Insurance Program Provided by Amwins Group Benefits
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Member Benefits
Manage Policy
Bank Draft Authorization
Changes to Name, Address, Phone and/or Email
Claim Forms
Online Bill Pay
Request Other Forms or Information
Home
Member Benefits
Manage Policy
Bank Draft Authorization
Changes to Name, Address, Phone and/or Email
Claim Forms
Online Bill Pay
Request Other Forms or Information
Request Other Forms or Information
You are here:
Home
Manage Policy
Request Other Forms or Information
Please send the following:
Change of Beneficiary Form for my The Hartford coverage
Bank Draft Authorization Form for coverages billed by AmWINS
The Hartford Hospital Claim Form
Chubb Cancer Claim Form
Transamerica Cancer Claim Form
Change my billing/payment mode as of my next premium billing to:
Quarterly
Semi-Annual
Annual
Copy of my certificate of insurance. If you have multiple coverages, please indicate which coverage certificate you need:
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