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DEATH OF A DEPENDENT




  • Insurance

Action: To remove spouse/child from medical/dental/vision/optional life insurance/optional AD&D effective on the date dependent passed.
    Forms »
Choices Enrollment Form
  • Optional Health Care Reimbursement Account:

Action: Decrease dollar amount of your election(s).
    Forms »
Change of Status
Election Form /Compensation Reduction Agreement (In office pick-up)
  • Dependent Life Insurance Claim

Action: To research benefit.
Consult Handbook

Action: To file a claim.
    Resources » Consult Benefits Specialist

  • Optional AD&D Claim

Action: To file a claim.
    Resources » Consult Benefits Specialist

  • Taxes

Action: Change number of exemptions.
    Forms » W4

  • Beneficiary Changes

Action:You may wish to reassign beneficiary status for the following:
    Basic Life/AD&D » use the reverse side of the Choices Enrollment (In office pick-up).

    Retirement »
TRS
PERS Enrollment Card (In office pick-up)
TIAACREF
    Final Salary Payout »
Decedent's Warrant

QUICK QUESTIONS




We've got the answers to your questions concerning, Insurance Group Numbers, Care Provider Networks, Coverage ID Cards, and more. Please visit the Quick Questions site.

For additional information or assistance regarding all benefits, please contact:

Rita Garland
Benefits Services
406.243.4238
406.243.6095 FAX

Human Resource Services

Emma B. Lommasson Center
Room 252

The University of Montana

Missoula, MT 59812

Phone: 406-243-6766

Fax: 406-243-6095