MetLife Enrollment

METLIFE GROUP LIFE INSURANCE PROGRAM

During the non-open enrollment period, you may choose coverage up to $500,000 for yourself, and up to $250,000 (maximum 1/2 of member coverage) for your spouse. Complete the Enrollment Form and the Medical Evidence of Insurability* below and return to SEBA, 735 E. Carnegie Dr., Ste. 125, San Bernardino, CA 92408. DO NOT MAIL TO METLIFE directly or your coverage may be delayed.

Review the Plan Benefits for Members and Retirees for your basic benefits available through SEBA's group life insurance plan. Not sure how much coverage is enough? Your Life Insurance Guide can help you make this very important decision.

In addition, you may choose Voluntary Accidental Death & Dismemberment (AD&D) coverage up to $500,000 for yourself, or choose the Family Protection Plan to cover yourself and your family. These may be added on the Enrollment Form as well.

To find the monthly amount for your Life and/or AD&D coverage, click here.

The MetLife plan also includes a number of other special features, such as Travel Assistance and Will Preparation Service. These features are at no additional cost to you.

When we receive your forms, we will forward them to MetLife's Underwriting Department. MetLife will inform us of when you coverage will be come effective (if approved) and we will in turn notify you.

Feel free to contact SEBA with any questions or concerns, (909)885-6074.

* Subject to approval by MetLife Underwriting.

Forms For Open Enrollment

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• Enrollment Form
• Medical Evidence of Insurability Form
• Plan Benefits for Members and Retirees
• Will Preparation Service
• Travel Assistance
• Your Life Insurance Guide

MetLife Monthly Rates

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• Active Members
• Members Who Retired AFTER 07/01/2004
• Members Who Retired BEFORE 07/01/2004
• Accidental Death & Dismemberment (AD&D)