Submit a Death Notice - Life Insurance Claim for Employee, Retiree, or Dependent

Show Help Hide Help

Notify Benefit Services when an employee, retiree, or dependent passes away to process life insurance claims and update insurance coverage within 31 days of the death.

Was the deceased an active employee, dependent, or retiree?

Was the passing accidental or natural?

What is the UIN of the deceased employee:

Please provide the name and contact information of the employee's next of kin?

Please provide the date of death of the employee:

Notice: Protecting Your Privacy and Ensuring HIPAA Compliance

At HROE, we are dedicated to safeguarding your privacy and ensuring full compliance with the Health Insurance Portability and Accountability Act (HIPAA). Please note that TeamDynamix is not designed to store or manage any personal identifiable information (PII) or protected health information (PHI).

To uphold the highest standards of data protection, we kindly ask that you refrain from sharing any PII or PHI in this electronic form.

Describe your request below (information left in this box is only visible to the Benefit & Retirement Services team):

Secure File Transfer Instructions

*If you need to send a file containing sensitive information, please use Filex for a secure transfer instead of attaching below. Detailed instructions on how to use Filex can be found here. To share information through Filex with the benefits team, simply share your uploaded file to benefits@tamu.edu.

Non-Secure File Transfer

File attachments associated with the ticket.

Browse...

Other Fields

Your name

Your email address

Your phone number

Verification Code