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Enrollment and Changes

To initiate the enrollment process or make changes to an existing policy, you will need to select, download and print the appropriate forms(s) from the list below. Once you have completed all the necessary forms and added supporting documentation as indicated, mail the whole application to the address provided on the forms.

Helpful tip: To determine how much insurance you will need, first download the Life Benefit Worksheet (.doc) and use it to assess your own situation.

These are the forms you may need to initiate the enrollment process.

Affadavit of Domestic Partnership (.pdf)
Change of Beneficiary
Spousal Waiver for Community Property States
Employee Enrollment Form
Evidence of Insurability - Short Form
Life Benefit Worksheet
Evidence of Insurability - Long Form

Additional Information

If you need further information or assistance, please contact LifeWise Assurance Customer Service.

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