Click on any of the links below to download the corresponding form.
Vendor Contact Information (Microsoft Word doc)
Exiting and/or Retiring Employee checklist (Microsoft Word doc)

Accident and Health

• Accident and Sickness for Volunteers Application
• International Campers & Miscellaneous Activities Application
• Miscellaneous Accident Application
• Pathfinder International Application
• Short Term Travel - ADRA
• Short Term Travel Application
• Volunteer Labor Application
• NAD Summer Youth Camp - Application (Microsoft Word doc)
• NAD Summer Youth Camp - Brochure

Accidental Death and Dismemberment

• Accidental Death and Dismemberment Claim
• Accidental Dismemberment or Loss of Sight Claim
• AD& D Certificate of Coverage
• AD & D Conversion Information and Instructions
• AD & D Conversion Form
• Children with Disabilities
• Hartford AD & D Enrollment
• Hospital Indemnity–AD & D
• Pilot History PA 1754
• Voluntary AD & D Benefit Highlight Sheet
• Waiver of Premium Claim Form

Group Life Insurance

• 2005 Policy Endorsement
• Absolute Assignment
• Accelerated Death Benefit Option Disclosure
• Beneficiary Assist
• Beneficiary Designation
• Children with Disabilities
• Consent Form for Payment of Accelerated Death Benefits
• Consent Form for Payment of Living Benefits
• Florida Beneficiary Designation
• Group Life Policy
• Life Conversations Brochure
• Living Benefits Claim
• Notice of Conversion Privilege
• Proof of Death
• Travel Assistance/ID Wallet Card
• Waiver of Premium Claim

Long Term Disability

• Ability Assist
• Application for Long Term Disability Income Benefits Form
• Premium Waiver Form
• LTD 90-day policy (effective 1/1/08)
• Notice of Conversion Privilege Form
• Complex Claim Advice–Submission Form

Supplemental Life Insurance

• Accelerated Death Benefit Option Disclosure Form
• Beneficiary Assist
• Beneficiary Designation Form
• Children with Disabilities
• Consent Form for Payment of Accelerated Death Benefits
• Consent Form for Payment of Living Benefits
• Group Term Life Brochure
• Hartford Supplemental Life Enrollment Form
• Hartford Portability Rates
• Life Portability Form
• Life Conversion Form
• Living Benefits Claim Form
• Personal Health Application (excluding CA and NY) * Not required for children.
• California Personal Health Application - CA residence only
• New York Personal Health Application
• Porting vs. Converting
• Proof of Death–Dependent Form
• Proof of Death Form
• Retiree Enrollment Form
• Supplemental Life Benefit Highlights Sheet
• Supplemental Life Certificate of Coverage
• Waiver of Premium Claim Form