Guardian form group life claim 2025

1. Click ‘Get Form’ to open the guardian form group life claim in the editor.
2. Begin with Section 1, where the Employer/Plan Sponsor must provide their information. Fill in the Planholder/Employer Name, Plan Number, and contact details including phone number and email address.
3. Proceed to Section 2 for Employee/Member Information. Here, enter the member's name, date of birth, social security number, and address. Ensure to indicate if the member was actively working at the time of death.
4. In Section 3, if applicable, complete Dependent Information by providing details about any dependents involved in the claim.
5. Finally, in Section 4, fill out Decedent/Claimant Information. Include details such as the deceased’s name and relationship to the claimant. If a minor is involved, ensure to complete guardianship information.

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