Form download and instructions

The Forms Index below allows you to quickly download and print commonly used forms.

PDF Format Our forms are available in Portable Document Format (PDF). To view the forms, you may need to download the latest version of Adobe® Acrobat® Reader available at www.adobe.com.

Administrative Forms Claims Forms


Administrative forms – Life

Beneficiary Designation All Other States

Beneficiary Tips All Other States

Minnesota Life Cobra Minnesota

Notice of Conversion Privilege California | Colorado | Connecticut | Florida | Iowa | Kentucky | Louisiana | Michigan | Minnesota | Mississippi | New Hampshire | New York | North Carolina | North Dakota | Oregon | Rhode Island | South Dakota | Texas | Utah | Virginia | Washington | Wisconsin | All Other States

Notice of Portability Privilege New York | All Other States

Administrative forms – Disability

Notice of Short Term Disability Conversion Privilege  New York | All States

Notice of Long Term Disability Conversion Privilege  New York | All Other States

Administrative forms – Other

Accident Only Portability Employee Application - To Age 65  All States

Cancer Only Portability Employee Application - To Age 65  All States

Critical Illness Portability Employee Application - To Age 65  All States

Payment Agreement and Bank Draft Authorization  All States

Request to Elect Critical Illness COBRA  All States

Request to Elect Cancer COBRA  All States

Request to Elect Group Hospital Indemnity GAP COBRA All States

Voluntary/Worksite Benefits Service Request All States

Worksite Contact List All States



Claims forms – Life

Life Insurance Claim Statement New York | New Jersey | All Other States

Disability Claim Statement-Life Insurance New York | All Other States 

Claims forms – Disability

Short-term Disability Claim Statement New York | All Other States
Spanish ( Español - Declaración Referente a la Reclamación por Concepto de Incapacidad a Corto Plazo)

Long-term Disability Claim Statement New York | All Other States
Spanish (Español - Declaración Referente a la Reclamación por Concepto de Incapacidad a Largo Plazo)

Claims forms – Worksite

Accident Claim Statement All States

Accident Claim Statement - Spanish All States - Spanish

Cancer Claim Statement All States

Cancer Claim Statement - Spanish All States - Spanish

Critical Illness Claim Statement All States

Critical Illness Claim Statement - Spanish All States - Spanish

Hospital Confinement Indemnity “Gap” Claim Statement All States

Hospital Confinement Indemnity “Gap” Claim Statement - Spanish All States - Spanish

Employee Paid Supplemental Claim All States

Employee Paid Supplemental Claim - Spanish All States - Spanish

Wellness & Cancer Screening Claim Statement All States

Wellness & Cancer Screening Claim Statement All States - Spanish 

Insurance products are underwritten by Union Security Insurance Company (USIC) (Kansas City, MO) and administered by Sun Life Assurance Company of Canada (SLOC) (Wellesley Hills, MA) in all states except New York. Prepaid dental products are provided by USIC and are administered by SLOC, and are provided by prepaid dental companies affiliated with SLOC in certain states except New York. Prepaid dental companies are Denticare of Alabama, Inc., United Dental Care of Arizona, Inc., UDC Dental California, Inc., United Dental Care of Colorado, Inc., Union Security DentalCare of Georgia, Inc., United Dental Care of Missouri, Inc., Union Security DentalCare of New Jersey, Inc., United Dental Care of New Mexico, Inc., UDC Ohio, Inc., United Dental Care of Texas, Inc., and United Dental Care of Utah, Inc. In New York, insurance products and prepaid dental products are underwritten or provided by Union Security Life Insurance Company of New York (Fayetteville, NY) and administered by Sun Life and Health Insurance Company (U.S.) (Lansing, MI). Group Hospital Confinement Indemnity “Gap” or Supplemental Medical Expense “Gap” insurance is underwritten by Fidelity Security Life Insurance Company (Kansas City, MO) and is administered by SLOC.

 © 2017 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. All rights reserved. Sun Life Financial and the globe symbol are registered trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us.