La Porte Website - Employee Forms

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Benefit Forms

Aetna Medical Forms:
Healthfund Guide
POS 500 Guide
Healthfund 1500 Information
Healthfund 1000 Information
POS 500 Information
Enrollment Form
Flexible Spending Account Enrollment
Flexible Spending Account Claim Form

United Healthcare Dental Forms:
DHMO Information
DPO Information
DPO Added Value to Employee
Enrollment Form

Block Vision Forms:
Gold 172 Plan information
Enrollment Form

ING Long Term Disability Forms:
Enrollment Form
Supplemental Life Enrollment Form
Supplemental Portable Coverage Request

Hartford Voluntary Short Term Disability Forms:
Enrollment Form
Short Term Application

TMRS Forms:
All TMRS forms may be returned to HR
or for forms that do not require certification
they may be faxed to TMRS at 512-476-4476
New Member Form
Change of Address
Refund Form
Electronic Direct Deposit
Non-Vested Change of Beneficiary
Vested Change of Beneficiary
Retirement Packet
Divorce Packet (QDRO)
Prior Service
Military Time

PARS Forms:
Designate Beneficiary
Refund Application

ICMA Forms:
Enrollment Form
Information Change
Request to Withdraw funds

Additional Employee Forms:
Vacation Leave Request

W-4 Tax Form

Direct Deposit Change/Cancel

Employee Handbook Effective March 2009

For Change of Address or name you must complete:
Change of Address and a
TMRS Address Change Form

Educational Reimbursement Form

Fitness Center Benefits

Employee Benefits