These forms will be of use to those insured through Covenant Benefits who need to add or update information or who need to terminate coverage.
Electronic Funds Transfer Form >>
Minister and Ministry Staff Enrollment >>
Covenant Offices Enrollment >>
Paper Invoice Suppression & Online Billing Access Election >>
Paper Invoice Suppression Election Form >>
Enrollment Form for Retiree Health and Medicare Supplemental Insurance >>
Life & Long-term Disability Insurance Change >>
Life/Accidental Death Beneficiary >>
Notice of Qualifying Event (Divorce, Dependent Child Ineligible) >>
Termination of Benefits or Employment >>
Contact Covenant Benefits with any related questions.
email: email@example.com | phone: (800) 313-8955 | fax: (773) 784-2249