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Beneficiary form template 2025

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The document is a Beneficiary Designation Form from the Office of Management and Enterprise Services, specifically for the HealthChoice Life Insurance plan. It provides instructions for members to designate primary and contingent beneficiaries, requiring detailed information such as names, relationships, and Social Security Numbers. The form must be completed in ink, signed, and mailed to EGID to become effective, replacing any prior beneficiary designations.

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Click ‘Get Form’ to open the beneficiary form template in the editor.
Begin by filling out the Member Information section. Enter your full name, Social Security Number (SSN) or Member ID, and current address clearly in ink.
In the Primary Beneficiary Designation section, list one or more primary beneficiaries. Specify their full legal names, SSNs, dates of birth, relationships to you, and addresses. If applicable, indicate the percentage of benefits each will receive.
Next, complete the Contingent Beneficiary section similarly. This is for beneficiaries who will receive benefits if all primary beneficiaries are unavailable.
Finally, sign and date the form at the bottom. Ensure your signature is original as it is required for processing.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (26 Votes)
2012	3.9 Satisfied (29 Votes)
2009	4.4 Satisfied (546 Votes)

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can you put yourself as your own beneficiary?

But when implemented correctly, you can be the beneficiary of your own life insurance policy. Your policy can help protect your familys financial security after your death and while youre still alive.

Is it a good idea to put a beneficiary on a bank account?

Yes, having a named beneficiary is helpful if you want that money to pass to the pass onto the beneficiary outside of probate. If you dont know what probate is, this is the process that occurs once someone dies.

Can I make myself a beneficiary?

Yes, you can name yourself as the beneficiary of your trust, but whether that will actually protect your wife and achieve your goals is the real question and that requires a full discussion with an attorney who has reviewed the trust rather than a simple yes/no.

Can someone make you a beneficiary without you knowing?

Yes. There is no signature required on any life insurance application for any beneficiary. The policy is a gift from the insured. As long as the insured proves ``Insurable interest someone could be a beneficiary without even knowing it. However, its better that the beneficiary know

Who should I not name as a beneficiary?

Estranged relatives or former spouses Family relationships can be complicated, so think carefully if an estranged relative or ex-spouse really aligns with your wishes. Pets Pets cant legally own property, so naming them directly as beneficiaries is problematic. Consider a pet trust instead.

Who should I put as my beneficiary if Im single?

If you are single, you may designate anyone you choose as your beneficiaries, such as a family member, friend, charity, or organization. When choosing a beneficiary, consider who is most important to you and who will benefit the most from your assets.

How to complete a beneficiary form?

Provide the following information on the beneficiary designation: The full name of the trust as it shows on the trust document. The date the trust was created. The name of the trustee, followed by the word trustee, or if you cannot provide a trustee, ETF may accept another contact person. The trustees address.

Beneficiary form template 2025

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