Personal Risk Forms (in PDF Format)

Employee Benefits Contact Information (MS Word) Retiring/Terminating Employee -- checklist (PDF)

Accidental Death and DismembermentAccidental Death and Dismemberment ClaimAccidental Dismemberment or Loss of Sight ClaimAD& D Certificate of CoverageAD & D Conversion Information and InstructionsAD & 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

Accident and Sickness

Accident and Sickness for Volunteers Application ACE NAD Summer Camps Brochure
ACE NAD Summer Camps ApplicationCampers International ApplicationMiscellaneous Accident ApplicationPathfinder International Application
Short Term Travel ApplicationTask Force/1 Year Missionary Application
Task Force/1-year Missionary Coverage Summaries
Volunteer Labor Application

Group Life Insurance

2005 Policy EndorsementAccelerated 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
Living Benefits Claim
Notice of Conversion PrivilegePorting and Conversion Made EZ (MS Word) Proof of Death
Proof of Death–Dependent
Travel Assistance/ID Wallet Card
Waiver of Premium Claim

Long Term Disability Ability Assist
Application for Long Term Disability Income Benefits Form
LTD 90 with COLA
LTD 90 day no COLA
LTD 180 day with COLA
LTD 180 day no COLA
Notice of Conversion Privilege Form
Complex Claim Advice–Submission Form

Supplemental Life InsuranceAccelerated 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
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 FormPersonal Health Application - NY residents ONLY