Forms for Active Employees

• Automatic Withdrawal Cancellation of Insurance Premiums - ERS GI 2.945
• Choose to Quit Certification Form - ERS 2.958
• Dependent Child Certification - ERS GI-1.081
• Disability Retirement Packet - ERS 2.11
• Request or Renew Health Coverage for a Disabled Dependent Child - ERS 2.654
• Securian/Minnesota Life
• Tobacco Use Certification Form - ERS 2.933
• Verification of Insurance - ERS 2.837
• Verification of Optional Retirement Program Participation - ERS 2.613