View and download copies of our life and disability forms.

Beneficiary Forms

Beneficiary Form (available online on My Health Plan by visiting the Forms page under Resources & Tools)
Beneficiary Designation Form (PDF version)

Claim Forms

Accident
Death 
Death (individual policyholders only)
Long-term Disability
Multi-claim Form (short-term disability, waiver of premium and accelerated death benefit)
Indemnity Claim Form (accident, critical illness and hospital benefits)

Group Applications

Life and Disability (Georgia form available below)
COSE
MRACC
TRCC

Miscellaneous