STATE EMPLOYEES RETIREMENT COMMISSION		55 ELM STREET HARTFORD, CONNECTICUT 06106-1775 TELEPHONE: (860) 702-3480 TELEFAX:(860) 702-3489
MEDICAL EXAMINING BOARD for DISABILITY RETIREMENT
HEALTH CARE COST CONTAINMENT COMMITTEE
	STATE OF CONNECTICUT RETIREMENT AND BENEFIT SERVICES DIVISION OFFICE OF THE STATE COMPTROLLER

RETIREMENT & BENEFIT SERVICES DIVISION MEMORANDUM

June 19, 2000

TO THE HEADS OF ALL STATE AGENCIES

As you are aware, a properly completed Form CO-931, "Designation of Retirement System-Tier-Plan-Beneficiary" is required for all individuals employed by the State of Connecticut with the exception of individuals employed in the following classifications:

The information provided on the CO-931 form is entered to the State Employees Data Base (SEDB) and used by the Retirement & Benefit Services Division to properly identify and track employees retirement plan benefits. The information maintained in the SEDB is also used to identify and track employees group life insurance benefits currently and, as of July 1, 2000, employees deferred compensation and Dependent Care Program (DCAP) benefits. In the future, the SEDB may be used for this purpose for other state employee benefits administered by the Retirement & Benefit Services Division.

Accordingly, the purpose of this memorandum is to advise you that effective July 1, 2000 the receipt of properly completed CO-931 forms is required in order for new employees to participate in group life insurance, deferred compensation and DCAP. Failure to comply with this directive will result in exclusion from the above mentioned benefits programs until such time as the CO-931 form is received in the Retirement & Benefit Services Division.

Additionally, receipt of properly completed CO-931 forms continues to be imperative in order to provide accurate retirement benefit information for annual employee benefit statements and actuarial purposes.

Instructions for completion of CO-931 forms were provided with the Retirement & Benefit Services Division memorandum dated August 13, 1998. Please refer to these instructions for completion of these forms.

All completed CO-931 forms should be forwarded to the Retirement & Benefit Services Divisions Data Base Unit 55, Elm Street, Hartford, Connecticut 06106.

If you have questions regarding the completion of CO-931 forms or need a copy of the instructions for completion of these forms, you should contact the Data Base Unit at (860) 702-3515. However, please do not refer individual employees to this number.

Very truly yours,

STATE EMPLOYEES RETIREMENT COMMISSION

NANCY WYMAN, SECRETARY EX OFFICIO

BY:

Steven Weinberger, Director

Retirement & Benefit Services Division

SW/JK

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