Benefits Forms

• FSA Claims Information

Lincoln Financial

• Lincoln Financial Disability Evidence of Insurability Form
• Lincoln Financial Disability Claim Form
• Lincoln Financial Disability Enrollment Form

The Standard

• The Standard Enrollment/Change Form
• The Standard Medical Statement Form
• The Standard Disability Claim Packet

MetLife

• MetLife Dental Domestic Partner Enrollment Form
• MetLife Dental Affidavit of Domestic Partner

Mandatory and supplemental retirement elections are managed electronically through ConnectCarolina. To enroll, terminate or submit changes to your mandatory and/or supplemental retirement plans:

1. Log in to ConnectCarolina
2. Choose Self Service from the drop-down menu at the top
3. Choose the My Benefits tile
4. Choose Benefits Enrollment on the left
5. Select Mandatory Retirement Plan OR Supplemental Retirement Plans

If you want to retire from TSERS or the ORP, please send an email to benefits@unc.edu indicating your name and PID. You can request that a Benefits Consultant reach out to you.

There may be times that you have to obtain forms directly from the benefit plan vendor. Here are links to certain vendor websites:

• NCFlex Benefit Plan Forms
• Teachers’ and State Employees’ Retirement System Forms
• State Health Plan of North Carolina