Life Insurance Forms
Enrollment in the University Life Insurance Plan is automatic for newly eligible faculty and staff hired after 1/1/2016, and does not require any forms. You must be enrolled in the University Life Insurance Plan in order to enroll in the Optional Plan or Dependent Life. Forms are available to enroll in additional coverage, to change or cancel your coverage, or to designate beneficiaries.
- University and/or Optional Group Term Life Insurance Application - Use this form to enroll in Optional Life or increase your coverage.
- Dependent Group Term Life Insurance Application - Use this form to enroll your spouse or OQA or your eligible unmarried dependent children in the Dependent Plan. No person may be insured as a Dependent of more than one U-M employee. The life insurance policies do not allow double coverage of any dependent.
- Group Term Life Insurance Withdrawal Form - Use this form to cancel life insurance coverage.
- MetLife Beneficiary for Group Life Insurance Form - Use this form to designate or change your life insurance beneficiaries. Please note that this form is only for your U-M life insurance beneficiary designations. There are separate beneficiary designations for U-M retirement savings plan accounts you may have with TIAA and or Fidelity. See Your Beneficiary for more information.