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Eligibility
Eligibility is the same as specified for medical and dental plans, except retiree term life insurance is only available to those who:
- Meet the Public Employees Benefits Board (PEBB) Program’s retiree eligibility requirements and are enrolled in life insurance through the PEBB Program as an active employee.
- Are a retiree of an eligible employer group, K-12 school district, or educational service district, who enrolled in life insurance through the PEBB Program as an active employee.
- Are not on a waiver of premium due to disability.
OR
AND
Dependents of retirees are not eligible for retiree term life insurance.
Amount of Insurance
The amount of insurance paid to your beneficiary is based on your age at the time of death, according to the following schedule:
| Age at Death | Amount of Insurance |
| Under 65 | $3,000 |
| 65 through 69 | 2,100 |
| 70 and over | 1,800 |
Premium Cost
The cost is $2.19 per month, regardless of your age. If the PEBB Program receives information that an adjustment should be made to your account, it will not collect or refund more than 12 months of premiums from the date PEBB receives the information.
Enrollment
Complete the 
PEBB-Sponsored Retiree Coverage Election Form (585.8 KB) enclosed in this packet and return
it to PEBB before you retire. There are no plans for future open enrollment periods for this life
insurance coverage.
Effective Date
If you enroll when eligible, insurance becomes effective on your retirement date.
No Exclusions
This plan covers death from any cause.
Disability
If you become disabled after the effective date of this insurance, you must continue making premium payments to keep your insurance in force.
Beneficiary
You may name any beneficiary you wish when you complete the enrollment form. If you should die with no named living beneficiary, payment will be made to your survivors in this order:
- Spouse/Washington State-registered domestic partner
- Children
- Parents
- Estate
If you are married and wish to name someone other than your spouse/domestic partner as beneficiary, or if you have special estate planning needs, you should seek legal/tax advice before completing your beneficiary designation.
Claim Filing
In the event of your death, your beneficiary should submit a certified death certificate as soon as possible to ING, Life Claims, P.O. Box 1548, Minneapolis, MN 55440-1548, or call them at 1-800-328-4090. Please notify the PEBB Program of the death so appropriate adjustments can be made to the account. We may share this information with the Department of Retirement Systems to better serve your survivors.
Insurance Certificate
This is a brief summary of the Retiree Term Life Insurance Plan. If you would like a copy of the complete insurance certificate, contact the HCA at 1-800-200-1004 or P.O. Box 42684, Olympia, WA 98504-2684.
