WAEPA Applications Library
Apply for membership and insurance
Apply for Associate Membership
Adjust your coverage
Apply for WAEPA Membership
Click on the form name to fill out an application or change form online:
WAEPA
7651 Leesburg Pike
Falls Church, VA 22043
Apply for Membership and Insurance |
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Form Name |
For: |
Description: |
Current and retired |
Apply to become a |
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First-time federal and USPS employees only |
Apply for open enrollment |
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New WAEPA
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This form is required for domestic partners to apply for dependent coverage. [Get info on this] Domestic Partner Coverage is not available in Virginia.
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WAEPA membership only |
This application is to be used only if you are joining WAEPA in order that your spouse/domestic partner, or non-dependent children can join WAEPA as Associate Members and apply for their own WAEPA coverage. |
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Apply for Associate Membership |
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| Form Name | For: |
Description: |
Application for WAEPA Associate Membership |
Spouses, domestic partners, and adult |
Apply to join WAEPA and purchase life insurance |
WAEPA members |
Use this form if you are joining WAEPA only so your spouse, domestic partner, or adult |
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New WAEPA |
This form is required for |
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Adjust Your Coverage |
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| Form Name | For: |
Description: |
Current WAEPA members |
Use this form to update the name on your policy. |
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Use this form to update the address on your policy. |
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Use this form to change |
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Use this form to increase the amount of your current WAEPA coverage. If you add coverage for your domestic partner, please attach a
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Use this form to reduce the amount of your current |
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About WAEPA online forms: The Online WAEPA Forms tool will create a document
in the Adobe Acrobat PDF file format. Most modern web browsers have built-in
Adobe Acrobat PDF file support/viewers, and will display the forms correctly.
About Adobe Acrobat Reader: Adobe PDF Reader is required to use these forms online. If you have an older web browser or are having difficulties viewing the PDF file, try downloading and installing the latest Adobe Acrobat PDF viewer (it's free).
About your browser’s security: The Online WAEPA Forms should work without any problem using a modern web browser and the default settings. However if you have changed the security settings to restrict dynamic content (JavaScript, ASP, etc), the forms will not work. For the Online WAEPA Forms to work correctly, your browser security settings must allow dynamic content (i.e., let scripts run).
If you are still having problems using the forms, there is an alternative "Print Only"
version of each form that does not provide any of the form validation, error checking, required field checking, or help messages. Look at the bottom of the form page
for the link to "Print Only" version of the form.
ONLINE FORMS:
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by mail
INFORMATION:
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online forms
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