Forms

Whether you’re enrolling in your group plan through work, or just changing contact information on your current plan, you’ll find everything you need here. And if you have questions on which form you need or how to complete it, we’re always here for you and ready to help. Just ask us. 800.433.0088 or cs@bestlife.com.

You can send your completed forms to changes@bestlife.com or fax them to 949.724.1603.

Dental

Employee Claim Form
PDF
Employee Enrollment/Change Form (English)
PDF  |  Online
Employee Enrollment/Change Form (Spanish)
PDF  |  Online
Employee Enrollment/Change Form - CA (English)
PDF   |  Online
Employee Enrollment/Change Form - CA (Spanish)
PDF  |  Online
Employee Coverage Termination Form
PDF
  |  Online

 

Dental and Vision

Employee Enrollment/Change Form (English)
PDF
| Online
Employee Enrollment/Change Form (Spanish)
PDF
| Online
Employee Coverage Termination Form
PDF
  |  Online

Vision

Employee Claim Form - Vision Indemnity
PDF
Employee Claim Form - Vision PPO Out-of-Nework
PDF
Employee Enrollment/Change Form (English)
PDF
| Online
Employee Enrollment/Change Form (Spanish)
PDF
  |  Online
Employee Coverage Termination Form
PDF   |  Online

 

Short Term Disability

Employee Claim Form
PDF
Employee Enrollment Form
PDF
Employee Enrollment Form - KY
PDF
Employee Group Roster Form
PDF
Employee Standard Health Form - IL
PDF
Employee Waiver of Coverage Form
PDF
Employee Coverage Termination Form
PDF
  |  Online

 

 

 

Group Term Life

Employee Accelerated Benefits Claim Form
PDF
Employee AD&D Claim Form
PDF
Employee Change of Beneficiary Form
PDF
Employee Death Benefits Claim Form
PDF
Dependent Death Benefits Claim Form
PDF
Employee Enrollment Form - Essential Life & Flex Life
PDF
Employee Enrollment Form -
Gold, Silver and Bronze Life

PDF
Employee Group Term Life Roster
PDF
Employee Uniform Application/Change Form - OH
PDF
Employee Waiver of Coverage Form
PDF
Employee Waiver of Premium Claim Form
PDF
Employee Coverage Termination Form
PDF
  |  Online

 

Other

Domestic Partnership Affidavit Form
PDF