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  • My Account
  • Property/Casualty
    • Pool Overview
    • File a Claim
      • Notice of Complaint
      • Property/Casualty Claim Contacts
    • Certificates of Insurance
    • Member Resources
    • Member Documents
    • History & Governance
    • Surety Bonds
    • Contacts
  • Workers' Compensation
    • Fund Overview
    • File a claim
    • Forms
    • Member Resources
    • Member Documents
    • Safety Program
    • History & Governance
    • Contacts
  • Employee Benefit Services
    • Services Overview
      • Comprehensive Consulting
      • ACA Tracking & Reporting
      • Online Enrollment & Consolidated Billing
      • Dental & Vision Claim Administration
    • Member Resources
    • History & Governance
  • Healthcare Center
    • Primary Locations
      • Corunna Cavaliers Location
      • Lansing Area Location
      • Van Buren Location
    • FAQ
  • Foundation
    • SET SEG Foundation
    • Donate
    • Donor Recognition
    • Scholarships & Grants
    • History & Governance
    • 2022 Annual Report
  • About Us
    • SET SEG Overview
    • Insurance Scholarship
    • Meet Our Team
    • Careers
      • Job Postings
    • News & Events
    • Contact Us
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Home >Employee Benefit Services >Standard Forms

Standard Forms

Administrative Forms

Application to Convert Group Life Insurance

HIPAA Disclosure Authorization Form

MEC Plan Subscriber Application

Waiver of Group Health Benefits

Claim Forms

ADN Dental Claim Form

ADN Vision Claim Form

Group Life Insurance Claim

Hospital Indemnity Claim Report

Long-Term Disability Claim Statement

Reliance Standard Accelerated Benefit

Reliance Standard Group Life & Accidental Death and Dismemberment

Reliance Standard Long-Term Disability

Reliance Standard Short-Term Disability

Reliance Standard Voluntary Life Claim Form

Short-Term Disability Claim Statement

Voluntary Products

Voluntary Benefits

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    • FMLA Administration
    • FSA Administration
  • Forms
    • Standard Forms
  • History & Governance
SET SEG | 1520 Earl Ave. East Lansing, MI 48823 | Phone (800) 292-5421 | Fax (517) 492-0883 | PRIVACY POLICY | SITE MAP
SET SEG 1520 Earl Ave. East Lansing, MI 48823 Phone (800) 292-5421 Fax (517) 492-0883
PRIVACY POLICY   |   SITE MAP