Skip to main
  • Life Insurance and AD&D Beneficiaries Form 2020-21
  • Click to view (pdf or doc)
  • Plan year July 1, 2020 through June 30, 2021Use this form to name your beneficiaries for your optional life insurance and optional accidental death & dismemberment insurance.
  • Revision date: 04/22/2020
  • Submit paper form to benefits@uky.edu
  • Email form back to Benefits Office, 112 Scovell Hall, Lexington KY 40506-0064