Beneficiary Designations

It is important to update your beneficiary designations when life changes occur. Not updating your beneficiary designation(s) can cause an unpleasant surprise at a very stressful time in your intended beneficiary's life. For example, if an ex-spouse is still listed as your beneficiary at the time of death, that person may receive benefits that you intended someone else to get upon your death.

Also, please don't forget to update your Emergency Contact information if it has also changed.

Following is information to make the task of updating your beneficiary designations easier:

Final Pay - Designation of Person Authorized to Receive Warrants

The Designation of Person Authorized to Receive Warrants (STD 243)(PDF) is the form you complete to designate your beneficiary to receive any outstanding pay owed to you by Cal Poly Pomona, including settlement pay, vacation, CTO, etc.).

The designation remains in effect throughout your employment with Cal Poly Pomona, unless the designation is superseded by the filing of a new designation. This form is maintained by Payroll Services. Assistance in updating this form is available through the Customer Service Center.

Retirement Plan Beneficiary Designation

Plan Information
Beneficiary Designation Form

California Public Employee's Retirement System (CalPERS)

CalPERS Beneficiary Designation Form

(This multi-part form is used to name a beneficiary to receive any CalPERS death benefits, if you should die before retiring.)

PST (Part-time, Seasonal, Temporary Retirement Plan)


PST Beneficiary Designation

Employer-Paid Group Life & Disability

Plan & Eligibility Information
Beneficiary Designation Form Link

Information on the Employer-Paid Group Life and Disability Insurance (The Standard Insurance Co.)

This designation is updated by the employee directly with Standard Insurance Co.

Employer Paid Life and AD&D Beneficiary Designation and Change Form

Self-Paid Voluntary Insurance Programs

Plan Information
Beneficiary Designation Form Link
Information on the Employee-Paid Voluntary Term Life Insurance (The Standard Insurance Co.) Voluntary Term Life Insurance Beneficiary Designation and Change Forms
Accidental Death & Dismemberment Insurance (Sanders & Associates)

ING Reliastar Beneficiary Designation Form (PDF)

AIG AD&D Beneficiary Form (PDF)

Call 1-800-537-2476, if questions.

Union-Sponsored Life Insurance Programs

Employees may have Union-provided death benefits, generally for those with Union membership status. Check directly with your Union to determine if you need to update a beneficiary designation form for any benefits they provide or that you may have purchased through your Union membership.

Tax-Shelter Annuities (TSAs)

If you contribute to a TSA (403b) Plan, you may need to update your beneficiary designation directly with your TSA Company. View the List of Authorized TSA companies for contact information.

Savings Plus 401(k) Thrift Plan/Savings Plus 457 Deferred Compensation Plan

Beneficiary Designation Forms and instructions:

Credit Union

If you are a member of the Cal Poly Federal Credit Union, please contact them to update your beneficiary designation on file:

Cal Poly Federal Credit Union
3801 W Temple Ave Bldg 35
Pomona, CA 91768
(909) 598-6548
campus ext. 6800
(909) 598-6548 Fax