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Log in to Account to submit:
To designate or re-designate your beneficiary, return this
completed form to
When you are within 60 days of your chosen retirement date, you may complete and submit an ACERA retirement application. Get detailed instructions here.
Use this form to enroll in an ACERA dental plan.
Use this form to enroll in all ACERA medical plans except for individual plans through Via Benefits and individual Kaiser Permanente plans outside of California.
Use this form for ask ACERA to calculate the cost of purchasing eligible time as service credit. Learn more about service credit on our service credit page.
Prior to submitting reimbursements, read Making
Your Via Benefits Medicare Reimbursements Easier for how to
set up recurring reimbursements and other helpful information.
Then visit https://my.viabenefits.com/acera
to file reimbursement claims for healthcare expenses in Via
Benefits healthcare plans.
Click here to report a death.
Use the IRS Tax Withholding Estimator to calculate your withholding. It works really well.
Note: ACERA does not allow you to withhold a flat amount with no allowances. This means you MUST enter a number in the Allowances box (box 2).
Use this form to enroll in an ACERA vision plan.
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