Life Help®

Insuring Members for Life

Member Services - Download Forms

Changes to the group policies listed below can be made by completing the required form and submitting it to LifeHelp, the plan administrator.

Select the type of group insurance policy and desired change that you have:

Life Insurance

New York Life Insurance Company – 10-Year Level Term Life

• NYL 10YT Change Form
• NYL 10YT Beneficiary Form

New York Life Insurance Company – Affinity Term Life

• NYL Affinity Life Change Form
• NYL Affinity Life Beneficiary Form

United States Life – 50-Plus Term Life

• United States Life 50+ Change Form
• United States Life 50+ Beneficiary Form

Accidental Death & Dismemberment

New York Life Insurance Company – AD&D

• NYL AD&D Change Form
• NYL AD&D Beneficiary Form

The Hartford – AD&D

• The Hartford AD&D Change Form
• The Hartford AD&D Beneficiary Form

American General Assurance– AD&D

• American General Assurance AD&D Change Form
• American General Assurance AD&D Beneficiary Form

United States Life AD&D

• United States Life AD&D Change Form
• United States Life AD&D Beneficiary Form

Health Statements

• New York Life Insurance Form
• United States Life Insurance Form

Please print, complete, sign and mail the downloaded form to:

LifeHelp
6724 Lockheed Drive
Redding, CA 96002-9004

Forms for The Hartford may be signed and faxed to: (530) 223-7712
Forms for New York Life, United States Life, or American General Assurance must be mailed to the above address.

If you are not sure what type of policy you have or from which insurance carrier, please contact Member Services at (800) 345-4543 from Monday to Friday, 5 a.m. to 5 p.m., Pacific Standard Time.