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Active State Employees Forms

• Active Employee – Online Enrollment – www.yes.az.gov
• University Employee, Where to Enroll
• Same-Sex Domestic Partner Enrollment Form & Instructions
• Same-Sex Domestic Partner’s Child Enrollment Form & Instructions
• Beneficiary Elections Form
• Flexible Spending Account Enrollment Form
• Limited Flexible Spending Account Enrollment Form
• Request to Cancel Same-Sex Domestic Partner Benefits Form
• Transition of Care Form

Retired State Employees Forms

• Retired State Employee – Online Enrollment – www.yes.az.gov
• Retired State Employee - Enrollment Form - Updated November 8, 2011
  Note: Some of the NAU Retiree rates provided on the 2012 Retiree Open Enrollment Form & the Retired State Employees - 2012 Open Enrollment Guide were incorrect. The Guide has been modified. An updated form dated November 8, 2011 has been posted.

• Same-Sex Domestic Partner Enrollment Form & Instructions
• Same-Sex Domestic Partner’s Child Enrollment Form & Instructions
• Beneficiary Elections Form
• Request to Cancel Same-Sex Domestic Partner Benefits Form
• Transition of Care Form

COBRA Participants Forms

• COBRA Participant - Enrollment Form
• Same-Sex Domestic Partner Enrollment Form & Instructions
• Same-Sex Domestic Partner’s Child Enrollment Form & Instructions
• Request to Cancel Same-Sex Domestic Partner Benefits Form
• Transition of Care Form