Livingston County Human Resources

Benefit Forms

Adult Child Certification - union groups

Adult Child Certification - non union groups

Blue Cross Blue Shield Change of Status Form

Flexible Spending Account Question & Answers

Flexible Spending Account Worksheet

Flexible Spending Account Enrollment Form

Flexible Spending Account Claim Form

Great West 457 Plan - Employee Change Form

Great West 457 Plan - Employee Name/Address Change

Great West 457 Plan - New Enrollment Form

Health Insurance - Medco Mail Order Rx Form

Life Insurance - Beneficiary Change Form

Life Insurance - Evidence of Insurability Form

MERS Defined Benefit Pension - Address Change/Name Change Form

MERS Defined Benefit Pension - Beneficiary Change Form

MERS Health Care Savings Program - Address Change/Name Change/ Beneficiary Change Forms

MERS Hybrid Pension and Defined Contribution Pension - Address Change/Name Change Form

MERS Hybrid Pension and Defined Contribution Pension - Beneficiary Change Form

Nationwide 457 Plan - Employee Change form

Nationwide 457 Plan - New Enrollment Form

Livingston County Michigan - Human Resources Department
HumanResources@co.livingston.mi.us
Mailing Address - 304 E. Grand River Ave., Suite 205, Howell, MI 48843
Phone 517.546.1010 Fax 517.546.6657

2012 Benefits