If group life insurance was assigned under a prior group policy, then in order to continue the assignment under the new Group Policy the insured person and the owner must complete and sign a Statement of Intent form.
The completed form must be sent to the insurer for approval, along with copies of all enrollment forms, beneficiary designations and the prior absolute assignment.
|Form Name||Form Number|
114963 (24661h) (rev 9/01/14)
116013 (46559d) (rev 9/01/14)