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Begin with SECTION I - Insured Information. Fill in your Customer Number, Employer Name, and personal details including First Name, Last Name, Address, Date of Birth, Phone Number, and SSN or Employee ID Number.
Move to SECTION II - Plan Information. Select the applicable life insurance plans by checking either 'All group term life coverage currently in effect' or specific options like Basic Life or Supplemental/Optional Life.
In SECTION III - Beneficiary Information, designate at least one primary beneficiary. Ensure that the total percentage for primary beneficiaries equals 100%. Repeat this for contingent beneficiaries if necessary.
Complete SECTION IV - Signature by signing and dating the form. If you are signing as an agent under a Power of Attorney, check the appropriate box and attach relevant documentation.
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Beneficiary designations allow you to transfer assets directly to individuals, regardless of the terms of your will. Beneficiary designations are often made when a financial account, retirement account, or life insurance policy is established. But, these designations should be reviewed periodically.
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GR-TR-BENE-EMP2 (10/12) Fs. Group Term Life Insurance Beneficiary Designation. This form MUST be signed before you return it. See SECTION III Signature
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