Document Library

Noteworthy Documents

UT FLEX Letter of Medical Necessity Form
This form should be completed by the attending physician to confirm treatment is necessary for a specific medical condition.
UT FLEX Health Care Reimbursement Claim Form
Use this form to file a Health Care FSA Claim Did you know that you can file this claim online? Login to and select Submit Claims.You can also submit claims and manage your account via the mobile app:
Create Your Own Will Online
Online will preparation is a value-added service with your group life insurance coverage from Dearborn National. The service provides you the ability to simply and quickly create a standard will that meets your needs and is valid in all states—free of…
Beneficiary Designation Form
Beneficiary Designation Form for Group Term Life (GTL) and Accidental Death and Dismemberment (AD&D)
About Online Beneficiary Management
Online Beneficiary Management makes naming your group life insurance beneficiaries quick and easy.
Accelerated Death Claim Form
Your Life Insurance policy allows you to apply for an accelerated benefit paid to you during your lifetime if you are determined to have a terminal illness. To apply, the Claim packet should be completed in full.
Death Claim Form
Life Portability Application
If your Insurance benefit terminates, you are eligible to continue your Voluntary Life, Voluntary Dependent Life coverage. You must apply for the continuation within 31 days of the date of termination of coverage.
Life Conversion Application
Upon becoming ineligible for group insurance, e.g., leaving employment, you may convert your Group Life Insurance coverage to an Individual Whole Life Insurance policy. This can be done regardless of your current health.