Forms
| Title | Purpose | Action |
|---|---|---|
| EFT Setup for Long Term Disability Claim Payments (All states except NY) | Used to request the electronic funds transfer (EFT) of Long Term Disability claim payments. |
Download |
| EFT Setup for Long Term Disability Claim Payments (NY) | Used to request the electronic funds transfer (EFT) of Long Term Disability claim payments. |
Download |
| Long Term Disability Claim Packet (All states except NY) | Use this packet to file a claim for a Long Term Disability plan issued outside of the state of New York. |
Download |
| Long Term Disability Claim Packet (NY) | Use this packet to file a claim for a Long Term Disability plan issued in the state of New York. |
Download |
| Short Term Disability Claim Packet (All states except NY) | Use this packet to file a claim for a Short Term Disability plan issued outside of the states of New York. |
Download |
| Short Term Disability Claim Packet (NY) | Use this packet to file a claim for a Short Term Disability plan issued in the state of New York. |
Download |
| State Disability Claim Packet (NJ) | Use this packet to file a claim through a New Jersey State Disability plan. |
Download |
| State Disability Claim Packet (NY) | Use this packet to file a claim through a New York State Disability plan. |
Download |
| Waiver of Premium Claim Packet (All states except NY) | If you have a life insurance policy issued outside of New York that includes the Waiver of Premium benefit, you can use this packet to request the waiver. |
Download |
| Waiver of Premium Claim Packet (NY) | If you have a life insurance policy issued in New York that includes the Waiver of Premium benefit, you can use this packet to request the waiver. |
Download |