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Instructions for Naming Beneficiaries
You may designate different beneficiaries for your basic and supplemental life insurance plans; however, you must complete two separate forms to do so.
1. To designate one person, insert the name and relationship in the spaces provided. If your beneficiary is not related to you, show relationship as "Friend."
2. If you wish to name your estate, insert "Estate" in the beneficiary name space.
3. To name more than one beneficiary — here are the most common examples:
If one of the above examples fits your wishes, insert your designation in the beneficiary name spaces, using the language of the selected example.
| Two beneficiaries: |
John J. Jones, father and Mary R. Jones, mother |
| Three or more beneficiaries: |
James O. Jones, brother; Peter I. Jones, brother; and Martha Jones, sister |
| Unnamed children: |
My children living at my death from my marriage to Lois P. Jones |
| One contingent beneficiary: |
Lois P. Jones, wife if living; otherwise Herbert I. Jones, son |
| More than one contingent beneficiary: |
Lois P. Jones, wife, if living; otherwise Herbert I. Jones, son, Alice B. Jones, daughter and Ann Y. Jones, daughter |
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| Unnamed children as contingent beneficiaries: |
Lois P. Jones, wife, if living; otherwise my children living at my death from my marriage to said wife |
4. If none of the above is suitable, explain in the space below
what is desired , or attach a note.
If you name more than one beneficiary, settlement will be made
in equal shares to the designated beneficiaries (or beneficiary) that survive you, unless otherwise provided in the designation.
If no beneficiary designation is made under the group policy (or if there is no surviving designated beneficiary and the
beneficiary designation does not indicate how the insurance proceeds are to be distributed), the settlement will be made
in this order of survivorship – spouse, children, parents, brothers and sisters; and if there are no such relatives surviving
the insured, settlement will be made to the estate.
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