Employee Group Insurance Change Request

This form is used for updating a beneficiary designation, submitting a name change, or recording a change in dependent status.

Employee Group Insurance Change Request Form
 

Administrator FormsConversion to Adjustable Life LegendIf any portion of your Minnesota Life group coverage terminates (because your employment or membership in a class eligible for insurance terminates or the master group contract terminates or is amended), you may be able to continue your life insurance protection. Your right to do this is called a conversion privilege, and its features are described here for you.Conversion to Advantage Elite 10 Term Life InsuranceIf you were insured by a group life insurance contract issued to a Minnesota company and continue your insurance under the state continuation law, you may be eligible to convert to this term insurance product.Minnesota Life Notice of DeathNotice of Death Claim Form for Minnesota LifeEmployee Group Insurance Change RequestThis form is used for updating a beneficiary designation, submitting a name change, or recording a change in dependent status.Beneficiary Statement for a Death ClaimThis Beneficiary Statement form is for the beneficiary to complete and return to MN Life upon the death of the employee.


"All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence." 
Martin Luther King, Jr.

© 2009 All Rights Reserved | Ochs, Inc.
Contact Us | The Municipal Pool | Benefit Administrators | Site Map