Important Documents and Forms
- Enrollment/Change Form 7-1-24 - 12-31-24 ONLY
- 1-1-25 Enrollment Change Form
- Beneficiary Questions and Answers
- Part Time Resolution Template
- Schedule B for Birth Registration
- Schedule C for Marriage Registration
- Sample Loss of Coverage Form
- Release of Health Information
- Domestic Partner Petition Template
- Affidavit for Domestic Partner
- Termination of Domestic Partner
- LTD Claim Packet
-
Retiree Life Insurance Application
(under age 65) -
Options for Continuing Life Insurance
Due to Retirement - Life Claim Packet
- Board Member Enrollment Application
- Employers' First Report of Injury/Illness
- Notice of Work Accident
Applying for Life and LTD Coverage
Applying for Life & LTD Coverage - Late Enrollment
For Additional Life or Long Term Disability that is declined or if the employee chooses to enroll after the 31-day enrollment deadline, to add these coverages the employee needs to:
- Complete an Employee Enrollment/Change Form or Request via Employee Login Online System
- Respond to Evidence of Insurability Email
- Wait for Decision by The Standard
This applies to requests for LTD coverage or Additional Life for the employee and Dependent Life coverage for spouse.
Step 1
Complete a paper Employee Enrollment/Change Form
and
submit to your employer’s Benefits office or apply via Employee Login online system.
Step 2
Respond to Evidence of Insurability email from The
Standard to complete the Evidence of Insurability application
Note: The late enrollment process is available anytime of the year. A tutorial can be found here.
What is evidence of insurability?
EOI is a statement or proof of a person's physical condition
that is required to obtain certain types of insurance.
- Accelerated Benefit Claim Packet
- Accidental Dismemberment
- Continued Dependent Life Insurance for Disabled Child
- Group Conversion Packet
- Life Claim Packet
- Portability Application
- Request for Group Life Conversion Materials
- Specified Disease Benefit Packet
- Long Term Disability Claim Packet
- Waiver of Premium Claim Packet
- Beneficiary Questions
- Options for Continuing Life Insurance
- Travel Assistance and Life Services Toolkit Brochure
- Life Services Toolkit (English)
- Life Services Toolkit (Spanish)
- Travel Assist Flyer (English)
- Travel Assist Flyer (Spanish)
- Travel Assistance Program Description
- For Employers: Guide to Taxation to Income Replacement (LTD) Benefits