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Forms

Life Forms

Change in Beneficiary Form
Change in Method of Settlement Form
Change in Name Form
Change of Policy Ownership Form
Policy Cash Surrender Form
Policy Loan Request Form

Life and Annuity Claim Forms

Life Claim Form
Annuity Claim Form
Group Term Life claim form

Health Plan Updates

Please call for plan updates

Health Product Claim Forms

American National Life Insurance Company of Texas (ANTEX)

Health claim form
Medicare Supplement claim form
Limited Medical/Accident claim form

Standard Life and Accident Insurance Company (SLAICO)

Disability claim form
Health claim form
Medicare Supplement claim form
Critical Illness claim form
Long Term Care claim form
Limited Medical/Accident claim form
Continuance of Disability claim form
Cancer claim form
Hospital Confinement claim form

Garden State Life Insurance Company (GSL)

Medicare Supplement claim form

HIPAA Forms

American National Life Insurance Company of Texas (ANTEX)

Notice of Privacy Practices
Personal Representative request
Request for access to medical records
Authorization for release of medical information
Request for amendment to medical record
Request for accounting of medical record distribution
Request to not disclose medical record dataset

Standard Life and Accident Insurance Company (SLAICO)

Notice of Privacy Practices
Personal Representative request
Request for access to medical records
Authorization for release of medical information
Request for amendment to medical record
Request for accounting of medical record distribution
Request to not disclose medical record dataset
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