2817 Life Insurance Election Form
form is due 60 days from
your entrance on duty.
Employee Group Life Insurance (FEGLI) Basic Coverage
is term insurance with 1/3 of the cost paid for by the
Federal Government. All eligible employees are automatically
enrolled in the Basic Coverage from the date of
entrance on duty unless coverage is waived as indicated
in the general instructions.
You have up to 60 days from your first day of employment to elect
or waive basic coverage or choose further options. If you wish
to elect coverage, refer to the booklet RI 76-21 for the various
If you do not want life insurance coverage you must complete
the form and sign the waiver.