Forms Library

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
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.

How to file a claim online
How to file a claim by phone
How to file using a claim form
Disability paper claim form guide
Tips for Employers for paper claims

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 Medical Authorization/Disclosure of Information 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 Attending Physician Statement 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 Electronic Funds Transfer (EFT) Authorization Form to: 
Metropolitan Life Insurance Company 
Attn: MetLife Disability Claims 
PO Box 14590 
Lexington, KY 40511-4590 
Fax: 1-800-230-9531

FMLA Certification
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 FMLA Certification to: 
Metropolitan Life Insurance Company 
Attn: MetLife Disability Claims 
PO Box 14590 
Lexington, KY 40511-4590 
Fax: 1-800-230-9531

PFML
These forms are used to gather information necessary for the ongoing management of Paid Family and/or Medical Leave Act (PFML) Claims for yourself, a family member or for some military family needs. Depending on the leave reason, you may need to have the physician complete this form after you file your claim.
PFML Claim Form
PFML Certification - All Leaves

HI specific
TDI – Temporary Disability Claim Form

NY specific
DBL – Disability Claim Form
PFL – Paid Family Leave Claim Form and Certifications

NJ specific
TDI – Temporary Disability Claim Form

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:

• Learn about the claims process and what you’ll need to submit your claim
• Get answers to frequently asked questions
• Search for a life insurance policy
• Start a claim

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.)

COMPLETE ONLINE or DOWNLOAD FORM

MetLife Claim Form 
In English PDF Version (161k) 
En Español PDF Version (163k)