Get The Purpose Of This Form Is To Update, Add, Or Change A Beneficiary Designation To Your Life

This guide will help you understand how to complete the form to update, add, or change a beneficiary designation to your life insurance coverage. Follow these steps to ensure that your information is accurate and submitted correctly.

Follow the steps to complete your beneficiary designation form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section 2, provide your employee information, including your full name, BSC ID, agency or department, and contact details. Make sure to fill in your marital status and date of hire.
3. Navigate to Section 3 to specify the benefit plan(s) you are making beneficiary changes to. Check the appropriate box for Basic Life/ADD, Supplemental Life, or Dependent Life.
4. In Section 4, detail your beneficiary designations. First, list your primary beneficiary(ies) including their full name, date of birth, Social Security number, relationship to you, and their home address. Indicate the percentage of benefits each primary beneficiary will receive.
5. Similarly, for contingent beneficiary(ies), provide the same details as above, noting that they will receive benefits if something happens to the primary beneficiary.
6. In Section 5, read the authorization statement and provide your signature and the date to confirm that you are aware this change supersedes your previous designation. Remember to include the last four digits of your Social Security number.
7. Once you have completed the form, save your changes. You can either download the form, print it, or share it as needed.

Start filling out your beneficiary designation form online today to ensure your preferences are updated.