Name Change Packet - revised 9-9-19

Individual Required Forms for changing your name:

• Employee Personal Information Change Form
• Emergency Contact and Demographic Form
• Form W-4
• Power School Premier User Account Application - if you currently have access
• Military Location Access - if Base or Post access is required
• Health Plan Waiver of Coverage - only if you are waiving health care benefits
• Beneficiary Change for Life Insurance - you are eligible to change this information at any time.  A qualifying event is not required.

Optional Forms and Documents when changing your name:

• Health Insurance Election Changes - If you are changing elections or adding/deleting dependents, complete a qualifying event request through ESS within 30 days of the qualfying event. Full-time employees who waive insurance must submit a signed Health Plan Waiver of Coverage form.
• Voya Life and Accidental Death and Dismemberment Insurance Enrollment Form -  you are eligible to change this information at any time.  A qualifying life event is not required.
• Beneficiary Designation for Retirement (TRS/PERS) - It is recommended that you complete these forms after a qualifying life event.  A copy of a legal document is required for submission to TRS/PERS when removing your spouse as a beneficiary.
  • If you are a PERS Employee:
    • Entered PERS between 1/1/1961 and 6/30/2006
      • Tier I, II, III employee: 
        http://doa.alaska.gov/drb/pers/index.html#.XAhprBO6NTY
    • Entered PERS after 6/30/2006
      • Tier IV employee:
         http://doa.alaska.gov/drb/dcrp/index.html#.XAhp_hO6NTY
  • If you are a TRS Employee:
    • Entered TRS between 7/1/1955 and 6/30/1990
      • Tier I & II employee: 
        http://doa.alaska.gov/drb/dcrp/index.html#.XAhrjhO6NTY
    • Entered TRS after 6/30/2006
      • Tier III employee: 
        http://doa.alaska.gov/drb/dcrp/index.html#.XAhyTBO6NTY