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FEGLI Life Insurance Election Form

Thursday, May 17, 2012


By law, unless you waive all coverage or are ineligible, you are automatically covered for Basic life insurance as an employee. When you first become eligible for FEGLI, you may: 

  1. Do nothing and have Basic automatically,
  2. Elect Basic and any or all of the options, or
  3. Waive all life insurance coverage.

Please use this form to make one of those selections.

For Federal Employees' Group Life Insurance (FEGLI) Program members only.