Remove Beneficiary or Dependent from Employee Portal

Purpose

This request form is to be used if you no longer want to have a dependent or beneficiary you have previously added, to be visible in your employee portal. This means they would no longer be an option when adding dependents to your benefit plans or beneficiaries to your insurance policies.

In order to be removed, the dependent(s) cannot be currently enrolled in any benefits, and the beneficiary(ies) cannot be currently named on an active insurance policy.

Last updated: 4/2020

Download the form below.