Employer Forms

Enrollment and Change Forms

• Enrollment & Change of Status Form - MI
  
• Enrollment & Change of Status Form - OH
  
• Employee Application (Life & Disability Only)
  
• Optional Benefits Enrollment Form
  
• Termination & COBRA Request Form

Evidence of Insurability

• Evidence of Insurability Form

Claim Forms

• Group Life Insurance Claim
  
• STD Claim Statement
  
• LTD Claim Statement
  
• HIB Claim Report