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Securian Financial

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Plan design

Documents

Basic group life insurance(pdf, 10/01/2016)
VRS optional life plan summary
Optional group life insurance(pdf, 08/01/2019)
An overview of the optional life coverage options for VRS members
Optional life premium calculation worksheet - existing insured(xls, 07/01/2019)
See how affordable optional life coverage can be using the common date
Optional life premium calculation worksheet - new participant(xls, 07/01/2019)
See how affordable optional life coverage can be using the applicant's current age
Optional life premium calculation worksheet- retiree continuation(xls, 07/01/2019)
Retirees have the option to continue a "portion" of their optional life insurance coverage within the group plan. See the cost if continuing in the group plan. Applicants coverage is subject to a reduction schedule.
Certificate of insurance(pdf, 07/01/2019)
Distribute to each insured employee
Conversion brochure(pdf, 02/01/2019)
(VRS-35) Enrollment information and form for conversion of group life insurance

 

Enrollment

Forms

Enrollment application for VRS optional group life insurance(pdf)
(VRS-39) Required to sign up for optional term coverage
Group life evidence of insurability(pdf)
(VRS-32) Complete to be underwritten for coverage that is not guaranteed

 

Administration

Forms

Request for change under optional group life insurance plan (pdf)
(VRS-39a) Required to make changes to your optional term coverage
Retiree optional life continuation(pdf)
(VRS-39R) For retirees who want to continue optional term coverage
Beneficiary change form(pdf)
(VRS-2) Required for changes to beneficiary
Absolute assignment of group life insurance(pdf)
(VRS-37) Required to transfer ownership of your VRS life insurance policy
Assignee's change of beneficiary(pdf)
(VRS-38) Required when the new policy owner wishes to change the beneficiary

 

Claims

Documents

Notice of claim (pdf, 01/01/2019)
Required for all claims
Beneficiary statement (pdf, 01/01/2019)
Required for designated beneficiary(ies)
Preference beneficiary statement (pdf, 01/01/2019)
Required when no beneficiary was designated
Notice of accidental loss - claimant statement (pdf, 01/01/2019)
(VRS-31) Required to claim this benefit
Notice of accidental loss - attending physician statement (pdf, 01/01/2019)
(VRS-31) Required to claim this benefit
Notice of accelerated benefit - claimant statement(pdf, 01/01/2019)
Required to claim accelerated benefits
Notice of accelerated benefit - attending physician statement(pdf, 01/01/2019)
Required to claim accelerated benefits