The East Dallas Government Center has relocated to 9731 Lake June Road, Dallas, Texas 75217. The former location at 3443 St. Francis Avenue is now closed. We look forward to serving you at the new facility.
DALLAS COUNTY ADOPTED A TAX RATE THAT WILL RAISE MORE TAXES FOR MAINTENANCE AND OPERATIONS THAN LAST YEAR'S TAX RATE.

THE TAX RATE WILL EFFECTIVELY BE RAISED BY 22.02 PERCENT AND WILL RAISE TAXES FOR MAINTENANCE AND OPERATIONS ON A $100,000 HOME BY APPROXIMATELY $29.08.

Employee Benefits

Benefits Forms

Records Building - 500 Elm Street, Suite 4100, Dallas, TX 75202
Phone: (214) 653-6161 • Fax: (214) 653-7608

2027 Benefits Forms

For convenience, these forms are also available in Oracle Fusion.

Click on the icon to download the form(s) to your computer.
BlueCross BlueShield Disabled Dependent Formacrobat icon
Benefits Enrollment Application for PY2027 - Changes Onlyacrobat icon
Certification of Other Comparable Coverage - MEDICAL OPT OUT for PY2027acrobat icon
Life Insurance – The Standard
  • For assistance, contact the HR Benefits Department at 214-653-6161
Grandchild Affidavitacrobat icon
Long Term Disability Formacrobat icon
Spouse Medical Plan Surcharge Affidavit

  • To be completed if you are enrolling your spouse in your employer medical plan (PPO Plan or HDP, including retiree PMD/PSD). If you are NOT enrolling your spouse in your employer medical plan you do not need to complete the electronic submission. If you fail to complete the electronic submission or are late submitting it and you enroll your spouse in your employer medical plan, a $200.00 per month surcharge will be assessed every month until the electronic submission is completed. NO REFUNDS!

    Click here for instructions on submitting a Spouse Medical Plan Surcharge Affidavit
Request for Continued Access to Providersacrobat icon