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Policy Holders
Humana Insurance Company
- Accident & Heart/Stroke (Humana)
- Cancer, Specified Disease & Intensive Care (Humana)
- Critical Illness (Humana)
- Hospital Indemnity (Humana)
- Wellness (Humana)
- Change and Service Request (Humana)
- Portability Request Form
Kanawha Insurance Company
Leaders Life Insurance Company
- Accident (Leaders Life)
- Accident - Physicians Statement (Leaders Life)
- Accident - Outpatient Phy Expense (Leaders Life)
- Accident - Outpatient Phy Expense - Call In Claim (Leaders Life)
- Death Claim (Leaders Life)
- FMLA, Gunshot, HIV/Hepatatis Exposure Claim Form
- Wage Protector (Disability-Leaders Life)
- Leaders Life - Beneficiary Change
- Leaders Life - Group Term Life (Portability Request Form)
- Leaders Life - Group Term Life (Policy Change Form)
Madison National Life Insurance Company, Inc.
- Accelerated Death Benefit (Madison National)
- Accelerated Death Benefit (Madison National - Indiana)
- Death Claim (Madison National)
- Waiver of Premium (Madison National - Attending Physican Stmt)
- Waiver of Premium (Madison National - Employee Statement)
- Waiver of Premium (Madison National - Employer Statement)
- Madison National - Beneficiary Statement
- Madison National - Change Beneficiary Form
- Madison National - Portability Request Form
- Madison National - Conversion Request Form
Manhattan Life Insurance Company
- Accident & Heart/Stroke (Manhattan)
- Cancer, Specified Disease & Intensive Care (Manhattan)
- Critical Illness (Manhattan)
- Hospital Indemnity (Manhattan)
- Wellness (Manhattan)
- Manhattan Life - Policy Change Form
- Manhattan Life - Portability Request Form
MetLife Insurance Company
National Union Fire Insurance Company of Pittsburgh, PA
- Accident & Heart/Stroke (AIG)
- Cancer, Specified Disease & Intensive Care (AIG)
- Wellness Benefit (AIG)
- Policy Change Form (AIG)
Prosperity Group Benefits
- Accident (Prosperity Life)
- Cancer, Specified Disease & Intensive Care (Prosperity Life)
- Critical Illness (Prosperity Life)
- Hospital Indeminity (Prosperity Life)
- Supplemental Insurance Claim Form (English) (Spanish)
- Supplemental Insurance Claim Filing Instructions
- Supplemental Prescription Benefit Claim Form (English) (Spanish)
- Wellness (Prosperity Life)
- Prosperity Life - Policy Change Form
Prosperity Life Group - Shenandoah
Reliance Standard Life Insurance Company
- Accelerated Death Benefit (RSL)
- Death Claim (RSL)
- Disability (RSL)
- Disability Continuance Report(RSL)
- Medical Treatment Benefit (RSL)
- Waiver of Premium (RSL Long Term Disability)
- Reliance Standard (Portability Request Form)
- Reliance Standard (Change Request Form)
The Hartford
Wellfleet Insurance Company
- Accident (Wellfleet)
- Accident (Wellfleet) POA
- Administrative Duty (Wellfleet)
- Critical Illness (Wellfleet)
- Health Screening (Wellfleet)
- Hospital Indemnity (Wellfleet)
- Premium Waiver Claim Form (Wellfleet)
- Short Term Disability (Wellfleet)
- Wellfleet (Attending Physician Statement)
- Wellfleet (Authorization to Release Information)
- Wellfleet (Portability Request Form)
- Wellfleet (Beneficiary Form)
- Wellfleet (Employee Change Request Form)
Miscellaneous
Agents
Retirement Plan Services
- Transaction Authorization Form
- Salary Reduction Agreement
- Transaction Authorization Form
- Salary Reduction Agreement
403(b) Forms
457(b) Forms
Section 125