HLIS Application (for US-based plans)
UN WWP Application
UN MIP Application
Short-term Insurance Plan Application
2022 Annual Enrollment Campaign Form
2022 Deductible Credit Request Form
ASHI Application Form
UN MIP ASHI Application Form
Return to ASHI Form
Life Insurance Application Form
Life Insurance Termination Waiver
Beneficiary Certification Form 1
Beneficiary Certification Form 2
The Hartford Life Insurance PHA/Evidence of Insurability (EOI) Form
Designation of Beneficiary Form
Notice of Conversion and/or Portability Rights
W-8BEN
Death Claim Form
Declaration of Medicare Part B Ineligibility Form
Medicare Part B Bank Form
Medicare Part B Annual Reimbursement Request Form