Brochures and Forms

Common Questions

Make Payments While on Claim or During Waiting Periods
Policy and Certificate Information
How to Change Your Beneficiary
Life Insurance Continuation Options


Transfer of Benefits

For questions regarding the transfer of benefits from Mutual of Omaha to CIGNA, please contact

GIS Benefit Center
PO Box 8633
Madison, WI 53708-8633

(877) 817-4801

Make Payments While on Claim
or During Waiting Periods

If you are currently out of work, either by an off-the-job accident, sickness or work related injury, premium payments must continue until the waiting periods are satisfied or your worker compensation claim is over, if you anticipate going back to work in a short time period.

To make premiums payments, please include the following information and forms:

Make sure to include the following information with your cover letter.  Please explain your disability situation, i.e. work comp, or filing a claim with CIGNA.

  1. Copy of your current paystub
  2. Type of insurance, long term disability, term life or both.
  3. Coverage selected LTD Plan 50% or 60% plan
  4. Life insurance amounts
  5. ACH form (click here for form)

Return all information to:

GIS Benefit Center
PO Box 8633
Madison, WI 53708-8633

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Policy and Certificate Information

Summary of Coverage

Voluntary Term Life

Voluntary Long-Term Disability

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How to Change Your Beneficiary

Members wanting to change their beneficiary or beneficiaries must complete a Beneficiary Designation form.

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Life Insurance Continuation Options

Your Voluntary Term Life insurance coverage provided through National Rural Letter Carriers’ Association under policy number GVTL-AC6C has two ways to continue your life insurance coverage after separating from service. Please review the following options:

Option 1: Portability
Portability is available if you retire, your employment ends, you are not otherwise actively employed, or you do not satisfy any other eligibility requirements.  If this is the case, you may continue coverage for you and/or your eligible dependents under the Portability provision in your Certificate by completing the Portability of Life Coverage Request form. Please note, that this option is not available if employment ended for reasons of your Injury, Sickness or Disability or you are age 70 or older.

Option 2: Conversion
Conversion is available if your employment ends, you are no longer an eligible employee or the group policy terminates.  If this is the case, you and/or your eligible dependents may convert to an individual whole life policy regardless of medical condition. Premiums for the whole life insurance plan remain level over the life of the policy.  If you or your eligible dependents choose Conversion, please complete a Conversion Application for each individual.

To continue your insurance coverage pursuant to either option above, you must complete the necessary forms to CIGNA within thirty (30) days from the last date of service this letter along with any premium due since your last payroll date.  Please call the GIS Benefits Center at (877) 817-4801 for premium amounts.

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