Health Questionnaire


This Health Questionnaire serves as an Evidence of Insurability Form for Minnesota Life Group Term Life Insurance and Assurant Employee Benefits Disability Insurance.
FormsBeneficiary Designation FormA Beneficiary Designation Form is used to name the beneficiary or change the exisiting beneficiary for benefts that are payable to survivors. Conversion to Adjustable Life LegendIf any portion of your Minnesota Life group coverage terminates (because your employment or membership in a class eligible for insurance terminates or the master group contract terminates or is amended), you may be able to continue your life insurance protection. Your right to do this is called a conversion privilege, and its features are described here for you.Conversion to Advantage Elite 10 Term Life InsuranceIf you were insured by a group life insurance contract issued to a Minnesota company and continue your insurance under the state continuation law, you may be eligible to convert to this term insurance product.Disability Claim FormsIf you have become disabled and were covered by Disability Insurance, claim forms are usually available from the carrier's website. We can help you access the forms most often used by Ochs, Inc. groups by clicking on the correct form. Employee Group Insurance Change RequestThis form is used by employees who participate in group life insurance through Minnesota Life. Health QuestionnaireThis Health Questionnaire serves as an Evidence of Insurability Form for Minnesota Life and Assurant Employee Benefits.Life Insurance ApplicationThe Group Term Life Insurance Application for our Minnesota Life clients is provided for your convenience.


"All labor that uplifts humanity has dignity and importance and should be undertaken with painstaking excellence." 
Martin Luther King, Jr.

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