Instructions:

Welcome to the World Bank Group HR Forms Instructions page.

This form filler tool is designed to assist you in electronically entering your data and printing a paper form with a unique barcode corresponding to your entered data. Once you've completed your answers and printed the form, you'll need to submit it either by email or in person, depending on the form type.  Please note that the data you enter is directly captured in the form's unique barcode, so it's important that you do not make any handwritten changes, corrections, or additions to the data or to the form after it has been printed. Doing so may result in data errors and processing delays.

In case you notice any errors after printing your form, or if you've left a field blank, we recommend starting over and completing a new form. It's also important to remember that your information is not saved by the form filler and can no longer be accessed after you print it. Therefore, please be extra careful in reviewing your answers, as it is impossible to make any corrections after the form is printed.

Each form will take approximately ten minutes to complete. Please ensure you have the needed documents such as passport to extract information that may be required in some fields. Do not close the forms until they are ready for a download. Partially filled forms cannot be saved to be completed later. If you need further assistance, please contact. Thank you!

Information on Completing the Form - Form must be completed electronically. If not, it will be rejected for processing

a.  Retiree & staff with no access to myHR self-service, use this form to report Birth/Marriage/Divorce/Legal Separation/Domestic Partnership registration or dissolution/Adoption.

b.  Reporting of life events must be made within 60 days from the life event date. For other scenarios it should be reported within 60 days from the end of active coverage date.

Note: For adding a new child to your medical coverage as a result of a birth or adoption, enrollment will be effective as of the birth/adoption date (retroactive premiums will be applied), so long as notice is provided within the first year of the event. All other supplemental insurance, dependent life insurance (if 1st eligible dependent) are not applicable if it is not reported within 60 days.

c.   If you do not request enrollment in the MIP /RMIP coverage within 60 days from end of active coverage and then later request enrollment in the MIP /RMIP coverage, you must provide evidence of coverage for three consecutive years, if applicable, by another medical insurance plan for the period immediately prior to requesting enrollment in MIP /RMIP coverage.

d.  For active staff, if you don’t opt to enroll into medical insurance now, you have a option to enroll during open enrollment.

e.  For enrollments requiring approval by HR Operations e.g. adoption, domestic partnership, supporting documentation that are not in English, an English translation must be provided. Please refer to the applicable checklist for the list of supporting documents.

f.  Save form after completing it electronically, ensure you sign and date it, and then send it to HR Operations (please use only one submittal method and submit once):
Fax +1 (202) 522-7026  or  via email:  hroperations@worldbank.org

Need Help? 

If you are experiencing any issues, please contact HR Operations via email: hroperations@worldbank.org  or phone 202-473-2222 or 5220+32222.

Revision 25 Apr 2023