Beneficiary Form Template PDF Details

At its core, the Beneficiary Designation Form provided by the Life Insurance Company of North America serves as a crucial tool for individuals to declare who will receive the benefits from policies such as life, accident, and disability insurance. Understanding the nuances of this document and completing it accurately can significantly impact the timely and proper distribution of insurance proceeds to designated beneficiaries. The form requires detailed information including the employer and employee's name, social security number, current address, and important numbers regarding basic life and accident insurance policies. It meticulously outlines the process for designating both primary and contingent beneficiaries, including how proceeds are divided and under what circumstances. Additionally, it underscores the influence of community property laws for married individuals residing in specific states, which can potentially delay or dispute payouts if a spouse is not named or has not consented to the beneficiary designation. Beyond the straightforward data entry, the document provides guidelines aimed at assisting individuals in making informed beneficiary designations. It addresses the considerations when naming minors, the complexities involved in designating trusts as beneficiaries, and the importance of revising beneficiary designations following significant life events. Furthermore, it emphasizes the potential necessity of consulting with an attorney to ensure that beneficiary designations are clear, reflect the owner's intentions, and comply with legal standards. This underscores the layered intricacy of such forms and the importance of thoughtful completion to safeguard the intended transfer of benefits and prevent unnecessary complications during difficult times.

QuestionAnswer
Form NameBeneficiary Form Template
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesbeneficiary designation form cigna, cigna life beneficiary designation, cigna beneficiary designation form, cigna life multiple beneficiary form pdf template printable

Form Preview Example

BENEFICIARY DESIGNATION FORM

Life Insurance Company of North America

Group Insurance

Life Accident Disability

Employer Name _____________________________________________

Employee Name_____________________________________________ Employee Social Security #_________________

Current Address__________________________________________ City__________________State______ Zip _______

Home Phone____________________Work Phone____________________ please enter all dates in mm//dd/yyyy format.

Primary and Contingent Beneficiaries – Unless you designate a percentage, proceeds are paid to primary surviving beneficiaries in equal shares. Proceeds are paid to contingent beneficiaries only when there are no surviving primary beneficiaries. If you designate contingent beneficiaries and do not designate percentages, proceeds are paid to the surviving contingent beneficiaries in equal shares. Unless otherwise provided, the share of a beneficiary who dies before the insured will be divided proportionately among the surviving beneficiaries in the respective category (primary or contingent).

Basic Life Insurance, Life Insurance Company of North America - Policy No. ________________

Employee’s Primary Beneficiary(ies):

Relationship

SS #

Date

of Birth

%(total must equal 100%)

Contingent(s):

Relationship

SS #

Date

of Birth

%(total must equal 100%)

Basic Accident Insurance, Life Insurance Company of North America - Policy No. ________________

Employee’s Primary Beneficiary(ies):

Relationship

SS #

Date

of Birth

%(total must equal 100%)

Contingent(s):

Relationship

SS #

Date

of Birth

%(total must equal 100%)

Community Property Laws - If you are married, reside in a community property state (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington or Wisconsin), and name someone other than your spouse as beneficiary, it is possible that payment of benefits may be delayed or disputed unless your spouse also signs the beneficiary designation.

Spouse Signature________________________________________________________________Date____/____/____

Owner Signature___________________________________________________________________Date____/____/____

Please refer to page 2 to review Guidelines for Designation of Beneficiaries. If you need additional space, using the above format, attach a separate piece of paper with the appropriate policy number, the date, and your signature.

GUIDELINES FOR DESIGNATION OF BENEFICIARIES

General - Please be sure to include the beneficiary’s full name, social security number and relationship to you. Providing this information can help expedite the claim process by making it easier to locate and verify beneficiaries.

Minors - While you may designate minors as beneficiaries, please note that claim payments may be delayed due to special issues raised by these designations. In the event of a claim and the beneficiary is a minor child, the insurance proceeds will not be released to the minor child. The insurance proceeds may be paid to a duly appointed guardian of the child’s estate. You may want to obtain the assistance of an attorney in drafting your beneficiary designation.

Trust as Beneficiary - You may designate a trust as beneficiary, using the following form: “To [name of trustee], trustee of the [name of trust], under a trust agreement dated [date of trust].”

If you wish to designate a testamentary trust as beneficiary (i.e., one created by will), you should recognize the possibility that your will which was intended to create this trust may not be admitted to probate (because it is lost, contested, or superseded by a later will). Claim payment delays can result if the beneficiary designation doesn’t provide for this situation.

Life Status Changes - We recommend that you review your beneficiary designation when significant life status events occur, such as marriage, divorce, or birth of a child.

See an Attorney! The above guidelines are general and are not intended to be relied on as legal advice. Unless your designation is a simple one, we recommend that you obtain the assistance of an attorney in drafting your beneficiary designation. A qualified attorney can help assure that your beneficiary designation correctly reflects your intentions, is clear and unambiguous, and meets legal requirements.

How to Edit Beneficiary Form Template Online for Free

It is possible to fill out cigna life benificary forms effectively with the help of our online PDF tool. To retain our tool on the leading edge of efficiency, we aim to put into action user-oriented capabilities and improvements on a regular basis. We are routinely pleased to get suggestions - join us in remolding the way you work with PDF forms. Getting underway is effortless! All you need to do is adhere to these easy steps below:

Step 1: Click on the orange "Get Form" button above. It is going to open up our tool so that you can begin filling out your form.

Step 2: With our handy PDF editor, it is easy to do more than simply complete blank form fields. Express yourself and make your docs look sublime with customized textual content incorporated, or modify the original input to perfection - all that accompanied by the capability to insert any images and sign the PDF off.

This form will need particular info to be entered, therefore ensure you take whatever time to provide precisely what is requested:

1. Begin completing the cigna life benificary forms with a selection of necessary fields. Note all of the important information and be sure nothing is forgotten!

Simple tips to fill in cigna life insurance beneficiary part 1

2. The next stage would be to submit all of the following fields: Contingents, Relationship, SS , of Birth, total must equal , Basic Accident Insurance Life, Employees Primary Beneficiaryies, Relationship, SS , Contingents, Relationship, SS , Date, of Birth, and total must equal .

cigna life insurance beneficiary writing process detailed (part 2)

Be really mindful while completing Relationship and of Birth, as this is where many people make errors.

Step 3: Right after you have glanced through the information in the blanks, simply click "Done" to conclude your document creation. Sign up with us today and immediately gain access to cigna life benificary forms, all set for downloading. All modifications made by you are saved , so that you can edit the file later when required. We don't share or sell the information that you use while filling out documents at our website.

Beneficiary Form Template isn’t the one you’re looking for?

Related Documents