Greater Georgia Life & Health Spotlight
At Greater Georgia Life our mission is to provide the people we serve with financial protection and security.

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Group Coverage @ Greater Georgia Life
Provide competitive employee benefits that fit your budget, with our group life and disability coverage.

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Voluntary Coverage @ Greater Georgia Life
Let employees choose their own coverage with voluntary life and disability insurance from Greater Georgia Life.

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Download Forms

PW_A108082
 
Enrollment Forms 
Employee Life Application
Employee Life Application with Medical Questionnaire
Evidence of Insurability Form
Individual Life Application
 
Claim Forms 
Accelerated Death Benefit Claim Form
Accelerated Death Benefit Attending Physician’s Statement
Accelerated Death Benefit Disclosure Statement
Accidental Dismemberment or Loss of Sight Claim Form
Life Claim Form
Life Waiver of Premium or Continuation of Benefits Claim Form
 
Portability & Conversion Forms 
Portability Benefit Request Form
Request for Group Life Conversion Information
 
Other Forms 
Cancellation Authorization Form (for Small Groups)
Cancellation Authorization Form (for Large Groups)
Change of Beneficiary/Name Form
Life Beneficiary Claim Form
Member Enrollment Change Form
Request for Change Form
Waiver of Coverage Authorization Form
Waiver of Coverage Authorization Form (Self-Administered Groups)
Life and Disability products underwritten by Greater Georgia Life Insurance Company, an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.