How Do I Enroll For Portable Life And AD&D Insurance Coverage For Myself And My Dependents? 1. Complete Part B beginning on page 1 of the attached Election of Portable Coverage Form and be sure to answer all sections. 2. Complete, sign and date the Designation of Beneficiary for Your Life Benefits (Part C of the attached Election of Portable Coverage Form). What Needs To Be Mailed To Complete My Enrollment? You must return: a) Your Election of Portable Coverage Form, including information for yourself and if applicable your spouse/domestic partner and child(ren) (Part A and Part B); and b) Designation of Beneficiary for Your Life Benefits (Part C) Mail all correspondence to: MetLife Recordkeeping and Enrollment Services P.O. Box 14401 Lexington, KY 40512-4401 Or Fax to: 1-866-545-7517 Please Note: Certain benefits and provisions that were available under the employer’s group policy will no longer be applicable or may be different under your portable coverage. MN Residents – Please contact our MetLife Customer Service Center at the toll free number below to receive a copy of your state specific schedule of rates. For questions or assistance, contact the MetLife Customer Service Center toll-free at 1-888-252-3607, Monday – Friday between the hours of 8:00 a.m. and 11:00 p.m. (EST). EPORT NW INSTRUCTIONS EPORT (07/19)