Make Payments While on Claim or During Waiting Periods
Policy and Certificate Information
How to Change Your Beneficiary

Make Payments While on Claim
or During Waiting Periods

If you are currently out of work, either by an off-the-job accident, sickness or work related injury, premium payments must continue until the waiting periods are satisfied or your worker compensation claim is over, if you anticipate going back to work in a short time period.

To make premiums payments, please include the following information and forms:

Make sure to include the following information with your cover letter.  Please explain your disability situation, i.e. work comp, or filing a claim with Mutual of Omaha.

1. Copy of your current paystub
2. Type of insurance, long term disability, term life or both.
3. Coverage selected LTD Plan 50% or 60% plan
4. Life insurance amounts
5. ACH form (click here for form)

Return all information to:

Bill Judge & Associates, Inc.
9609 Gayton Road, Suite 200
Richmond, VA 23238

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Policy and Certificate Information

Voluntary Term Life

• Master Policy
• Certificate
• Summary of Coverage

Voluntary Long-Term Disability

• Master Policy
• 50% Summary of Coverage
• 50% Detail of Coverage
• 60% Summary of Coverage
• 60% Detail of Coverage

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How to Change Your Beneficiary

Members wanting to change their beneficiary or beneficiaries must complete
a Beneficiary Designation form.

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