Forms & publications
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Employee enrollment/change for medical groups only 201952-030-2019
Use this form to enroll in or make changes to PEBB Program benefits for you and your dependents if your employer offers PEBB Program medical coverage only.Form
Employee enrollment/change form 201950-400-2019
Use this form to enroll in or make changes to PEBB Program benefits for you or your dependents.Form
MetLife employee enrollment/change form
Use this form to enroll in or change enrollment in basic life and AD&D insurance, as well as optional life, and/or AD&D insurance for yourself and your dependents. You may need to complete a statement of health. Return this form to MetLife.Form