSRI Member Portal.
Use this form if you would like to change the amount of Rhode Island state taxes withheld from your monthly pension payment. Note: ERSRI payees can also update this information using the ERSRI Member Portal.
Use this HARTFORD Life Insurance Beneficiary Designation form if you would like to name a new beneficiary on your HARTFORD life insurance policy. This form must be sent directly to the HARTFORD Insurance address located on the form.
Use this Monthly Notification of Post-Retirement Employment form to report or track the days you’ve worked each month for an employer that participates in ERSRI.
Use this Retiree Healthcare Cancellation form if you no longer wish to receive health care benefits through the state of Rhode Island. This form must be sent directly to the State’s Department of Administration-Office of Employee Benefits at the address located on the form.