Accidental Death & Dismemberment (AD&D) - Basic - Employer Paid

Accidental Death & Dismemberment (AD&D) - Basic - Employer Paid  

Accidental Death & Dismemberment

Valuable protection on or off the job.


Your employer has provided you with basic insurance coverage (employer paid). You can increase your family’s measure of financial security by buying additional coverage on a voluntary basis (employee paid).


Additional insurance coverage can serve as the foundation of a well-rounded financial strategy and help to ensure that no matter what happens, your immediate and future financial needs are met.


Remember, you can designate your beneficiaries by clicking on the “My Account” link at the top right corner of your screen.

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing. Click here to download a free copy of Adobe Acrobat Reader.

Beneficiary Form

If you submit your beneficiary designation via a paper form, we will enter it into the NYL GBS Benefits Guide website so you can view it online through My Account.

Beneficiary Designation Form

Claim Forms 

The information requested in the forms below is required for us to begin reviewing your claim. It's important that you provide us with complete and accurate information to avoid a delay in the processing of your claim.

Accidental Death & Dismemberment (AD&D) Insurance Claim Form