Insurance Forms

Life happens and things change. Ensure all of your insurance information is up to date, so your loved ones are well taken care of.

Beneficiary Designation Form

The beneficiary designation form is a legal document that allows the insured to name their primary and contingent beneficiaries. Also available in Spanish!

Access Form

Rate Sheet
Check out our rate sheet for a breakdown of how the additional life insurance premium is calculated based on age brackets as well as our age reduction policies.

Download Rate Sheet

Online Insurance Payment Procedure
Making a payment online is easy with our step-by-step guide that walks you through our online payment process.

Download Process Form

Newly Credentialed Minister Enrollment Form

All newly UPCI credentialed ministers have 90 days from the time of their credentialed status to enroll in guaranteed additional insurance. If you are a newly credentialed minister, enroll today!

Download Enrollment Form

Enroll Online!

Evidence of Insurability Form (EOI)

The instructions below will lead you to Securian’s application portal where you can easily apply for additional life insurance. The Evidence of Insurability (EOI) form is an application which helps our underwriter, Securian, determine the applicant’s eligibility for additional life insurance through the request of additional information.

Download EOI Instructions

AD&D Plan Summary

Do you need additional AD&D coverage? This summary highlights all the AD&D insurance benefits available to you through The Hartford’s group voluntary additional AD&D program.

Download Plan Summary

AD&D Enrollment

If you think that AD&D insurance is for you, enroll today!

Enroll Today!

Self-Administrated Universal Life Claim
If you think that AD&D insurance is for you, enroll today!

Start Claim

Value Added Benefits

Every credentialed minister residing in the U.S. and Canada are provided $10,000 group term life insurance, underwritten by Securian Insurance. Check out these free services and educational resources from Securian!

Travel Assistance
Beneficiary Financial Coaching
Advisor Connection
Enrich Financial Wellness
Legacy Planning Resources
Lifestyle Benefits

24/7 online, pre-trip resources and support for emergency travel assistance as well as other services when traveling 50+ miles from home.

Beneficiaries receiving $25,000 or more are invited to take advantage of this program when the life insurance claim is paid. Services include dedicated financial coaching, budgeting tools, financial fitness assessment, and survivor guide workbooks.

Convenient educational seminars provide actionable strategies to help you address your financial wellness.

Personalized financial education that provides behavior-changing, interactive financial education to help you improve your financial well-being.

Access a variety of online resources, including end-of-life and funeral planning.

All active ministers and their families can access these legal, financial, and grief resources.