Find the required forms and documents based on your state of residence for your Voya® Employee Benefits insurance policies. Note: These forms are in PDF format. In order to open, view or print these forms you will need to have Adobe Acrobat Reader installed on your computer. This is available with a free download from the Adobe Systems website. When printing multiple-page documents, please use the 2-sided option whenever possible.

Alabama+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Arkansas+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

California+

If you reside in the state of California, the following forms and documents apply to you. 

Name and Instructions
Number
Secondary Addressee Form

Please complete and return to address shown on the form (optional)

Connecticut+

If you reside in the state of Connecticut, the following forms and documents apply to you.

Name and Instructions
Number
Secondary Addressee Form

Please complete and return to address shown on the form (optional)

District of Columbia+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Georgia+

If you reside in the state of Georgia, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

Idaho+

If you reside in the state of Idaho, the following forms and documents apply to you. 

Name and Instructions
Number
Secondary Addressee Form

Please complete and return to address shown on the form (optional)

Illinois+

If you reside in the state of Illinois, the following forms and documents apply to you. 

Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Buyers Guide

Please Read

Indiana+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Kansas+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Kentucky+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Louisiana+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Maine+

If you reside in the state of Maine, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

Maryland+
Name and Instructions
Number
Supplemental Statement to Application for Life Insurance

Please complete and return to address shown on the form

Massachusetts+

If you reside in the state of Massachusetts, the following forms and documents apply to you. 

Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Spouse/Dependent Signature Form

Please complete and return to address shown on the form if the covered dependent is age 15 or older (required)

Michigan+

If you reside in the state of Michigan, the following forms and documents apply to you. 

Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Spouse/Dependent Signature Form

Please complete and return to address shown on the form if the covered dependent is age 15 or older (required)

Minnesota+

If you reside in the state of Minnesota, the following forms and documents apply to you. 

Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Montana+

If you reside in the state of Montana, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

Secondary Addressee Form

Please complete and return to address shown on the form (optional)

New Hampshire+

If you reside in the state of New Hampshire, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

North Carolina+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Ohio+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Oklahoma+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Pennsylvania+

If you reside in the state of Pennsylvania, the following forms and documents apply to you. 

Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Spouse/Dependent Signature Form

Please complete and return to address shown on the form if the covered dependent is age 15 or older (required)

Rhode Island+

If you reside in the state of Rhode Island, the following forms and documents apply to you. 

Name and Instructions
Number
Secondary Addressee Form

Please complete and return to address shown on the form (optional)

Texas+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Utah+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Vermont+

If you reside in the state of Vermont, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

Secondary Addressee Form

Please complete and return to address shown on the form (optional)

Virginia+
Name and Instructions
Number
Accelerated Benefit Disclosure

Please read, sign and return to address shown on form -  only if Accelerated Benefit Rider is offered.

Washington+

If you reside in the state of Washington, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

Parent/Legal Guardian Signature Form

Please complete and return to address shown on the form  when the you are not the parent or the legal Guardian for the covered dependent - required

Spouse/Dependent Signature Form

Please complete and return to address shown on the form  if the covered dependent is age 15 or older - required

Wisconsin+

If you reside in the state of Wisconsin, the following forms and documents apply to you. 

Name and Instructions
Number
Buyer's Guide

Please read

All Other States (Except NY)+

If you reside in a state not listed above (with the exception of New York), the following forms and documents apply to you.

Name and Instructions
Number

Voya® Employee Benefits insurance products and services in the U.S. are provided by ReliaStar Life Insurance Company (Home and Administration Office: Minneapolis, MN) and ReliaStar Life Insurance Company of New York (Home Office: Woodbury, NY. Administration Office: Minneapolis, MN). Within the State of New York, only ReliaStar Life Insurance Company of New York is admitted, and its products issued. Both are members of the Voya® family of companies. Product availability and specific provisions may vary by state.