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Forms & Downloads - Great West Life Printable Forms
Great West Life Printable Forms
Great West Life Short Term Disability


Short Term Disability Income Benefits
The plan member must complete the Employee Statement in order to claim for Short
Term Disability benefits. The plan member's physician must complete the Attending
Physician's Initial Statement Disability Income Benefits form. Download Form

Life Waiver – Employee's Statement
This form is used to claim premium free continuance of life insurance benefits. The plan
member must submit this completed form at least eight (8) weeks prior to the
end of the LTD elimination period. Download Form

Application for Group Short Term Disability Benefits - Employer's Statement
The plan sponsor must complete this form in order for the employee to claim for Short
Term Disability Benefits. Download Form

Employer Life Waiver of Premium - Notice of Claim
This form is used to claim waiver of premium. This form is used to claim premium free
continuance of life insurance benefits. The plan sponsor must submit this completed form
at least eight (8) weeks prior to the end of the LTD elimination period. Download Form

 

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