Beneficiary Designation

Introduction


If you participate in one of the benefit plans listed below, you have the option to designate who will receive payments in the event your death, or where applicable, the death of an insured spouse, domestic partner or dependent. Please see your recent earning statements, found at My UW System, to review your benefit plan participation.

If you do not elect to designate beneficiaries, or if your designated beneficiaries are deceased, there is a default sequence of beneficiaries, known as a "standard sequence." The standard sequence describes the order of which survivor receives payments upon the death of the insured person. The standard sequence for all benefit plans is listed below:

If you want to designate your beneficiaries, please complete the appropriate form and mail it to the address provided on the form.

Note: If you participate in the Tax Sheltered Annuities (TSA) 403(b) program, please contact your investment company for standard sequence information and to obtain a beneficiary designation form. | TSA Investment Companies Contact Information

Please retain a copy of your beneficiary designation forms for your records. The UW Service Center does not process, store or have access to beneficiary designation forms. Please contact the benefit plan administrators directly for information regarding your beneficiary designations.

Beneficiary Designation Forms


EPIC Benefits+
Plan Document | Group Number: 3180

Note: You, the insured employee, cannot name beneficiaries for the EPIC Accidental Death and Dismemberment benefit for spouse / domestic partner and dependent coverage. You are the only beneficiary.

Individual Family and Group Life Insurance
Plan Document | Policy Number: 32871-G

University Insurance Association Life Insurance (UIA)
Plan Document | Policy Number: 32872-G

UW Employees, Inc. Life Insurance
Plan Document | Group Policy Number: 46

Accidental Death and Dismemberment Insurance (AD&D)
Plan Document | Policy Number: GTU 8364005

Note: You, the insured employee, cannot name beneficiaries for the Accidental Death and Dismemberment benefit for spouse / domestic partner and dependent coverage. You are the only beneficiary.

State Group Life Insurance and Wisconsin Retirement System (WRS)
State Group Life Plan Document | WRS Plan Document

These two benefit plans use the same Beneficiary Designation Form. If you want the beneficiary designation to apply to specific benefit plan(s) or account(s), use the space at the bottom of the form to specify the benefit plan(s) or account(s) to which you want the designation to apply. See the "Effective for all benefit plans and accounts" section of the instructions before completing this section of the form.

Tax Sheltered Annuities (TSA) Contact Information

If you participate in the Tax Sheltered Annuities (TSA) 403(b) program, please contact your investment company for standard sequence information and to obtain a beneficiary designation form. If you have a Fidelity, T. Rowe Price, or TIAA-CREF investment account, you may update your beneficiary designation through your online account page.

Wisconsin Deferred Compensation (WDC)
Plan Document