Direct deposit change form
Have coverage through your advisor? You’re in the right place.
If you have coverage through your employer or plan sponsor, use our workplace insurance forms instead.
Make a change
Use this form to set up direct deposit and receive your benefits payments directly into your bank account. You’ll find instructions on how to return the completed form on the form itself.
Download this form and print it, or fill it out in Adobe Reader XI or higher (not your browser) and save.