Beneficiary changes and changes to electronic funding/payment options are unable to be made by phone. All changes and/or requests must be submitted in writing to the address above.
Service Change Form
The form below will be needed for the following changes:
Change of address, change of name, change in benefits/reduction or increase in coverage, cancellations, request for duplicate certificate, billing changes.
Beneficiary Change Form
In order to make any changes to your beneficiary, the form below must be completed and mailed to the address listed above. All sections must be completed and you MUST include the social security number of the beneficiary.
If you are listing more than one beneficiary, the percentage of all beneficiaries must equal 100%.
Automatic Payment Option Form
Use this form to set up automatic premium deductions from a checking or savings account.