The following are some events that you may experience during your employment with ACPS, and instructions on how to make changes to your benefits and other information if applicable. Changes to benefits must be completed within 30 days of the life event. A more complete list of approved events and documentation required is available in the Benefits Summary document.
If you wish to make changes to your benefits but have not experienced a qualifying event, you may request the changes during the annual Open Enrollment period (typically held in May), with an effective date of July 1.
Links to the forms are available at http://www.acps.k12.va.us/hr/benefits/forms.php.
|Relocation/Change of Address||Logon to ESS or submit the Personnel Information Change Form to Human Resources.
VRS members must update addresses directly with Virginia Retirement System online at https://myvrs.varetire.org/login/ or by phone at 1-888-827-3847.
|Personnel Information Change Form|
|Marriage - you must provide a copy of the marriage license and evidence of a shared household such as a utility bill with both names (benefit changes must be made within 30 days of event date).||Complete Personnel Information Change Form (for name/address changes) and benefits forms, and submit to Human Resources.||Personnel Information Change Form, Benefits Enrollment Form, Beneficiary Forms (VRS and Principal), Tax Form (Maryland, Virginia, DC), Optional Life Enrollment Form|
|Divorce - you must submit a copy of the divorce decree to Human Resources in order to make changes to your benefits (benefit changes must be completed within 30 days of event date).||Complete Personnel Information Change Form (for name/address changes) and benefits forms, submit to Human Resources||Personnel Information Change Form, Benefits Enrollment Form, Beneficiary Form (VRS and Principal), Tax Form ( Maryland, Virginia, DC), Optional Life Enrollment Form|
|Birth/Adoption - benefits changes must be completed within 30 days of the date of birth/adoption. Dependent verification is required.||Make changes to your benefits enrollment, beneficiaries, taxes, and optional life insurance.||FMLA form (submitted 30 days prior to birth), Benefits Enrollment Form, Beneficiary Form (VRS and Principal), Tax Form ( Maryland, Virginia, DC), Optional Life Enrollment Form|
|Loss of Coverage||You may enroll with ACPS benefits within 30 days of the loss of previous coverage. Complete the Benefits Enrollment Form and submit to Human Resources with proof of the loss of prior coverage.||Benefits Enrollment Form, FSA Enrollment Form|
|Eligible for Coverage - You may become eligible for ACPS benefits due to a change in position (moving from part to full time, for instance). You must enroll in ACPS benefits within 30 days.||Enroll in benefits - see Forms.||Benefits Enrollment Form, FSA Enrollment Form, Beneficiary Designation Form (VRS and Principal), Optional Life (VRS) Enrollment/Waiver Form (Minnesota Life), Optional Life Evidence of Insurability Form, Long Term Disability Buy-Down Enrollment/Waiver Form (Madison National Life), Long Term Disability Buy-Down Evidence of Insurability Form|
|Leave - eligible employees may request Family and Medical Leave. There are other types of leave available.||Complete and submit the FMLA form to Human Resources 30 days prior to the commencement of leave. If requesting a Leave of Absence or similar long term leave, send an e-mail to .||FMLA - Personal Illness, FMLA - Family Illness, FMLA - Care for Service Member|
|Long Term Disability||You may apply for Long Term Disability after the elimination period.||LTD Employee Statement, LTD Physician Statement|
|Death - The death of an employee or a family member may require changes in areas such as benefits enrollment, beneficiaries, taxes, and optional life insurance.||Please contact Human Resources at 703-619-8010 or e-mail for assistance with this process.||Benefits Enrollment Form, Beneficiary Form (VRS and Principal), Tax Form (Maryland, Virginia, DC), Optional Life Enrollment Form, Virginia Retirement System, Principal Financial Group|
|Termination of Employment||For details, see Separation of Employment||Personnel Information Change Form, Sick Leave Termination Options Form|