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Employer Forms

Whether you're enrolling a new employee, ready to sign adoption or participation agreements, updating contact information or much more, you'll find all our Employer Forms here. Click the links on the left to view the forms specific to your MERS program. To view a list of all our MERS forms, click here.

Form #

Name

Product

Audience

1	Membership Agreement	Defined Contribution Plan, Hybrid Plan,	Employer
2a	Employee Prorated Prior Service Agreement	Defined Benefit	Employer
3	Prior Service Credit - The Prospective MERS Municipality	Defined Benefit	Employer
5	Membership Application	Defined Benefit	Employer, Employee
6	Restated Initial Actuarial Valuation and Supplemental Valuation Procedure	Defined Benefit	Employer
7	Restated Fee Schedule for Initial Actuarial Valuations and for Supplemental Actuarial Valuations	Defined Benefit	Employer
8	Special Annual Expense Charges Procedure	Defined Benefit	Employer
9	MERS Statement on Modification of Standard Benefit Programs	Defined Benefit	Employer
10	Transfer Of Contributions Within MERS Defined Benefit Plan (excluding Hybrid Benefit Program DB Component)	Defined Benefit	Employer
11	Request for Initial Actuarial Valuation	Defined Benefit	Employer
12	MERS Initial Valuations: Important Comments	Defined Benefit	Employer
13a	Request for Supplemental Valuation	Defined Benefit	Employer
13b	Request for Projection Study	Defined Benefit	Employer
14a	MERS Supplemental Valuations: Important Comments	Defined Benefit	Employer
15	Request for Valuation of Temporary Benefit Program (Window)	Defined Benefit	Employer
16	MERS Window Valuations: Important Comments	Defined Benefit	Employer
17	Employee Census	Defined Benefit	Employer
19	Uniform Resolution Defining Hours Per Month for Part-Time Employees and Service Credit Conversion Upon Promotion to Full-Time Status	Defined benefit	Employer
51	Application for Disability Retirement	Defined Benefit, Disability	Employer, Employee
53	Physician's Statement	Defined Benefit, Disability	Employer, Employee
54	Psychiatric Medical Report	Defined Benefit, Disability	Employer, Employee
69	Revised Uniform Defined Contribution Program Resolution	Defined Contribution	Employer
70	Uniform Defined Contribution Program Adoption Agreement	Defined Contribution	Employer
76	MERS Participating Municipalities	Defined Benefit, Defined Contribution, Hybrid	Employer, Employee
77	Reciprocal Retirement Act (“Act 88”) - Adopting Units	Defined Benefit, Defined Contribution, Hybrid	Employer, Employee
79	Resolution adopting Act 88	Defined Benefit, Defined Contribution, Hybrid	Employer
82	Resolution Adopting Benefit Program PRO (Post-Retirement Option)	Defined Benefit	Employer
85	Customer Contact	Defined Contribution Plan, Health Care Savings Program, 457	Employer
86	MERS Enforcement Procedure for Prompt Reporting and Payment	Defined Benefit, Hybrid	Employer
90	Restated Policy for Closed Groups	Defined Benefit, Hybrid	Employer
91	Amortization Policy for Closed Divisions Within Open Municipalities	Defined Benefit, Hybrid	Employer
94	Employer Resolution Establishing Uniform Transfer Provision	Defined Benefit, Defined Contribution, Hybrid	Employer
MD-043	MERS Uniform Hybrid Program (Benefit Prog H) Resolution	Hybrid	Employer
MD-044	MERS Uniform Hybrid DC Component Adoption Agreement	Hybrid	Employer
MD-070	MERS Restated Defined Contribution Plan Adoption Agreement	Defined Contribution, Hybrid	Employer
MD-071	MERS Loan Addendum	Defined Contribution	Employer
MD-072	MERS Loan Procedures	Defined Contribution	Employer
MD-469	457 Uniform Resolution	457	Employer
MD-470	457 Participation Agreement	457	Employer
MD-471	457 Loan Addendum	457	Employer
MD-472	457 Loan Adoption Procedures	457	Employer
MD-473	457 Employer Contribution Addendum to Participation Agreement	457	Employer
MD-474	457 Eligible Automatic Contribution Arrangement Addendum to Participation Agreement (EACA)	457	Employer
2160	Proposal Process & Data Checklist	Group Life & Disability Insurance	Employer
None	Defined Contribution Enrollment Kit	Defined Contribution	Employer
None	Wire and ACH Instructions	Defined Contribution	Employer
MD-400	457 Program Enrollment Kit	457	Employer
None	Plan Document	457	Employer
None	Hybrid Enrollment Kit	Hybrid	Employer
None	Health Care Savings Program Enrollment Kit	Health Care Savings Program	Employer
None	HCSP & RHFV Restated MERS Trust Agreement	Health Care Savings Program, Retiree Health Funding Vehicle	Employer
None	HCSP & RHFV Plan Document	Health Care Savings Program, Retiree Health Funding Vehicle	Employer
MD-169	HCSP Uniform Resolution	Health Care Savings Program	Employer
MD-170	HCSP Participation Agreement	Health Care Savings Program	Employer
None	Wire and ACH Instructions	Health Care Savings Program, Retiree Health Funding Vehicle, Investment Services Program	Employer
RH-669	RHFV Uniform Resolution	Retiree Health Funding Vehicle	Employer
RH-610	Retiree Health Funding Vehicle Direct Deposit Agreement	Retiree Health Funding Vehicle	Employer
None	Life Insurance Enrollment and Change	Group Life & Disability Insurance	Employer
None	Medical History Statement	Group Life & Disability Insurance	Employer
None	Application for Group Insurance with 25 Employees or Over	Group Life & Disability Insurance	Employer
None	Application for Group Insurance with Under 25 Employees	Group Life & Disability Insurance	Employer
None	Life Insurance Benefits Claim Packet	Group Life & Disability Insurance	Employer
None	Accelerated Benefit Claim Packet	Group Life & Disability Insurance	Employer
None	Waiver of Premium Claim Packet	Group Life & Disability Insurance	Employer
None	Life Insurance Portability Form	Group Life & Disability Insurance	Employer
None	Request for Life Conversion Materials	Group Life & Disability Insurance	Employer
None	Disability Claim Packet	Group Life & Disability Insurance	Employer
None	Accidental Dismemberment Claim Packet	Group Life & Disability Insurance	Employer
DB-001a	Administrative Order Adopting The Municipal Employees' Retirement System Defined Benefit Plan	Defined Benefit	Employer
DB-001b	Resolution Adopting The Municipal Employees' Retirement System Defined Benefit Plan	Defined Benefit	Employer
DB-002	Defined Benefit Adoption Agreement	Defined Benefit	Employer