580 Taylor Ave. A-1
Annapolis, MD 21401
Please notify HR as far in advance of your last day as possible. This will ensure that you are paid correctly and your benefits are stopped accurately.
Complete the LC separation form.
- The Judge’s chambers will complete the top part and enter your separation date.
- You as the LC will complete the middle section
- As indicated on the form if this is a new address, please submit address change forms along with your form.
- If you move at any time during the rest of the current year, please submit an address change form for CPB so your W-2, earning statement, will be mailed to the correct location in January of the following year.
- Remember all original forms need to be returned to HR.
I am transferring to another State agency
- Please let HR know if you plan to transfer to another State agency
- It will effect your benefits if we remove you from payroll; you would have to reapply for them and this could take another 4 weeks.
- Ask the human resources representative from the new agency to call our office.
When will my health benefits end?
- Any health benefits will continue through the end of the time period covered by the last premium deduction -- Benefit deductions chart
- Either the 15th or last day of the month.
- See page 17 in your health benefits booklet.
When will I receive information regarding COBRA?
- Once HR informs DBM - Health Benefits of your last day of employment, they will mail the information out to your address of record.
- See pages 61- 64 of your health benefits booklet for detailed information regarding COBRA.