Forms

Easily apply online for Disability and Life insurance coverage by using our DocuSign application form.

Use this link to provide proof of good health when it’s required for your enrollment. You may need to complete a separate statement for your spouse/domestic partner if requested. Instructions: to begin, please use Policy Number 501000. For Division/Location, select your current district. When prompted, select coverage(s) you are applying for: Long Term Disability and/or Life.

Use this form to specify beneficiaries for benefits related to your voluntary Life and Disability coverage. Designating beneficiaries is an optional process.

Use this form to reinstate your coverage or update your address, name and salary information.

Use this form to specify beneficiaries for benefits related to your voluntary Life and Disability coverage. Designating beneficiaries is an optional process.

Use this form to terminate part or all of your coverage(s).

Use this packet if you need all forms related to filing a disability claim (including employer's and physician's statements and authorizations).

Use this packet if you need all forms related to filing a life claim.

To start a claim, please log in to CTAMemberBenefits.org/TheStandard. Once logged in, please return to this page to start a claim online. Please note that the online claims form does time out after a period of inactivity and you will need to start over.

Use this form to continue your life insurance during a temporary leave of absence resulting from a temporary layoff, a scheduled leave of absence approved by your employer, a state mandated Family or Medical Leave Act, or a strike, lockout or other work stoppage caused by a labor dispute.

Use to request application to convert group life insurance to an individual policy after insurance ends.