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Life Insurance Forms

Basic and Select Life Forms

Basic and Select Life Insurance Enrollment or Change form
Basic and Select Life Insurance Enrollment or Change Form 5-301a [PDF 87K]
Use this form to enroll or change benefits for Basic Life and AD&D Insurance, Select Life and AD&D Insurance, or to designate beneficiaries.

Optional Benefits Forms

Voluntary Supplemental Benefits Beneficiary (Life, AD&D and Survivor)
Life and AD&D [PDF]
Survivor [PDF]
These forms name the people you want to receive Supplemental Life, Accidental Death and Dismemberment, and/or Survivor insurances which you may have elected. These forms may also be used to change those names at any time.

Courtesy Forms

Designation of Beneficiary for Unpaid Compensation
Designation of Beneficiary for Unpaid Compensation Form DBUNCP [PDF 29K]
This form names the people you want to receive unpaid wage compensation (including salary and paid leave owed to you) in the event of your death while an employee of the State of Alaska. It can also be used to change those names at any time.