See forms for:

Employee forms


Flexible spending arrangement (FSA) and Dependent Care Assistance Program (DCAP)

Health savings account (HSA)

Life and accidental death and dismemberment (AD&D) insurance

Note: Life insurance portability forms are available through your employer.

Long-term disability (LTD)

Retiree forms


Health savings account (HSA)

Life insurance

Continuation of coverage forms

For COBRA, Leave Without Pay (LWOP), and PEBB Extension of Coverage


Dependent certification forms

For enrolling a registered domestic partner, a domestic partner's child, a dependent child with a disability, or an extended legal dependent child.


Surcharge attestation forms

Release of private information