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Most Requested Forms

 

Select links to download forms (PDFs).

 

Loan Application, Agreement and Promissory Note: Use this form to establish a loan on your retirement account for group retirement products.

 

Loan Application, Agreement and Promissory Note (Group Retirement Products Only)

 

Loan Application, Agreement and Promissory Note (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

 

Non-Financial Change: Modify or change information regarding: Owner, Joint Owner, Annuitant, Beneficiary and/or address change.

 

Non-Financial Change (Group Retirement Products Only)

 

Non-Financial Change (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

 

Forms:

Security Benefit Healthcare Reimbursement Account 

 

For help on filling out the forms, please view the instructions.

 

Form Description
Asset Reallocation Use this form to automatically transfer account values to maintain a specific percentage allocation among your current and future investment options.
Change Investment Allocations Use this form to modify your existing and/or future investment allocations.
Claim Form Use this form to request medical expense reimbursement following severance from employment.
Dollar Cost Averaging Use this form to request periodic exchanges from one investment option to one or more investment options.

Non-Financial Change

(Name, Address, etc.)

Use this form to modify or change information regarding the roles on your account.

 

Forms for Advisors

Form Description
Employee Change Notification Use this form to change employee status. Complete this form and enclose it with your payroll for any new employees not listed or terminated since the last contribution list.
Employee Enrollment Use this form to establish a new Healthcare Reimbursement Account. Provide your employer a copy of this form.
Employer Information Use this form for each employee group adopting the Security Benefit Group Healthcare Reimbursement Account (HRA)

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