Enrollment & Change: Use this form to enroll within 31 days of initial eligibility. This form is also used update name, and address changes, and to enroll newly acquired dependents (e.g. new spouse, newborn, adoption) within 60 days of becoming eligible.
Spouse or Qualified Domestic Partner Certification: This form must be completed If enrolling a spouse or qualified domestic partner.
Student Certification: Use this form if enrolling dependent children ages 20 through 23.
Adult Dependent Enrollment & Change
Certification of Dependents with Disabilities
Extended Dependent Certification
2010 Medical & Dental Forms
Enrollment & Change
Enrollment: Use this form if you enroll within 60 days of initial eligibility.
Change: Use this form if you enroll more than 60 days after initial eligibility, or if you want to change your current life insurance.
Evidence of Insurability
Beneficiary Change
Non Smoker Certification
Conversion Request
Member Information
Beneficiary Designation
Student Exemption
Plan 3 Change of Investment Program: Choose between the Washington State Investment Board (WSIB) and the Self-Directed Investment Programs.
Name & Address Change: To be completed by inactive members, retirees and beneficiaries receiving benefits. Active members update your address through your MyWSU account, my.wsu.edu.
VEBA Enrollment Form
Salary Reduction Agreement: Use this form to designate your desired contribution for the TIAA-CREF Voluntary Investment Plan.
Participation Election
How To Enroll Online Guide
10% Increased Contribution: At any time following your 50th birthday you may elect to increase your contribution rate to 10%.
Paper Enrollment Form: Use this form to enroll by mail. Use the How to Enroll Online Guide above to enroll online.
Salary Reduction Agreement: Use this form to designate your desired contribution for the TIAA-CREF Voluntary Investment Plan.
VEBA Enrollment Form
Change of Name: Use this form to update your name on your retirement account. Return completed form to address noted on top of form.
