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Supplemental death 2026
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- Click ‘Get Form’ to open the Supplemental Death Benefits form in the editor.
- Begin by entering your personal information in the 'Member Information' section, including your name, Social Security Number, mailing address, and daytime phone number.
- Designate your primary beneficiaries by filling out their full names, Social Security Numbers, sex, relationship to you, and date of birth. You can add up to three primary beneficiaries.
- If applicable, complete the 'Custodian Under TUTMA' section for any minor beneficiaries by providing the custodian's name and relationship.
- Next, designate up to three alternate beneficiaries in the same manner as the primary beneficiaries. Ensure all required fields are filled accurately.
- Finally, review all entries for accuracy before signing and dating the form at the bottom. Remember that this designation revokes any previous ones.
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beneficiaries beneficiary spouse
Death: Check if death was an outcome of the adverse event, or if the cause of the death is unknown. Include the date of death, if known. DO NOT check if
In the event of your death, the Supplemental Death Benefit Plan will automatically provide your beneficiaries with a lump-sum payment equal to one months base
Supplemental Accidental Death and Dismemberment (ADD) Additional ADD insurance can be purchased for employee or family coverage. Enrollment is anytime, up to