Contact Form: Customer Services

Personal Information








Your Workplace Information

If applicable. Please provide your customer number or the last four digits of your social security.
Comments/Concerns/Requests
If you can provide additional information, especially a policy and/or claim number. It helps us address your concern.

Quick Access

  • Your Account

    View your policies, download forms and check the status of your claims - all in one spot!

  • Claim & Flex Forms

    1Select the forms you need:

    Flex Benefits
    Accident Benefits
    Cancer Benefits
    Critical Illness
    Disability Benefits
    Hospital Indemnity
    Life Benefits
    Medical (GAP)
    HRA Benefits

    2Select your state & industry:

  • Check Claim Status
  • FAQs

    Please select a category or type your question in the box below.

    Keyword Search
    All FAQs