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Insurance Enrollment & Change Forms

Medical Forms:

  • AFLAC Enrollment Form
  • AWC Change of Address Form (PDF)
  • AWC Enrollment Form (PDF)
  • AWC Life Insurance and Beneficiary Change Form
  • Decision Point 457 (b) Enrollment Form
  • Decision Point 457 (b) Elective Deferral Change Form
  • Decision Point 457 (b) Investment Option Performance  
  • Decision Point 457 (b) Services & FAQ's
  • DRS Name/Address Change Form
  • DRS DCP Beneficiary Change From
  • DRS DCP Enrollment Guide
  • DRS DCP Quick Enrollment Form
  • DRS PERS Plan Choice Booklet
  • Health Benefit Summary: DEA Employees
  • Health Benefit Summary: EXEMPT Employees
  • Health Benefit Summary: Fire Employees
  • Health Benefit Summary: Police Employees
  • HSA Direct Deposit Authorization
  • ICMA 457 Enrollment Book
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  • ICMA 457 (b) Contribution Change Form
  • LEOFF Plan 2 Booklet
  • LEOFF 2 Enrollment Form
  • Waiver of Insurance
  • W-4 2021
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City of DuPont

  1. 1700 Civic Drive
    DuPont, WA 98327

    Phone: 253-964-8121

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