Important forms to apply for and manage your coverage.
Below are important forms to manage your coverage.
These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing. Click here to download a free copy of Adobe Acrobat Reader.
Beneficiary & Claim Forms
Beneficiary Form
Review and update your current beneficiary designations online in My Account. You may wish to complete a paper Beneficiary Designation form to make your designation, particularly if you have estate tax considerations or have needs that are more complicated that this online system allows. We strongly encourage you to consult the legal advice of an attorney in these instances. If you submit your beneficiary designation via a paper form, we will enter it into the NYL GBS Benefits Guide website so you can view it online through “My Account”.
Beneficiary Designation Form (English)
Beneficiary Designation Form (Spanish)
Claim Forms
The information requested in the form below is required for us to begin reviewing your claim. It's important that you provide us with complete and accurate information to avoid a delay in the processing of your claim.Return completed VTL claim forms to the address at the top of the form. For questions on filing a claim or completing the claim form, call 800.231.1193
How and Where to Return Forms
Completed Beneficiary Forms or Change Forms can be returned to the NYL GBS Customer Service Center:
Mail to: NYL GBS Customer Service Center
Administered by Infosys McCamish Systems, LLC
PO Box 14577
Des Moines, IA 50306-3577
Email to: DSM_NYLGBSCustomerSupport@infymccservices.com
Completed Claim Forms can be returned to the address at the top of the form. For questions on filing a claim or completing the claim form, call 800.231.1193.