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Service Request/ Quick Forms

 

In an effort to assist in simplifying your employees’ benefit needs, Benefit Specialists has provided the most often requested forms in a downloadable format below.

 

If you do not see the appropriate form below please fill out a service request with the information regarding the type of form and company you are looking for and we will respond to you within 24 hours.

_________________________________________________________________________________________________________

 

Please feel free to contact Benefit Specialists through the service request tool below if you have a question or would like more information on a specific carrier, product or service.

 

Please note that fields designated with a * are required information and must be supplied before submitting.

*Name:
*Company:
*Email:
*Telephone:
*Request:

 

 

Quick Forms

Avesis
Avesis claim form
Avesis Employee App
Companion Life
Companion Life Enrollment Form
Agent Claims Authorization
Fort Dearborn Life
Application with evidence of insurablity
Beneficiary form- English
Guardian
Life Claim Form
LTD Claim Form
STD Claim Form
Beneficiary Form
Dental Claim Form
Evidence of Insurability Form
The Hartford
Manuals & forms
Lincoln Financial
Evidence of Insurability
Life Claim Form
STD Claim Form(Omaha)
LTD Claim Form (Omha)
Beneficiary Designated Form
EOI form
Metlife
Manuals & forms
Midland National Life
Policy Change, reinstatement, conversion form
Midland bank draft
Midland beneficiary form
Midland Service form
Pioneer Mutual (One America)
Bank Draft Authorization
Pioner Mutual Bene. Change form
Death Claim form
Pioneer general service form
Reliance Standard Life
Reliance Beneficiary form
Reliance Integrated DI Claim Form
VIP LTD Conversion Form
Spirit Dental
Spirit Dental Employee Enrollment Form
Spirit Dental employee FAQ
Spirit Dental Employer FAQ
Spirit Dental Change Form
Spirit Dental Bank ACH
Standard Insurance of Oregon
Consolidated Disability claim packet 2047 for ND
Evidence of Insurability
Beneficiary form for ND
1794 Life Claim Packet for ND
UNUM Life
Unum reinstatement and change app
Bank Draft form
Unum evidence of insurablitiy form
Unum claim form
Non Disabling Injury claim form
LTC Continuation Notice
Unum Beneficiary form

Primary Companies with Links:

- Assurant www.assurantemployeebenefits.com

- Avesis www.avesis.com How to use the vision benefits
- Fort Dearborn Life www.fdl-life.com

- Guardian www.guardianlife.com/employeebenefits/employee_benefits_prod.html

- The Hartford www.thehartford.com/groupbenefits
- Medica www.medica.com
- MetLife www.metlife.com

- Metlife for employees - www.metlife/mybenefits.com

- Principal www.principal.com/grouplh/index.htm
- Pioneer Mutual/One America www.oneamerica.com
- Reliance Standard www.reliancestandard.com
- Standard Insurance of Oregon www.standard.com
- UNUM www.unum.com
- Spirit Dental www.spiritdental.com
- Illinois Mutual www.illinoismutual.com
- Purchasing Power www.purchasingpower.com
- Unitrin Direct www.udpreferred.com

- Live Well Solutions www.www.livewellworklife.com