


Enrollment and Claim Forms
Your Symetra representative can help facilitate the enrollment process and work with you and the beneficiary in the event of a claim.
State-specific enrollment, evidence of insurability, and claim forms can be found here.

Conversion Forms
The Conversion Right enables an eligible employee, whose coverage under a Symetra Group Life policy is terminating, to request to continue all, or part, of their life Basic or Supplemental insurance coverage. Benefits may continue under an individual conversion policy and employees do not have to provide Evidence of Insurability.

Portability Forms
The Portability Continuation Privilege allows an eligible, terminated employee to continue the coverage that was in-force under the Symetra Supplemental Group Life policy at group rates as long as the portability option is included in the policy.
If you are unsure which portability form to use, please contact your Symetra GroupCopyright © 2004 - 2010 Symetra Life Insurance Company, 777 108th Ave NE, Suite 1200, Bellevue, WA 98004. All rights reserved. Symetra® and the Symetra Financial logo are registered service marks of Symetra Life Insurance Company.