Life and AD&D service forms
Life insurance service forms
Please download and fill out your form, then mail it to the address on the form. Fax is not available at this time. Requests will be processed once our systems are restored.
View forms associated with your policy type. Find your policy certificate/number.
Service request form - Policies starting with 41 or 51:
Request changes to your payment frequency, policy withdrawals, or cancellation/surrender.
Service Request - CMFG Life Insurance Company
Service request form - Policies starting with 06:
Request adjustment to or withdrawal of dividends, loan or partial withdrawal, or cancellation/surrender.
Service Request - CMFG Life Insurance Company
Service request form - Policies starting with 21:
Request adjustment to or withdrawal of dividends, loan or partial withdrawal, or cancellation/surrender.
Service Request - MEMBERS Life Insurance Company
Beneficiary change form and instructions - Policies starting with 06, 41 or 51:
Change of Beneficiary Request Form - CMFG Life Insurance Company
Beneficiary change form and instructions - Policies starting with 21:
Change of Beneficiary Request Form - MEMBERS Life Insurance Company
Change ownership of the policy - Policies starting with 06, 41 or 51:
PLEASE NOTE: A W-9 must also be completed and returned with this Absolute Assignment form.
Absolute Assignment - CMFG Life Insurance Company
Change ownership of the policy - Policies starting with 21:
PLEASE NOTE: A W-9 must also be completed and returned with this Absolute Assignment form.
Absolute Assignment - MEMBERS Life Insurance Company
Change ownership of a policy with multiple owners - Policies starting with 06, 41 or 51:
PLEASE NOTE: A W-9 must also be completed and returned with this Absolute Assignment form.
Absolute Assignment (Multiple Owners) - CMFG Life Insurance Company
Change ownership of a policy with multiple owners - Policies starting with 21:
PLEASE NOTE: A W-9 must also be completed and returned with this Absolute Assignment form.
Absolute Assignment (Multiple Owners) - MEMBERS Life Insurance Company
Payer’s request for taxpayer identification number:
Must be completed and returned along with Absolute Assignment form(s).
AD&D service forms
Please download and fill out your form, then mail it to the address on the form. Fax is not available at this time. Requests will be processed once our systems are restored.
View forms associated with your policy type. Find your policy certificate/number.
Service request form for AD&D:
Request cancellation, change coverage amount, or plan type.
Beneficiary change form for AD&D, including instructions:
Change of Beneficiary Request form
Mail in requests
Mail your request to the address on your form. Fax is not available at this time.
Please provide as much detail as possible when completing the form to help us review our request. These forms should be completed, signed and mailed to TruStage. They will be processed as our systems are restored. Requests will be honored dating back to when the request was received.
Thank you for your patience and understanding.