Forms Library
NJ Buyers Guide (Auto)
Whether you are buying a new insurance policy or renewing your current policy, you must make many decisions about what coverage you need and how much you can pay. The following guide outlines how to make choices that work for you.
New Jersey Auto Insurance Buyers Guide
NJ Bill of Rights (Auto)
Auto insurance is required in New Jersey. As a New Jersey driver, you have many choices when it comes to purchasing auto insurance. Each choice you make affects the coverage you receive and the amount you pay.
Automobile Insurance Consumer Bill of Rights
Electronic Payment Authorization Forms
Tired of mailing your insurance payment every month? Simplify and go green! We offer two monthly electronic payment options that are safe, secure, and convenient. Plus, they’re better for the environment.
ExpressIT®
We will automatically deduct the amount due from your checking/savings account each month. You may even receive a discount with this plan!
Recurring Credit Card
We will charge your credit card each month for the amount due. We accept Visa, MasterCard, Discover, and American Express. PAK II policies are not eligible for this payment plan.
Monthly Recurring Credit Card Authorization Form
Enroll Now
Download and complete the appropriate form above. Don’t forget to sign it. Then fax it to us at the number listed on the form. It’s that simple! Please allow 15 business days to process this change.
Visit www.metlife.com/annuityforms to find frequently used forms to service your Annuity.
Download and complete the appropriate form below. Then mail or fax it to us at the address or number provided.
Mail form to:
MetLife
PO Box 10356
Des Moines, IA 50306 - 0356
Fax: 1-877-549-5834
Change of Beneficiary
Use this form to correct, change or designate your beneficiaries.
PDF version (52k)
Make Corrections to Group Participant Information
This form is for use by an Administrator to change Group Participant information (e.g., name changes, deletions, corrects, etc.).
PDF version (52k)
403(b) Withdrawal Request Form - Non-ERISA
This form is for a participant or alternate payee to request a distribution from a 403(b) Non-ERISA annuity other than for a hardship or as a systematic withdrawal.
PDF version (52k)
Coronavirus-Related Withdrawal Form
Use this form if you were impacted by SARS-CoV-2 or COVID-19 and are eligible to take a distribution as defined by the CARES Act.
PDF version (53k)
403(b) Beneficiary Change
Use this form for a change of Beneficiary and Spousal Consent for ERISA or Non-ERISA 403(b).
PDF version (52k)
For additional forms please visit
https://eforms.metlife.com
Dental Claim Form
COMPLETE ONLINE or DOWNLOAD FORM
If you download a form we recommend that you bring a claim form with you when you visit your dentist for an appointment.
Medical Authorization/Disclosure of Information
Use the form to inform your physician(s) that MetLife will be administering your disability claim and give authorization to release your medical information to MetLife.
PDF Version (41k)
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Attending Physician Statement
This form is used to gather medical information necessary for the ongoing management of disability claims. Have your physician complete this form when your case manager requests new/updated medical information.
PDF version (237k)
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Health Care Provider Certification-FMLA
These forms are used to gather medical information necessary for the ongoing management of Family and Medical Leave Act (FMLA) Claims for yourself, a family member or a service-member family member. Have the physician complete this form after you file your claim.
Certification for Employee's Serious Health Condition
Certification for Family Member's Serious Health Condition
Certification for Qualifying Exigency for Military Family Leave
Certification for Covered Service-member for Military Family Leave
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Electronic Funds Transfer (EFT) Authorization Form
Complete, sign and mail/fax this form to MetLife to authorize electronic funds transfers of your disability insurance payments directly to your bank. Please verify that your employer's plan offers electronic funds transfer for disability income benefit payments before submitting this form to MetLife.
PDF version (41k)
Mail Above form to:
Metropolitan Life Insurance Company
Attn: MetLife Disability Claims
PO Box 14590
Lexington, KY 40511-4590
Fax: 1-800-230-9531
Current life insurance policyholders can visit metlife.com/lifeinsurance to:
- Access forms
- Manage your life insurance policy
- Get answers to frequently asked questions
Beneficiaries of a life insurance policy can visit metlife.com/lifeinsuranceclaims to:
Visit www.metlife.com/ltc/documents to find frequently used forms to service your Long-Term Care policy.
TCA – Beneficiary Designation Form
To add or change beneficiaries on your Total Control Account.
COMPLETE ONLINE or DOWNLOAD FORM
Change Accountholder’s Name or Address of Record
To change or correct TCA Accountholder name and address.
COMPLETE ONLINE or DOWNLOAD FORM
TCA Death of Accountholder Standard Claim Form
To make a claim for benefits upon the death of a TCA Accountholder, or to replace a claim for previously sent to you by MetLife upon the death of a TCA Accountholder.
(Use the Standard Claim Form if the Accountholder did not reside in MN or NY at the time of death, or if the beneficiary does not reside in AK, FL, LA, MN, or NY. Please call 1-800-638-7283 for questions.)
COMPLETE ONLINE or DOWNLOAD FORM
TCA Death of Accountholder Elective Claim Form
To make a claim for benefits upon the death of a TCA Accountholder, or to replace a claim form previously sent to you by MetLife upon the death of a TCA Accountholder.
(Use the Elective Claim Form when the Accountholder resided in MN or NY at the time of death, or if the beneficiary resides in AK, FL, LA, MN, or NY. Please call 1-800-638-7283 for questions.)
MetLife Claim Form
In English PDF Version (161k)
En Español PDF Version (163k)
SafeGuard Grievance Forms
California Dental/Vision Grievance Form PDF Version (173k)
Florida Dental/Vision Grievance Form PDF Version (263k)
New Jersey Dental/Vision Grievance Form PDF Version (234k)
New York Dental/Vision Grievance Form PDF Version (18k)
Texas Dental/Vision Grievance Form PDF Version (268k)