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Forms & Publications

Short Term Disability Benefit Publications - Clergy

Title What is This For? Pgs
A Guide to the Short Term Disability Benefit for Active Clergy Details about Short Term Disability pension benefit for active clergy

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Long Term Disability Benefit Publications - Clergy

Title What is This For? Pgs
Liberty Mutual LTD Benefit Summary Clergy - Employer Paid Benefit Summary Liberty Mutual Long Term Disability Insurance - Clergy Employer Paid

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Liberty Mutual LTD Benefit Summary Clergy Employee Paid Summary of Benefits Liberty Mutual LTD Insurance - Clergy Employee Paid

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Disability Insurance Forms

Title What is This For? Contact Information
Employer Initial Enrollment Form - Employer-Paid Plans Initial application form for employers to enroll in a non-contributory (employer-paid) disability plan

Church Pension Group
19 East 34th Street
New York, NY 10016
Attn: Angelica Merola

Employer Initial Enrollment Form - Voluntary Plans Initial application form for employers to enroll in a voluntary (employee-paid) disability plan

Church Pension Group
19 East 34th Street
New York, NY 10016
Attn: Angelica Merola

Enrollment Data Collection Form To enroll, change, or terminate employees in Group Term Life and Disability Insurance plans.

Please fax the completed form to: (212) 251-8969
or mail to: The Church Pension Fund, 19 East 34th Street, New York, NY 10016, Attn: Policy Service

Liberty Mutual Evidence of Insurability Form for Disability Coverage Form to complete when applying for disability insurance

Liberty Life Assurance Company of Boston
Attn: Group Underwriting Department
P.O. Box 1525
Dover, NH 03821-1525

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