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Beneficiary Designation Form CAPE Survivor Benefit Group Term Life Insurance from Blue Shield of California Life & Health Insurance Company (Blue Shield Life) Send completed form to: Dexheimer-Erickson
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How to fill out bbeneficiary designationb form

Who needs beneficiary designation form?
01
Individuals who have life insurance policies: Life insurance policyholders often need to fill out a beneficiary designation form to specify who will receive the death benefit.
02
Retirement plan participants: Individuals who have employer-sponsored retirement plans, such as 401(k) or IRA accounts, need to designate beneficiaries who will receive the remaining funds in their account upon their death.
03
Employers or plan administrators: It's essential for employers or plan administrators to provide beneficiary designation forms to their employees or plan participants as part of their retirement benefit package.
How to fill out beneficiary designation form:
01
Obtain the form: Contact your insurance company, retirement plan administrator, or employer to request a beneficiary designation form. Alternatively, you may find the form online on their website or through their customer service.
02
Personal Information: Fill in your personal details, including your full name, address, phone number, and social security number. Ensure that all information is accurate and up to date.
03
Primary beneficiaries: Specify the primary beneficiaries who will receive your assets or death benefits. Provide their full names, relationship to you, and their contact information.
04
Contingent beneficiaries: Optionally, you can name contingent beneficiaries who will inherit your assets if your primary beneficiaries predecease you or are unable to receive the benefits for any reason. Include their full names, relationships, and contact details.
05
Percentage or allocation: In some cases, you may need to allocate a specific percentage of the proceeds to each beneficiary. Indicate the percentage or specific amount of the benefits each beneficiary should receive, ensuring that the total adds up to 100%.
06
Signature and date: Read the form thoroughly and ensure you understand its contents. Once you're ready, sign and date the form in the designated areas to validate your beneficiary choices.
07
Submit the form: Follow the provided instructions to submit the completed beneficiary designation form. Some forms may require mailing, faxing, or electronic submission, so pay attention to the instructions.
08
Store a copy: Make a copy of the filled-out form for your records. Keep it in a safe and easily accessible place, along with your other important documents.
Always review and update: It's crucial to periodically review and update your beneficiary designation forms, especially after significant life events such as marriage, divorce, birth, or death of a beneficiary. Ensuring your beneficiary information is current can help avoid complications and ensure your assets are distributed as per your wishes.
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What is beneficiary designation form?
The beneficiary designation form is a document that allows an account holder to specify who will receive the assets of the account upon their death.
Who is required to file beneficiary designation form?
Any account holder who wants to designate beneficiaries for their account is required to file a beneficiary designation form.
How to fill out beneficiary designation form?
To fill out a beneficiary designation form, the account holder must provide their personal information, the information of the beneficiaries, and specify the percentage of assets each beneficiary will receive.
What is the purpose of beneficiary designation form?
The purpose of a beneficiary designation form is to ensure that the account holder's assets are distributed according to their wishes upon their death.
What information must be reported on beneficiary designation form?
The beneficiary designation form must include the account holder's personal information, the beneficiaries' information, and the percentage of assets each beneficiary will receive.
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