Group Term Life Insurance Beneficiary Designation - Erie County 2025

1. Click ‘Get Form’ to open the Group Term Life Insurance Beneficiary Designation in the editor.
2. Begin with SECTION I - Insured Information. Fill in your Customer Number, Employer Name, and personal details including your First Name, Middle Name, Last Name, Address, City, State, Date of Birth, Phone Number, SSN or Employee ID Number, and ZIP Code.
3. Move to SECTION II - Beneficiary Information. Designate at least one primary beneficiary by providing their details such as First Name, Middle Initial, Last Name, Address, City, Relationship to Employee, Social Security Number, and Date of Birth. Ensure that the total percentage for primary beneficiaries equals 100%.
4. If applicable, complete the Contingent Beneficiary section similarly. Remember that if any listed beneficiaries predecease you, their share will be divided among remaining beneficiaries.
5. In SECTION III - Signature, ensure you sign and date the form. If completing as an agent under Power of Attorney, check the appropriate box and include a copy of the Power of Attorney documentation.
6. Finally, return all pages of this completed form to MetLife Record Keeping Center at the provided mailing address.

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