Long Term Disability (LTD) & Life Waiver: (800) 254-0085 or [email protected] LTD and Life Waiver claims address: LifeMap Claims 300 Southborough Drive, Suite 200 South Portland, ME …

Active or passive PPO, Dental HMO (in some areas) or even a no-network plan. LifeMap has coverage that will work for your location and the needs of your company and employees. Tell us who’s going to …

Assignment of Life Insurance Proceeds I, _____________________, being entitled to receive benefits under Policy Number _____________ issued by LifeMap Beneficiary Name Assurance Company …

If you have more than on LifeMap insurance policy, we will apply this authorization to all policies. I AUTHORIZE LifeMap Assurance Company (LifeMap) to disclose the following of information: …

Dependent Eligibility Requirement Dependents must be a Legal spouse and/or child(ren) up to age 26 of the covered employee to be eligible for coverage. LifeMap Network

• I understand that LifeMap will release information to my employer necessary for return to work and accommodation discussions, and when performing administration for my employer’s self-funded (and …

This Guide contains information regarding LifeMap’s standard administrative processes and standard plan provisions and is applicable to all of LifeMap’s lines of coverage. At all times, coverage is …

This means legal expenses for the beneficiary and delay in the payment of the insurance. Please take this into consideration when naming your beneficiary. If you have any questions, please see your …

LifeMap ofers FMLA, ADA and other types of leave administration as a buy-up option through FMLASource. Sign up and you’ll enjoy: • Lower administrative costs and improved eficiency • …

LifeMap is not liable for any errors or omissions in this document. If there is any discrepancy between this document and the master policy, master policy provisions will prevail.