Sglv 8286 Form PDF Details

Understanding the SGLV 8286 form is essential if you are serving in the military, a veteran, or making changes to your life insurance policy. The purpose of this form is to allow individuals to make important decisions regarding their Servicemembers’ Group Life Insurance (SGLI) coverage and ensure that their benefits will be delivered as intended where indicated on the form. This blog post will break down everything you need to know about completing and submitting an SGLV 8286 so that you can make informed decisions for yourself or your family members who serve.

Question	Answer
Form Name	Sglv 8286 Form
Form Length	4 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min
Other names	sglv 8286, sglv8286, sglv army, fillable sglv 8286 form

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Servicemembers’ Group Life Insurance

Election and Certificate

Office of Servicemembers'

Group Life Insurance

1. About You

Print Name (First, Middle, Last)	Rank, title or grade	Social Security Number


Duty Location	Branch of Service	Current Amount of SGLI

2. About Your Coverage (This form replaces all prior designations)

I am completing this form to: (Check all that apply)

Name or update my SGLI beneficiary. You must complete sections 3 & 5.

Increase or restore my SGLI coverage to $		. You must complete sections 3, 4, & 5.
(Increasing SGLI does not automatically increase FSGLI, if FSGLI was < $100,000.)
Reduce my SGLI coverage to $	. You must complete sections 3 & 5.

Decline or cancel SGLI coverage. Write below “ I do not want insurance at this time.” You must complete section 5 only.

“

.”

Coverage is available in increments of $50,000 up to

amaximum of $400,000

3.About Your Beneficiaries (Please always complete this section unless you are declining coverage. If you do not specifically name beneficiaries, your insurance will be paid by law. Please read the information on page 3 before selecting your beneficiaries.)

			Share to each (% or $
			amounts. The sum of the
			shares must equal 100% or	Payment Option
Primary			the full dollar amount of your	(Lump sum* or
Primary	Social Security Number	Relationship	insurance.) (Each share must	36 equal monthly
Name and Address	(If available)	to you	be greater than $0.00 or 0%)	payments)

Secondary

Have more beneficiaries? Check this box if 1.) you have additional beneficiaries and are completing the Supplemental SGLI Beneficiary Form, SGLV 8286S or, 2.) You are attaching additional documentation to complete your beneficiary designation noted above.

*If the insured member elects a lump sum payment, the beneficiary(ies) will be given the option of receiving the lump sum payment through the Prudential Alliance Account®, by check, or Electronic Funds Transfer (EFT). Alliance Account is not available for payments less than $5,000, payments to individuals residing outside the United States and its territories, and certain other payments. These will be paid by check.

The Bank of New York Mellon is the Administrator of the Prudential Alliance Account Settlement Option, a contractual obligation of The Prudential Insurance Company of America, located at 751 Broad Street, Newark, NJ 07102-3777. Draft clearing and processing support is provided by The Bank of New York Mellon. Alliance Account balances are not insured by the Federal Deposit Insurance Corporation (FDIC). The Bank of New York Mellon is not a Prudential Financial company.

GL.2010.094 Ed. 2/2015

SGLV 8286

Page 1 of 4

4.About Your Health Complete this section ONLY if you are restoring or increasing coverage.

Your gender

Your date of birth (MM, DD, YYYY)

Your weight

Your height

Female Male

Have you had, been treated for, or
had known indications of:	Yes	No

a. A heart condition?

b. High blood pressure?

c. A neurological disorder? d. Diabetes?

e. Cancer or tumors?

f. Have you ever been diagnosed as having a disease of the immune system?

g. Do you have any known physical impairments, deformities, or ill health not covered above?

Did you answer “YES” to any question? If so, reference the question by letter and list date, duration and details below. Please attach additional documentation if necessary.

If you answered “yes” to any question above, a request to increase coverage does not take effect until approved by the Office of Servicemembers’ Group Life Insurance (OSGLI). If you answered “no” to all the questions above, your request for increased coverage takes effect immediately.

5.Your Signature You must complete this section.

I have read the information on page 3 and instructions on page 4 and understand that:

This form replaces any prior beneficiary or payment instructions.

I can have SGLI and Veterans’ Group Life Insurance (VGLI) coverage at the same time, but the combined amount cannot be more than $400,000.

Reducing or declining SGLI coverage can affect the amount of my family coverage, traumatic injury coverage and post-separation coverage (see instructions on page 4).

Please take note:

If my spouse is…	and…	then…

also a member of the	we married on or after January 2, 2013	spouse SGLI coverage is not automatic, but I may apply for spouse coverage by
uniform services		completing SGLV 8286A.

not a member of the	I am married, or get married after completing	spouse SGLI automatically covers my spouse. I must register my spouse in DEERS so
uniformed services	this form, and have not declined SGLI,	my branch of service can deduct premiums from my pay. Failure to do so will result in a
		debt for unpaid premiums. I can decline spouse coverage by completing SGLV 8286A.

I am free to name anyone I want as my beneficiary. I understand if I am married and have designated someone other than my spouse or child as my beneficiary, the person I have named is the person I intend to receive my insurance proceeds. I also understand that my spouse may be notified that he/she (or my child) is not my designated beneficiary.

I certify that, to the best of my knowledge and belief, the above statements are complete and true. Any deception or false statement, either by reference, omission, or otherwise can result in loss of coverage or denial of a claim for benefits.

Service Member Signature	Social Security Number	Date (MM, DD, YYYY)

Address

Submit this form to your Unit Personnel Clerk.

For Branch of Service Use Only

Name of Personnel Clerk

For OSGLI Use Only

Representative

Rank, title or grade

Approve

Contact telephone/email

Disapprove

Date

Address

GL.2010.094 Ed. 2/2015

SGLV 8286

Page 2 of 4

Information for the Service Member

About your SGLI Coverage

Servicemembers’ Group Life Insurance (SGLI) is granted under title 38, United States Code, and is subject to the provisions of that title and its amendments, and title 38 Code of Federal Regulations.

The following charts provide information you should review before naming a beneficiary or selecting a payment option.

Naming Beneficiaries who will receive the insurance

	If you…	Then…
	are married and decline coverage upon	your spouse will be notified that you declined coverage.
	entry into service

	are married and designate any person	your spouse will be notified in writing, by the Branch of Service that he/she or your child is not the named beneficiary,
	other than your spouse or child for any	unless:
	amount of insurance	– your spouse has been previously notified, OR
		– your spouse is not designated as beneficiary for any amount of insurance prior to the new election.

	are married and your spouse is designated	your spouse will be notified in writing of your election to decline or reduce coverage.
	as beneficiary and you decline coverage
	or elect less than maximum coverage, and
	that election reduces your coverage from
	the automatic maximum or from a
	previously elected amount of coverage
	have any life event such as marriage, divorce,	you should complete a new beneficiary form. Beneficiaries are not automatically changed by life events.
	or children after completing this form

	name more than one beneficiary	the sum of the shares must equal 100% or the full dollar amount of your insurance.

	want to name more than four primary or	you must complete the SGLI Supplemental Beneficiary Form, SGLV 8286S or attach additional documentation to
	secondary beneficiaries	complete your beneficiary designation.

	name minors as beneficiaries		OSGLI will pay the insurance benefit to the court-appointed guardian of the minor’s estate if the beneficiary is a
			minor at time of claim; or
			you can establish a trust for the benefit of the minor and name the trustee of the trust as beneficiary.
			naming a trust as a beneficiary on this form does NOT create a trust.

	name more than one primary beneficiary	OSGLI will pay the shares equally among the remaining primary beneficiaries.
	and one or more of them predeceases you
	want to name a Trust as a beneficiary	you must create a trust. Please consult with a military attorney, professional financial planner, or estate planner to
		help you create Trust documents. (Please note: Do not send Trust documents to OSGLI until the time of claim).

	have no surviving primary beneficiaries	OSGLI will pay the insurance benefit to the secondary beneficiaries, if any.

	do not name a beneficiary or	OSGLI will pay the insurance benefit in the following order:
	there are no surviving primary	1. Widow or widower
		1. Widow or widower
	or secondary beneficiaries	2. Children in equal shares (the share of any deceased child will be distributed equally among the
	OR
	OR		descendants of that child)
	indicate that payment should be made		descendants of that child)
	indicate that payment should be made	3. Parent(s) in equal shares or all to surviving parent
	by law	3. Parent(s) in equal shares or all to surviving parent
	by law	4. A duly appointed executor or administrator of your estate

		5. Other next of kin

	Payment Options

	If you want the beneficiary to…	Then…
	receive the insurance proceeds in one	write the phrase “lump sum” under Payment Options. If you elect a lump sum payment, your beneficiary(ies)			will
	lump sum	be given the option of receiving the lump sum payment through the Prudential Alliance Account®*, by check,			or
		Electronic Funds Transfer (EFT).
		* Alliance Account is not available for payments less than $5,000, payments to individuals residing outside the
			United States and its territories, and certain other payments. These will be paid by check.
	receive the insurance proceeds in 36		write “36” under the Payment Option.
	receive the insurance proceeds in 36		write “36” under the Payment Option.
	equal monthly payments		your beneficiary cannot change this payment option.
			your beneficiary cannot change this payment option.
	have a choice	write the phrase “lump sum” under Payment Option or leave blank.

GL.2010.094 Ed. 2/2015			SGLV 8286	Page 3 of 4

Instructions for Personnel Clerk and the Service Member

1.A representative of the Uniformed Services must complete the “For Branch of Service Official Use Only” section to indicate receipt of the form from the member after reviewing the following table:

	The Personnel Clerk should inform
If the service member…	the service member…		Then the Personnel Clerk should…
has just entered the service	he or she is automatically insured for $400,000 SGLI, unless the		have the service member designate beneficiaries by
	service member declines or reduces coverage.		completing SGLV 8286.

is increasing or restoring SGLI	he or she must complete Section 4, About Your Health.			approve form if the responses to questions 4a through
is increasing or restoring SGLI	he or she must complete Section 4, About Your Health.			approve form if the responses to questions 4a through
				4g are “No” and forward the form to payroll to change
				SGLI premium deductions.
				send form to OSGLI if any answer to questions 4a through
				send form to OSGLI if any answer to questions 4a through
				4g are “Yes.” Only inform payroll when approved by OSGLI.

Reduces, declines,		an application with health questions is required to increase,		forward the form to payroll to change SGLI premium
Reduces, declines,				forward the form to payroll to change SGLI premium
or cancels SGLI		elect, or restore coverage at a later date.		deductions.
		of the following:		if canceling SGLI, have the service member complete
		of the following:		if canceling SGLI, have the service member complete
		– the purpose and role of life insurance in financial planning.		SGLV 8286A to end payment of Family SGLI premiums.
		– the difference between term life insurance and whole life insurance.		No form is required to end TSGLI premium deductions.
		– the availability of commercial life insurance.		if the member is married and reduces, declines, or
		– the availability of commercial life insurance.		if the member is married and reduces, declines, or
		– the relationship between SGLI and VGLI.		cancels SGLI, inform the member that his her spouse
		– declining or canceling SGLI will also cancel Family SGLI— both		may be notified in writing, by the Branch of Service, of
				the member’s election based on Title 38, USC 1967 (f).
		spouse and dependent child coverage— and Traumatic Injury		the member’s election based on Title 38, USC 1967 (f).
		spouse and dependent child coverage— and Traumatic Injury
		Protection (TSGLI).

gets married to another member of	spouse SGLI coverage is not automatic and the member may		if member wants spouse SGLI coverage, provide the
the uniformed services on or after	apply for spouse SGLI coverage by completing SGLV 8286A.		member with SGLV 8286A, Spouse Coverage Election and
January 2, 2013			Certificate, and follow the instructions therein.

is married or gets married after		spouse SGLI automatically covers spouse.	if applicable, forward the form to payroll to begin
is married or gets married after		spouse SGLI automatically covers spouse.	if applicable, forward the form to payroll to begin
completing this form and is not		he or she must register their spouse in DEERS for	premium deductions for the spouse coverage.
completing this form and is not			premium deductions for the spouse coverage.

married to another member of the		payroll to deduct premiums.
		payroll to deduct premiums.
uniformed services		If the member wants to decline coverage or take a lesser amount

		of spouse coverage, the member must complete SGLV 8286A.

has questions about this form	the advice of a military attorney is available at no expense.		direct them to the appropriate resource.

wants to designate more	he or she must complete the Supplemental SGLI Beneficiary Form		attach the Supplemental Beneficiary Form to the SGLV
beneficiaries than the form allows	SGLV 8286S or attach additional documentation to complete your		8286 or attach additional documentation to complete your
	beneficiary designation.		beneficiary designation.
designates any person other than		while the member is free to designate anyone he or she	have the member sign SGLV 8286 to certify that he/she
designates any person other than		while the member is free to designate anyone he or she	have the member sign SGLV 8286 to certify that he/she
his/her spouse or child for any		chooses as beneficiary, the member must certify that he	understands that:
amount of insurance		or she is designating someone other than a spouse or		he/she is free to name anyone as beneficiary.
		child and the person named will receive the benefit.		he/she is free to name anyone as beneficiary.
		child and the person named will receive the benefit.		if he/she designated someone other than his/her
		if the member is married, the member’s spouse will be		if he/she designated someone other than his/her
				spouse or child as beneficiary, the person the member

		notified in writing by the Branch of Service, that he/she or
				has named is the person he/she intends to receive the
		the member’s child is not the named beneficiary, unless:		has named is the person he/she intends to receive the
		the member’s child is not the named beneficiary, unless:		insurance proceeds.
		– the spouse has been previously notified, OR		insurance proceeds.
		– the spouse has been previously notified, OR		if married, the spouse will be notified that he/she
		– the spouse is not designated as beneficiary for any		if married, the spouse will be notified that he/she
		– the spouse is not designated as beneficiary for any		(or any child) is not the designated beneficiary.
		amount of insurance prior to the new election.		(or any child) is not the designated beneficiary.
		amount of insurance prior to the new election.

2.After the form is completed, Personnel Clerk should:

File a copy in the member’s official personnel file

Provide a copy to the service member

Provide a copy of the form to the payroll office for the member’s unit

Submit the form to OSGLI ONLY if the member is increasing or restoring SGLI coverage and answered “Yes” to one or more of the health questions

OSGLI

PO Box 41618

Philadelphia, PA 19176-9913

If a member is making a Beneficiary change only, the form DOES NOT have to be forwarded to OSGLI.

GL.2010.094 Ed. 2/2015

146202-09142

SGLV 8286

Page 4 of 4

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This form requires particular info to be filled in, so be sure you take the time to provide exactly what is required:

1. To get started, once filling out the sglv pdf, start out with the form section containing following blanks:

2. After the first part is done, go on to enter the applicable information in these: Secondary, Have more beneficiaries Check this, If the insured member elects a, and The Bank of New York Mellon is the.

3. Your next part is generally simple - fill out all of the blanks in About Your Health Complete this, Your date of birth MM DD YYYY, Your weight, Your height, Your gender, Female Male, Have you had been treated for or, a A heart condition, b High blood pressure, c A neurological disorder, d Diabetes, e Cancer or tumors, Yes, Did you answer YES to any question, and f Have you ever been diagnosed as in order to finish this segment.

Always be extremely careful when filling in c A neurological disorder and Yes, as this is where many people make errors.

4. This fourth part comes next with these form blanks to fill out: I certify that to the best of my, Service Member Signature, Social Security Number, Date MM DD YYYY, Address Submit this form to your, For Branch of Service Use Only, Name of Personnel Clerk, Rank title or grade, Contact telephoneemail, Date, Address, For OSGLI Use Only, Representative, Approve, and Disapprove.

Date MM DD YYYY, Address, and I certify that to the best of my inside sglv print

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