To enroll in the WEA Trust Life Plan, please download, complete and submit the enrollment form below.
Life Plan Enrollment Form Life Beneficiary Form Life Evidence of Insurability
Helpful tips for completing the Life Plan enrollment:
- Please print legibly
- Check with your employer for:
- WEA Trust group number
- First day of employment
- Your exact annual salary
- Complete Sections 1, 2, 3, 4, 7 (if enrolling in dependent life coverage), 8, and Beneficiary Designation Page of the form
- The Life Insurance Beneficiary Designation should be completed, signed, and dated.
- If your spouse/domestic partner is not designated as Primary Beneficiary, his/her signature is required.
- Complete Section 5 only if you’re waiving Life coverage.
Send your completed enrollment form to:
P.O. Box 21538
Eagan, MN 55121-5038