A Guide for Successfully Completing the Group Short-Term ...
provide on this form to effectively determine if you qualify for group short-term disability benefits. This guide provides information and instruction to help you successfully complete and submit the claim form. Please consult your employer/benefits administrator if you need assistance in providing information for the form.
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A Guide for Successfully Completing the Group Short-Term ...
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content.mutualofomaha.comThe death benefit of the Policy is payable to the Beneficiary(ies) of record. If the New Owner(s)/Trustee(s) desire(s) the Beneficiary(ies) to be changed, the New Owner(s)/Trustee(s) must request this change in accordance with the Policy Provisions. The Beneficiary Change Request Form included may be used to change the Beneficiary(ies).
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content.mutualofomaha.comcompany affiliated with Mutual of Omaha, unless I make a separate designation for each coverage, either on or after the date of this designation. I also understand that this Designation of Beneficiary is subject to change as provided in the group contract(s).
Policyowner Information - Mutual of Omaha
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content.mutualofomaha.com[Mutual of Omaha], 3300 Mutual of Omaha Plaza, Omaha NE 68175. 8. I understand that if the person/organization authorized to receive the use of the Personal Information is not a health plan or health care provider covered by federal and state privacy regulations, the …
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