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Life Insurance Enrollment and Change Forms for EXEMPT Employees

Complete these forms to enroll in Life Insurance if you are in an appointed, elected or other eligible positions designated by your agency.  This is not the enrollment form for career service employees or employees who are eligible for benefits during a temporary assignment.  If you have questions, please contact a Human Resource Representative at ERIC by calling 801.538.3742 or your local HR office.

State-Exempt Group Term Life Enrollment Form

Disclosure Form

Group Term Life Change Form

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