For your convenience, claim and administrative forms can be found below. Please follow instructions included in the forms to submit your claim.

Forms by product

Life
Disability
Dental
Vision
Accident
Critical Illness

Administrative forms

Benefits Continuation
Notice of Conversion
Portability Form - Life Insurance
Portability Form - Accident & Critical Illness Insurance

Still have questions?

We are here to help. If you have any questions about claims processing or need assistance with filling out a form, please give us a call.

Phone

(866) 274-9887

Monday - Friday 8:00 AM - 8:00 PM

HIPAA  |  Legal

GE-4215506.1 (01/2022) (Exp. 01/2024)