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Life Insurance
Active members receive basic term life insurance ($10,000) at no cost and may purchase optional life insurance coverage with pre-tax earnings through MetLife. Non-Medicare retirees and Medicare retirees may purchase basic and optional life insurance from MetLife.
If a form has (Complete Form Online) next to it, you can complete it online by going to Manage My Benefits. It's easier, faster and leads to fewer mistakes than printing a form and sending it to PEIA.
Life Insurance Forms and Publications
- Basic Life Insurance Enrollment Form (Complete Form Online)
- Retiree Basic Life and Health Enrollment Form
- Optional Life Insurance and Dependent Life Insurance Enrollment Form (Complete Form Online)
- Retired Employee's Optional and Dependent Life Insurance Enrollment Form
- Disability Life Insurance Premium Waiver - Please contact MetLife for this form
- Basic and/or Optional Life Insurance Change of Beneficiary Form - Please contact MetLife for this form or visit MetLife's website to update
- Basic and/or Optional Life Insurance Beneficiary Form - Please contact MetLife for this form or visit MetLife's website to update
- Active Employee Life Insurance Plan Certificate - Please visit MetLife's website to view
- Retiree Life Insurance Plan Certificate - Please visit MetLife's website to view
Important Note Regarding Beneficiaries: To view and/or change beneficiaries for your plan, please visit MetLife's website. For more information, please contact MetLife at 888-466-8640.
Contact MetLife
- Phone: 888-466-8640
- To file a death claim, please call 800-638-6420, Option 2.
- MetLife Website