This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Optional Life Insurance and Dependent Life Insurance Enrollment Form is a legal document that was released by the West Virginia Public EmployeesInsurance Agency - a government authority operating within West Virginia.
Q: What is the Optional Life Insurance and Dependent Life Insurance Enrollment Form?
A: It is a form that allows employees in West Virginia to enroll in optional life insurance and dependent life insurance coverage.
Q: Who can use this form?
A: Employees in West Virginia who are eligible for optional life insurance and dependent life insurance coverage.
Q: What is optional life insurance?
A: Optional life insurance is additional life insurance coverage that employees can choose to purchase for themselves.
Q: What is dependent life insurance?
A: Dependent life insurance is life insurance coverage that employees can choose to purchase for their dependents, such as their spouse or children.
Q: Is enrollment in optional life insurance and dependent life insurance coverage mandatory?
A: No, enrollment is optional. Employees can choose whether or not to enroll and purchase coverage.
Q: What is the purpose of this form?
A: The form is used to collect the necessary information and authorization from employees who wish to enroll in optional life insurance and dependent life insurance coverage.
Form Details:
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the West Virginia Public Employees Insurance Agency.