This tool is for plan sponsors and administrators to submit a group benefits life claim. If you are not the plan sponsor or a benefits administrator, please contact them to report the death and do not complete this form.
Select the Start new life claim button to begin your submission. If you have any questions about submitting a life claim, please contact your service specialist.
To begin the process, you will need information about the member's coverage and employment status:
You will also need:
At any point , you can select Save for later in the application and return when you are ready to continue. Once you select Save for later, you will be emailed a link with instructions on how to access your saved application. Pending applications will be saved for 30 days, if not resumed within this time, you will have to start a new submission.
Please refer to the legal, privacy and security pages for information on the use of this site.