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Comprehensive list of Forms and Documents. Alphabetical list of PEIA forms and documents . Documents for Benefit Coordinators
Standard Form 2817 Revised September 2021 Instructions for Agencies 1. Who Should File This Form? New employees eligible for life insurance who want optional insurance or no insurance. Note: New employees who want only Basic do not have to file. Employees appointed to positions that allow life insurance coverage following service in positions ...
The following is an alphabetical list of forms and documents on the Web site. If you see (Complete Online) next to a form, you can do this 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.
The employee's copy of this form, when completed by the employing office, together with the FEGLI Program Booklet (FE 76-21 or FE 76-20 for U.S. Postal Service employees) constitute the employee's Certificate (proof) of Insurance.
Download Fillable Form Sf-2817 In Pdf - The Latest Version Applicable For 2024. Fill Out The Life Insurance Election Online And Print It Out For Free.
Forms & Downloads. Wellness Tools. FAQ. Contact PEIA. PEIA Finance Board Public Hearings Set for November. Changes for Plan Year 2026 (Benefits from 7/1/25 – 6/30/26) are being finalized and public hearings have been scheduled for November. Read more... Manage My Benefits. Make changes without filling out a paper form...click here.
You must use the downloadable Adobe Acrobat PDF version posted here. Previous versions are NOT usable. If individual agencies need a published version for their forms stock, they can download the PDF file and submit a printing request to the Government Printing Office.
