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Forms & Downloads - Great West Life Printable Forms
Great West Life Printable Forms
Great West Life SelectPac


Forms for group plans with 3 to 35 members

Application for Group Coverage
A new member must complete this form upon becoming eligible to participate in their
group insurance plan. Download Form

Employee Change Form
This form is used to update information about plan members and/or their dependents.
Download Form

Trustee Appointment
This form is used to designate a trustee for a beneficiary who is a minor or who is
legally unable to manage their own affairs. Download Form

Evidence of Insurability
This form is used to collect the information needed to apply for group benefits which
require medical underwriting, such as Optional Life, Excess Life, and LTD, Supplemental
Life and Late applicants. Download Form



Forms for group plans with more than 35 members:

Application for Group Coverage
A new member must complete this form upon becoming eligible to participate in their
group insurance plan. Download Form

Group Coverage Change Form
This form is used to update information about plan members and/or their dependents.
Download Form

Trustee Appointment
This form is used to designate a trustee for a beneficiary who is a minor or who is
legally unable to manage their own affairs.Download Form

Evidence of Insurability
This form is used to collect the information needed to apply for group benefits which
require medical underwriting, such as Optional Life, Excess Life, Supplemental
Life and Late applicants. Download Form

Group Life Conversion Privilege Notification Form
This form is used to provide information necessary for converting group life insurance
plan members to a conversion individual life insurance policy. Download Form



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