If you're covered for group life or disability, or you administer group benefits, browse this list of frequently-used forms.

Group Forms

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PDF

Looking for forms for New York group policies? Click here.

Form Nbr

Description

Dental and Vision

XGR/2262

SLHIC (U.S.) Dental Claim Statement

XGR/2326

Vision Claim Form - SLHIC (U.S.)

DENTAL_ROLL_RENEW

Employee Handout: Rollover at Renewal

Enrollment

XGR/645

Group Enrollment Form

SLF_ENROLL_INSTR_SP

SLF Enrollment Instructions - Spanish

XGR/645-SP

Enrollment Form - Spanish Version (except VA)

XGR/823

Life/AD&D-Only Enrollment Form (non-contrib)

Evidence of Insurability

Now Available: Online Evidence of Insurability
If your employer has asked you to complete an Evidence of Insurability (EOI) application, you can use our secure web site to send in your required EOI information. Select Online Evidence of Insurability Application below and complete the questionnaire (it normally takes less than 15 minutes).

  • Online Evidence of Insurability Application

     

  • If you cannot use our Online EOI application, or your employer does not participate in our online services, click below for a printable EOI Application.

  • Printable EOI Application (requires Acrobat Reader)
  • Life and AD&D

    XGR/404-NEW

    Life Conversion Notice

    GR/2284

    Group Life Conversion Kit

    XGR/1787

    Sun Universal Protector Plus Handout

    XGR/2361

    Group Death Claim Packet

    XGR/1548

    Group Life and Disability Claim Packet

    XGR/740

    Beneficiary Designation

    XGR/740-SP

    Beneficiary Designation - Spanish version

    Long Term Disability

    XGR/1640

    Long Term Disability Claim Employer's Statement

    XGR/1641

    Long Term Disability Claim Employee's Statement

    XGR/1642

    Long Term Disability Claim Attending Physician's Statement

    XGR/464

    LTD Conversion Application

    XGR/351

    LTD Conversion Notice

    LOOK-BACK_FORM

    Look-Back Percentage Form

    LOOK-BACK_FORM_NY

    Look-Back Percentage Form (NY)

    Miscellaneous

    XGR/1385

    Authorization (Complies with HIPAA)

    W-2_LTD

    W-2 Service Agreem't (STD and/or LTD)

    XGR/1277

    ERISA Booklet Endorsement

    Premium/Billing

    XGR/389

    Statement of Premiums Due

    XGR/1457

    List Billing Change Form

    XGR/390

    Premium Statement for Life Step-Rates

    XGR/388

    Stop-Loss Statement of Premium Due

    Short Term Disability

    XGR/432

    Short Term Disability Claim Packet

    Disab_Auth_APS

    STD Employee Stmt Authorization and APS

    SLF_Auth_APS

    STD Authorization and APS

    LOOK-BACK_FORM

    Look-Back Percentage Form

    LOOK-BACK_FORM_NY

    Look-Back Percentage Form (NY)

    Stop-Loss

    XGR/437

    Specific Stop-Loss Claim/50% Notice

    XGR/1348

    Stop-Loss Simultaneous Reimbursement

    XGR/467

    Aggregate Monthly Claims Report

    XGR/1679

    Stop-Loss Direct Deposit Form

    SunAdvisor®

    XGR/647

    SunAdvisor® Claim Packet

    SLF_SA_AUTH_APS

    SunAdvisor Authorizations & APS

    SLPC5578


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