Forms

Forms  

Forms

Remember, you can designate your beneficiaries by clicking on ‘Beneficiary Administration Login’ at the top of your screen.


These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing. Click here to download a free copy of Adobe Acrobat Reader.


Beneficiary Forms 

If you submit your beneficiary designation via a paper form, we will enter it into the Cigna Trusted Advisor® website so you can view it online through My Account.

Beneficiary Designation Form

 

Claim Forms 

The information requested in the forms below is required for us to begin reviewing your claim. It's important that you provide us with complete and accurate information to avoid a delay in the processing of your claim.

Claim Form

 

Change Forms 

Request for Service Life Change Form

Use this form to make changes to the features and benefits of your plan, including reducing your coverage or cancelling coverage for your children.

Surrender/Cancel Form

Use this form to make cancel/surrender your or your spouse’s coverage.

Funds Withdrawal Form

Use this form to withdraw funds from your Cash Accumulation Fund or to cancel your contributions.