Other

Dollar Cost Averaging for Healthcare Reimbursement Account

Use this form to request periodic exchanges from one investment option to one or more investment options.

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Other

Fund Investment Options Sheet for Texas Teachers Advisor Mutual Fund Program

This quarterly performance sheet lists the fund codes for the investment line-up for Texas Teachers Advisor Mutual Fund Program.

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By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
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For questions or assistance, please call 800.747.3942
Other

Incoming Funds Request for Texas Teachers Advisor Mutual Fund Program

Use this form for transferring assets from your Current Carrier to Security Benefit. Please refer to the most recent 

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By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund | Variable Annuity | Other

Internal Exchange Statement and Agreement for Custodial Account

Use this form to transfer funds internally from one account to another. (This includes transferring assets from one employer plan to another employer plan).

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By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Other

Letter of Medical Necessity for Security Flex 125 Program®

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By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Other

Medical/Dependent Care Reimbursement Program Claim for Security Flex 125 Program®

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Use this form to request medical expense or dependent care reimbursement. 

By Mail

Security Flex 125
P.O. Box 75066
Topeka, KS 66675
United States

Overnight Delivery

Security Benefit
Mail Zone 600
One Security Benefit Place
Topeka, KS 66636
United States

By Fax
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You may also email your form to [email protected]
Mutual Fund | Variable Annuity | Other

Non-Financial Change for Custodial Account

For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner, or Joint Owner of the Contract.

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Please type or print in black ink. Complete all necessary fields and signatures.

By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund | Other

Outgoing Funds Request for Custodial Account

Use this form to transfer funds from your Security Benefit account to a new carrier.

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You must sign in to access this content. Please sign in with your username and password.

Mutual Fund | Variable Annuity | Other

Proof of Death for Custodial Account

This form is to be completed in order to claim proceeds payable upon death. A separate Proof of Death form should be completed and signed by each beneficiary.

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Please type or print in black ink. A separate Proof of Death form should be completed and signed by each beneficiary.

Although the Company reserves the right to require or obtain further information, the following is required:

  1. Proof of Death Form
     
  2. Death Certificate
     
  3. Consular Report of Death of a U.S. Citizen Abroad (if the deceased died in a foreign country)
     
  4. Notice of Name Change
By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Other

Reimbursable Over-the-Counter Medications & Program Updates for Security Flex 125 Program®

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By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942