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Beneficiary Changes

Beneficiary designations for final compensation and life insurance can be completed on-line in your MI HR Self-Service account. If you cannot access your MI HR Self-Service account, contact the MI HR Service Center* at 1-877-766-6447.

Please Note: Not all forms are mailed to the same address. Mailing instructions are provided on each form.

  • 401(k) and 457 Plans Beneficiary Designation Form
  • Defined Benefit Retirement Beneficiary Designation Form
  • Life Insurance and Accidental Duty Death Designation Form
  • Final Compensation Beneficiary Designation Form

    Do I need a 401(k)/457 Plan beneficiary form?
    If one or more of the following plans are listed on your earnings statement, or on the beneficiary summary screen under the Beneficiary menu in your MI HR Self-Service account, you need to have a 401(k)/457 Plan beneficiary form on file with CitiStreet.

  • 457 COMBINED AMOUNT & PERCENT DC01
  • 401(K) COMBINED AMT & PERCENT DK21
  • DC RETIREMENT-EE CONT >3% MATCH DZ21
  • STATE DEFINED CONTR 3% MATCH DZ40
  • STATE DEFINED CONTR 4% MAND DZ4S
  • SPL JD DC 401K > MATCH DJ21
  • JD DEFINED CONTR MATCH DJ40
  • JUDICIAL DEFINED CONTR 4% MAND DJ4S
  • HEALTH CONTRIB FOR DC RETIREES RE40
  • 401K LOAN DL31
  • If you are recieving a quarterly statement from CitiStreet.

    * Secretary of State, Attorney General, Legislative, and Judicial employees should contact their agency Human Resource Office for assistance.


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