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Group Insurance Administration Manual
Group Insurance Administration Manual 
930K - replaced by form M6797(ER330780) below
1285 - replaced by form M4437 below
1541 - replaced by form M6809 below
CSSB.8001 - Life Insurance and Dependents Insurance Appointment and Election Statement (updated form available from our office)
CSSB.8002 - Application for Changes to Dependents Insurance
CSSB.8003 - Application for Changes In LIfe Insurance Class
CSSB.8004 - Continuation of Group Insurance During An Employer Approved Leave of Absence or Lay-Off
CSSB.8005 - Waiver of Group Insurance During An Employer Approved Leave of Absence or Lay-Off
CSSB.8006 - Life Insurance Retirement Notice CSSB.8007 - Bi-Weekly Contribution Remittance Report
CSSB.8008 - Insurance Waiver Application - memo
CSSB.8009 - Life Insurance Death Claim - memo
CSSB.8010 - Dependents Insurance Death Claim - memo
CSSB.8011 - Accidental Disablement Claim - memo
CSSB.8012 - Request for Dependents insurance or an Increased Number of Units - memo
CSSB.8013 - Request for a Higher Life Insurance Class - memo
M4437 (replaces form 1285) - Application for Accidental Disablement or Specific Loss
M62-8/06 (previously 254) - Death Claim Report - Group Life/Dependents/Accidental Death
M6621-12/04 [previously G220136H] - Statement of Health for Group Insurance
M6622-12/04 [previously G0056ADCE] - Application for Dependents Coverage
M6697-2/06 [previously 1536] - Beneficiary Designation Form
M6723-5/06 [previously 1537] - Certificate By Employee of Change in Name
M6797(ER330780) (previously 930K) - Waiver of Premium Benefit Application -
Employer Statement
M6809 (previously 1541) - Form of Assignment
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