Forms & publications

Can't find what you need? Visit UMP Forms and publications for more documents.

For Your Benefit: Employees and non-Medicare Retirees (2018-06)

PEBB Program's June 2018 edition of For Your Benefit newsletter. Articles include SmartHealth, UMP's joint replacement benefit, HCA's updated website, Free will preparation from MetLife, and Have you heard of SEBB?

Newsletter

For Your Benefit: Medicare Retirees (2018-06)

PEBB Program's For Your Benefit newsletter June 2018 edition. Articles include New Medicare cards, HCA's website is updated, Free will preparation from MetLife, and Have you heard of SEBB?

Newsletter

MetLife beneficiary designation

Use this form to name the persons or entities you want to receive your life insurance proceeds after your death. Return this form to MetLife.

Form

MetLife cancellation of life insurance - retiree

51-857

Use this form to notify MetLife that you wish to cancel your Retiree Life Insurance. If you cancel your Retiree Life Insurance, you may not reenroll in life insurance unless you regain eligibility for life insurance at a later date.

Form

MetLife cancellation of optional life insurance form - employee

Use this form to notify MetLife that you wish to cancel your Optional Life Insurance and/or Optional Accidental Death & Dismemberment (AD&D) Insurance. For employees only: Employee Basic Life Insurance ($35,000) and Employee Basic AD&D Insurance ($5,000) is not affected by this form. It is provided by your employer at no cost to you. You cannot cancel your Employee Optional Life Insurance and keep Dependent Life Insurance.

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

MetLife employees Certificate of Coverage (COC) non-Washington residents 2017-2018

This is the certificate of coverage (COC) for MetLife life insurance and accidental death and dismemberment insurance policies for employees who do not live in Washington.

Publication

MetLife employees Certificate of Coverage (COC) non-Washington residents 2019

MetLife employee Certificate of Coverage (COC) Washington residents 2019.

Publication

MetLife employees Certificate of Coverage (COC) Washington residents 2017-2018

MetLife employee Certificate of Coverage (COC) Washington residents 2017-2018.

Publication

MetLife employees Certificate of Coverage (COC) Washington residents 2019

MetLife employee Certificate of Coverage (COC) Washington residents 2019.

Publication

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