Beneficiary Form - Life Insurance
To designate or change your beneficiary, download and complete the Principal Beneficiary Designation/Change Form (PDF).
- Contingent beneficiaries only receive the life insurance payout if the primary beneficiaries are deceased
- If you have Group Basic Term Life, complete pages 1 and 4
- If you have Voluntary Term Life, also complete pages 2 and 3
- If you do not wish to designate different beneficiaries on pages 2 and 3, just write “Same as Page 1”
- Social Security Numbers are not required for your beneficiaries and they may reside outside of the U.S.
- Consider the custodial appointment for minors as seen on page 4
- Sign and date the form (this is required)
Submitting the Form
Once completed, submit the form using one of the options below: