LTD, LTC & Life Forms for Download: All forms in Acrobat .pdf format unless otherwise noted.
The Standard LTD Policy #: 146481Unum LTC Policy #: 220185
Contact Info for UNUM: Contact Info for The Standard: 500 West Monroe Life Claims 800-628-8600 Suite 3400 Life Benefits Department Chicago, IL 60661 PO Box 2800 (800)-633-7479 Portland OR 97208 Long Term Disability Claims Ph: 800-368-1135 Fax: 971-321-8400 Employee Benefits Department PO Box 2800 Portland OR 97208
Contact Info for UNUM: Contact Info for The Standard:
500 West Monroe Life Claims 800-628-8600 Suite 3400 Life Benefits Department Chicago, IL 60661 PO Box 2800 (800)-633-7479 Portland OR 97208 Long Term Disability Claims Ph: 800-368-1135 Fax: 971-321-8400 Employee Benefits Department PO Box 2800 Portland OR 97208
The Standard Long Term Disability Forms and Info: Standard Enrollement & Change Form Standard Group Life Ins. Summary Plan Description Standard Group LTD Cert and Summary Plan Desc Standard Life Insurance Benefits Claim Form Standard LTD Claim Form Standard AD&D Claim Form Standard Survivor Income Application Standard Waiver of Life Premium Form
Other Unum provided services Worldwide Emergency Travel Assistance Work Life Balance Program
Long Term Care Employee enrollment form Long Term Care Family enrollment form Long Term Care Benefit Highlight Sheet Long Term Care Rate Sheet Long Term Care Certificate Booklet Long Term Care Conversion Form – Use this form when LTC coverage is terminating.
Each employee at Nagle Hartray Danker Kagan McKay Penney has a life and accidental death and dismemberment benefit. Please see Human Resources to determine the amount of coverage available.