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Forms & Publications

 

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Disability Insurance Forms

  Title What is This For? Contact Information
N/A Employee Enrollment Form for Group Life, LTD, & STD 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: Client Services

N/A Evidence of Insurability Form for Disability Coverage Form to complete when applying for disability insurance. *Please download this form and open using Adobe Acrobat reader for proper functionality

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

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Short Term Disability Benefit Publications - Clergy & Lay

  Title What is This For? Pgs
Short-Term Disability Benefit Summary-13 Weeks 60% Employee Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-13 Weeks 66.67% Employee Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-26 Weeks 60% Employee Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term-Disability Benefit Summary-26 Weeks 66.67% Employee Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-13 Weeks 60% Employer Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-13 Weeks 66.67% Employer Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-26 Weeks 60% Employer Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Short-Term Disability Benefit Summary-26 Weeks 66.67% Employer Paid Additional details about short-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

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To request a copy by mail, check the box next to the title and click 

Long Term Disability Benefit Publications - Clergy & Lay

  Title What is This For? Pgs
Long-Term Disability Benefit Summary-90 days 50% Employee Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-180 days 50% Employee Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-90 days 40% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-90 days 60% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-90 days 66.67% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-180 days 40% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-180 days 60% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

Long-Term Disability Benefit Summary-180 days 66.67% Employer Paid Additional details about long-term disability - To verify what plan you have, call Client Services (866) 802-6333 or Zurich (800) 206-8826

2

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* Our online documents are available for immediate download and viewing using Adobe's FREE Acrobat Reader.

Policy Number: CNYEX01112
Disability Insurance Disclaimer