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Designation of Agent

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MOSERS Designate an Agent

Who would take care of your MOSERS affairs if you became incapacitated and unable to make decisions for yourself? Identify an individual by filling out a simple Designation of Agent form.

What is the responsibility of an agent?

An agent will be responsible for handling your MOSERS benefits in the event you become disabled or incapacitated. This form applies only to your MOSERS benefits. The Designation of Agent form does not give your agent broad powers like those usually found in a durable power of attorney. Once you have designated an agent, he or she can do the following on your behalf:

  • Make retirement decisions
  • Name a retirement or insurance beneficiary (by permission only)
  • Decide where your benefit payments are sent

If you are interested in giving your agent broad powers, please consult with an attorney who can advise and help you prepare a durable power of attorney.

Naming an Agent and Successor Agent

Complete the Designation of Agent form to name an agent and a successor agent. MOSERS will recognize your agent first regarding the distribution of your benefits upon receipt of a physician’s statement notifying MOSERS in writing that you are disabled or incapacitated. If your agent cannot or will not perform these duties, MOSERS will look to your successor agent for instructions (if one has been named).

What if I don't have an agent on file?

If you become disabled or incapacitated and have not designated an agent to make decisions regarding your MOSERS benefits, one of the following persons may act as an agent upon submission of a written statement from your physician regarding your disability or incapacity and the completion of a family member affidavit (available by contacting MOSERS). The powers of an agent will be granted, in the following order, to your:

  1. Spouse.
  2. Child.
  3. Parent.
  4. Brother or sister.
  5. Niece, nephew, or grandchild.

When does it take effect?          

Your designated agent will be allowed to make decisions on your behalf ONLY after MOSERS receives written notification from a doctor that you are disabled or incapacitated.

To complete the form, log into your secure Member Homepage and you will find it listed under Forms on the main menu.


MOSERS is not liable with regard to any payment made in good faith to your agent.

Missouri State Employees' Retirement System
Address: 907 Wildwood Dr., Jefferson City, MO 65102 Phone: 800.827.1063 URL: Email: Founded On: September 1, 1957