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Revised Reciprocal Self-Certification Form

May 16, 2024
Circular Letter: 200-003-24
Topic: Membership

To: All CalPERS Employers

Purpose

The purpose of this Circular Letter is to inform you of the revisions to the Reciprocal Self-Certification Form (CalPERS-1187) (PDF). We have also made updates to the employer reference guides and to the Public Employees’ Pension Reform Act (PEPRA) page on the California Public Employees’ Retirement System (CalPERS) website.

Revised Form

Based on feedback from members and employers, the Reciprocal Self-Certification Form was revised and shortened to help members understand the information being requested and improve accuracy of responses via a question-and-answer format. The information members are required to provide remains the same, including the reciprocal retirement system name and membership details, if applicable. Member instructions on how to complete the form can be found on the PEPRA webpage.

Notable revisions to the form include:

  • Added a new reciprocal retirement system to the List of Qualifying Reciprocal Retirement Systems in California, the City of Delano Retirement Plan
  • Added a question for members to indicate if they are currently a CalPERS member with funds on deposit
  • Clarified requirement of last activity date, instead of separation date, if the individual is a member of the California State Teachers’ Retirement System
  • Removed employer certification section

Reference Guides and Website Updates

The employer State Reference Guide (PDF, 2.8 MB) and Public Agency & Schools Reference Guide (PDF, 2.9 MB) are updated with the new Reciprocal Self-Certification form details and provide improved instructions for processing the form in myCalPERS.

If a member needs assistance with completing the form, advise them to contact CalPERS, or visit the Instructions for Completing the Reciprocal Self-Certification section now available on the PEPRA webpage.

When completing the form, members are instructed to verify the information they are providing on the form with their reciprocal system for accuracy. However, we recommend that you obtain substantiating information from the member regarding their reciprocal membership details to ensure the form is completed properly and thoroughly to allow you to better assist the member with completing the form.

Employer Responsibilities

It is your agency’s responsibility to obtain a completed form from all members enrolled in CalPERS on or after January 1, 2013, and retain the completed form in the employee’s employment records for auditing purposes. When enrolling the member into myCalPERS, you must use the self-certified data on the Reciprocal Self-Certification Form to complete the Reciprocity panel within the appointment which helps determine the member’s enrollment level. Failure to provide and process the form timely and properly may result in financial impacts and adjustments to your agency and the member.

Questions

If you have questions, call our CalPERS Customer Contact Center at 888 CalPERS (or 888-225-7377888-225-7377).

 

Brad Hanson, Interim Division Chief
Employer Account Management Division

Attachment: Reciprocal Self-Certification Form (CalPERS-1187) (PDF)