MetLife Administration Manual
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  The following is a list of the most frequently requested forms and all the information you may need regarding these administrative tasks:  
     
Downloading or Viewing Forms
 

How can I view or download a form if the Internet Explorer window displays a pop-up or not working?

To successfully view or download forms you must determine if your Internet Explorer (IE) window is operating in 8, 7 or prior versions.

Quick View (For all IE users): Using your mouse, right click on form link, then click open.

Internet Explorer 8 users: To fix the download issue, open an Internet Explorer window, go to tools, then internet options. Click the Security tab, then Custom level button. Go to “Downloads – Automatic prompting for file downloads” click on enable, then click ok.

Internet Explorer 7 or previous versions: After choosing an Enrollment or Statement of Health form (left click with mouse), a pop-up window will display. Click on the Download File button and a file download box will appear. Click Open to display the form and a temporary file will be loaded on your computer. Click here for additional instructions.

     
Distributing Certificates
 

When will I receive my certificates?
Under separate cover, MetLife will send copies of your group's policy and certificate. Upon receipt, please distribute a certificate to each covered employee.

If you request a plan design change, you will receive new certificates, or the necessary pages to update those certificates you have distributed and those you have in supply. We will provide instructions with any new forms. 

  Billing Information  
 

See a sample list bill?

See a sample self-administered bill?

How do I calculate Basic Life or Core Life premium?
Click here to see an example Of How To Calculate Basic Life (or Core Life) and AD&D Premium.

How do I calculate Supplemental Life or Buy-Up Life premium?
Click here to see an example of how to calculate Supplemental Life (or Buy Up Life) premium.

How do I calculate LTD premium?
Click here to see an example of how to calculate LTD premium.

How do I calculate STD premium?
Click here to see an example of how to calculate an STD premium.  

 
  Enrollment of New or Rehired Employees  
 

Where do I find enrollment forms for my state?

  • Enrollment Forms*

*Please refer to the Form Finder to download these forms.

How do I enroll my new employee(s) for contributory coverage?

Group Life

For groups effective prior to 1/1/2013
Once new employees have met the requirements for coverage, they have 31 days to enroll in your group plan.

For groups effective 1/1/2013 and later, they have from the first day on which they are eligible for the coverage (or the first day following a qualifying event, if applicable) through the earlier of the next following annual enrollment period or the day before the next following Policy Anniversary to enroll. In no event will this period be more than a year, or less than 31 days to enroll in your group plan.

Employees who do not enroll within this period are considered late enrollees. Late enrollees may apply for coverage at any time, subject to certain restrictions. Please refer to the Late Enrollments section of this manual for more details. Any employee who chooses to waive coverage must complete the waiving coverage section and sign the Enrollment Form.

For Life benefits employees must complete a Statement of Health Form for coverage amounts in excess of the non-medical maximum that can be found in the Schedule of Benefits in your Certificate of Insurance.

For Dental and Disability:
Once new employees have met the requirements for coverage, they have 31 days to enroll in your group plan. Employees who do not enroll within this 31-day period are considered late enrollees. Late enrollees may apply for coverage at any time, subject to certain restrictions. Please refer to the Late Enrollments section of this manual for more details. Any employee who chooses to waive coverage must complete the waiving coverage section and sign the Enrollment Form.

How do I enroll my new employee(s) for non-contributory coverage?
All employees are to be covered on the date they are eligible. There are no late enrollments for non-contributory benefits. Enrollments processed after the billing period has ended for the eligibility date will be back-billed on the first available billing after the enrollment has been received and processed.

The completed Enrollment Form should be sent to MetLife. Keep a copy of the Enrollment Form in your files as evidence that the new employee was given the opportunity to enroll. All requested information is necessary to promptly and accurately enroll your employees.

For all benefits, except dental, employees must complete a Statement of Health Form for coverage amounts in excess of the non-medical maximum that can be found in the Schedule of Benefits in your Certificate of Insurance.

How do I enroll a rehired employee?
Any rehired employee should be enrolled as if he or she were a new employee regardless of whether or not this person was previously covered under your group plan. The only exception is if the employee is rehired within 6 months of the date on which coverage terminated because employment ended.

Any rehired employee returning from the armed services does not have to meet the requirements for coverage of your group plan. Please note on the Enrollment Application that the employee is returning from the armed services and the date he or she returned to full-time employment.  

 
  Late Enrollment for Life, AD&D, LTD and STD  
 

Where do I find the forms I will need for late enrollees?

  • Enrollment Forms*
  • Statement of Health Form*

*Please refer to the Form Finder to download these forms.

What number do I call for a status of my submitted statement of health form?
Contact Customer Service at 1-800-ASK-4-MET (1-800-275-4638)

Are late enrollees covered for non-contributory coverage?
All employees are to be covered on the date they are eligible. There are no late enrollments for non-contributory benefits.

Are there late enrollment penalties for voluntary short term disability?
Employees who do not enroll when first eligible must wait until the next annual enrollment period on your group's anniversary date. Late enrollees for Voluntary STD are allowed to enroll for the minimum benefit level of $100.

 
  Late Enrollment for Dental  
 

What is the late enrollment period for my traditional or transitional plan coverage? Click here to view information regarding Late Enrollment Period For Customers With Dental Plans Covering Type A, B, and C Expenses.

What is the late enrollment period for my basic plan coverage?
Click here for information regarding Late Enrollment Period For Customers With Dental Plan Covering Type A and B Expenses Only.

How do I handle late enrollment for non-contributory coverage?
All employees are to be covered on the date they are eligible. There are no late enrollments for non-contributory benefits.

 

 
  Reporting Changes and Terminations  
 

What form do I need to report changes and terminations?

Examples of changes in employee status
Examples of changes that require notification include:

  • Employee has a change in earnings or occupation that affects benefit amounts.
  • Employee cancellation of a contributory coverage.
  • Employee changes benefit class.
  • Employee changes name.
  • Employee deletes a dependent or all dependent coverages.
  • Divorce or legal separation.
  • Death of dependent.
  • Death of employee.
  • Dependent marries or reaches the limiting age as determined by individual's State requirements (see Certificate of Insurance for details).
  • Employee adds a new dependent to existing dependent coverage including marriage, becoming a parent or legal guardian.

What should I do in the case of the death of an employee?
In the case of death of an employee, all of the deceased employee's dependent(s) coverages must be cancelled. A covered dependent may be eligible for Dental coverage under COBRA or State Continuation. Please refer to the Dental COBRA Continuation Coverage Section. Complete a Change Request Form reflecting the date of death as the coverage termination date and submit to MetLife.  

 

 
  Renewal/Plan Change Procedures  
 

What information will MetLife need to process my renewal?
Most policies are renewed annually. Renewal underwriting and pricing typically occur before your group’s anniversary.

About four months before this date, MetLife will contact you to verify the accuracy of the insured data shown on your premium statement according to your records. We ask that you verify this information 90 days prior to your renewal date. If we have not received it, we will follow up with you.

What happens if my group falls below participation requirements?
Your group plan may terminate if the participation falls below the required participation percentage noted in your Certificate of Insurance.

When will I receive my renewal action letter?
MetLife sends a renewal action letter prior to your group’s anniversary. The letter states the status of your plan and any renewal changes.

 

 
  Life Claim Information  
 

What form do I need to file a Life claim?

  • Life Claim Forms

*Please refer to the Form Finder to download these forms.

Note: New Life Claim Forms are now available. Be sure to download the new forms!

The Standard Total Control Account® (TCA) is the standard Life insurance claim settlement option for all states except policies sitused in Alaska, Colorado, Florida, Louisiana or Maryland. The proceeds must be $5,000 or more in order to qualify for the Total Control Account.* Account holders have full access to their money and can withdraw all or part of it at any time with no penalty or loss of interest, simply by writing a draft. If the payee is a corporation or similar entity, resides in a foreign country or will receive less than $5,000 the payment is generally made with a check.*

*Subject to state law, and/or group policyholder direction, the Total Control Account is provided for all Life and AD&D benefits of $5,000 or more. The TCA is not insured by the Federal Deposit Insurance Corporation or any government agency. The assets backing TCA are maintained in MetLife’s general account and are subject to MetLife’s creditors. MetLife bears the investment risk of the assets backing the TCA, and expects to earn income sufficient to pay interest to TCA Accountholders and to provide a profit on the operation of the TCAs. Guarantees are subject to the financial strength and claims paying ability of MetLife.

What are beneficiary designations?
The beneficiary is the person or persons that the employee designates to receive the proceeds of life insurance benefits. The beneficiary is usually an immediate relative (wife, husband, son, daughter, parents, or fiancée). If the beneficiary is a minor child, MetLife recommends the employee consult an attorney. At initial enrollment, the full name and relationship of the beneficiary should be entered on the Enrollment Form. To make changes to a beneficiary designation, the employee should complete the Beneficiary Designation Form.

What steps do I take to file a Life claim?
Click here for more information regarding Steps for filing a Life Claim.

What are the requirements to file a Life claim?
Click here for more information regarding Requirements.

What number do I call for claim assistance?
Contact MetLife at 1-800-ASK-4-MET (1-800-275-4638)

 

 
  Accelerated Benefit Claim Information  
 

What forms will I need to request accelerated benefit insurance?

  • Accelerated Benefit Claim Forms*
* Please refer to the Form Finder to download these forms.

What steps do I take to file an accelerated benefit claim?
Click here for more information regarding Steps for Filing an Accelerated Benefit Claim.

What are the requirements for accelerated benefits?
Click here for more information regarding Requirements For submitting an Accelerated Benefit Claim.

 

 
  Accidental Death and Dismemberment  
 

What form do I need to file an AD&D claim?

  • Accidental Dismemberment Claim Form
  • Beneficiary Designation Form

*Please refer to the Form Finder to download these forms.

What are the requirements to file an AD&D claim?
Click here for more information regarding Steps for filing a Life Claim.

What are the requirements to file an AD&D claim when the employee dies?
Click here for more information regarding Requirements For Submitting An Accidental Death Claim when A Covered Employee Dies.

What number do I call for claim assistance?
Contact MetLife at 1-800-ASK-4-MET or (1-800-275-4638).

Where can I find information regarding Travel Assistance?
Click here for more information regarding For Customers with Travel Assistance.

 
  Dental  
 

COBRA
Click here for information regarding COBRA, including:

  • What is COBRA continuation coverage?
  • Where do I send COBRA election forms?
  • How do I notify the insured of their COBRA rights?
  • Can a third party administrator assist my group with our COBRA billing?

What is CAL-COBRA?
Click here for information regarding CAL-COBRA including:

  • How do I notify the insured of their CAL-COBRA rights?
  • Where do I send CAL-COBRA election forms?
  • What are qualifying events for CAL-COBRA coverage?
  • What is the length of eligibility for CAL-COBRA coverage?
  • When does CAL-COBRA coverage end?
  • What is the cost of CAL-COBRA Coverage?

State Continuation Coverage
Click here for information regarding State Continuation Coverage, including:

  • What is State Continuation Coverage?
  • How do you notify insured’s of their State Continuation rights?
  • What are the qualifying events?
  • What is the length of eligibility for state continuation?

Where do I find a Dental ID Card?

Refer employees to MyBenefits to print a personalized Dental ID card. The Dental ID Card will include: the employee's name, network, group plan number along with the dental claim office information.

What form do I need to file a Dental claim?

What steps do I take to file a Dental claim?

  • Click here for information regarding the steps necessary to filing a dental claim

Where do I submit Dental claims?

  • The employee may contact the MetLife Claims Office at the following address

MetLife Dental Claims Unit
P.O. Box 981282
El Paso, TX 79998-1282

What number do I call for claim assistance?

  • The employee may contact the MetLife Claims Office at the following telephone number: 1-800-275-4638

VisionAccess Program
Click here for information regarding the VisionAccess Program including:

  • What is the VisionAccess Program?
  • Does my plan include this eyecare program?
  • Where do I find a participating provider?
  • What retailers are participating?

 

 
  Long Term Disability  
 

LTD Claim Information

What forms do I need to file a LTD Claim?

When do I file a LTD Claim?
Click here for information regarding LTD Claim Info

How do I file a LTD Claim?
Click here for information regarding How to File a Claim

What is a rehabilitation program?
Click here for information regarding Rehabilitation Program

What are social security disability award recoveries?
Click here for information regarding Social Security Assistance Program

Where can I find Tax Information regarding disability income?
Click here for information regarding Tax Information

What are the reporting requirements for LTD?
Click here for information regarding Reporting Requirements

 

 
  Short Term Disability  
 

STD Claim Information

What forms do I need to file a STD claim?

When do I file a STD claim?
Click here for information regarding When to File a Claim.

How do I file a STD claim?
Click here for information regarding How to File a Claim.

Additional information for long periods of absence?
Click here for information regarding Additional information for long periods of absence.

When do I notify MetLife regarding my employees returning to work?
Click here for information regarding Notification of Return to Work.

STD claim office guidelines for medical confidentiality?
Click here for information regarding medical confidentiality.

Where can I find Tax Information regarding disability income?
Click here for information regarding Tax information