Important Documents

Life Claim Forms

• Life – Claim Form

Disability Claim Forms

• Disability – Physician Statement
• Short Term Disability Claim Form
• Long Term Disability – Employer Claim Form
• Long Term Disability – Employee Statement

Miscellaneous Items

• Employee Enrollment Form
• Group Change Form
• Disability Claims – Electronic Funds Transfer Authorization
• WMC/MetLife Contacts
• Portability Application
• Statement of Health
• Conversion Application

---

WMC Employee Benefits Department
(608) 258-3400
E-mail