Forms & Documents

Broker Materials

Appointment & Commission

	Broker-Agency Direct Deposit Authorization Form
	CoPower Producer Agreement CA

Calculators

CoPower UNUM Voluntary Life Premium Census Calculator 2025

Enrollment Forms

Employee

	Benefit Waiver and Declination Form
	New Group Enrollment/Waiver Form
	New Group Enrollment/Waiver Form (Spanish)
	Unum Beneficiary Designation Form
	Unum Beneficiary Designation Form (Spanish)
	Unum Employee Voluntary Life Application
	Unum Evidence of Insurability Form (Spanish)
	Unum Member Voluntary Life Application (Spanish)
	UnumEvidence of Insurability Form

Employer

	CoPower Enrollment Census (All Carriers) - California
	CoPower SELECT Employer Application with Delta Dental, VSP, UNUM, & Landmark
	W-9 Form

In-Force Group Materials

Employee Forms

	Existing Group Enrollment and Change Form
	Existing Group Enrollment and Change Form (Spanish)
	Unum Change Request Form - Voluntary Life
	Unum Life Long Term Disability Claim Form
	Unum Life Short Term Disability Claim Form
	Unum Portability Form
	Unum Waiver of Premium Claim Form

Employer Administration

	CoPower Contact Sheet
	Unum Life & AD&D Claim Form

Employer Forms

	Direct Debit Authorization Form
	Employee Termination Form
	Federal COBRA and CalCOBRA Status Notification Form
	Group Address Change Form
	Group Cancellation Form
	One Time Bank Draft Authorization Form
	Renewal Date Change Request Form
	Unum Notification of Conversion Form

Sales Guides & Flyers

Value Add Programs

	CoPower Vantage Powerful Perks Flyer
	Discount RX Card
	Discount RX Card - Spanish
	Zywave CoPower Flyer

Product Guides

	CoPower ONE Product and Rate Guide 2025 - California
	CoPower SELECT Unum Product and Rate Guide 2025

Brochures/Flyers: Broker/Employer

	CoPower & Unum Key Points and Differentiators
	CoPower ONE Pick One Flyer CA Region 1
	CoPower ONE Pick One Flyer CA Region 2
	CoPower Portfolio
	CoPower SELECT Unum Grp Voluntary Life Flyer
	Empower Group Flyer
	Unum Group LTD Benefit Summary Flyer
	Unum Through CoPower

Brochures/Flyers: Member

	Employee Assistance Program Flyer
	Group Voluntary Term Life EE Guide
	Unum Group LTD Employee Education Flyer
	Unum Long Term Disability Benefit Summary Flyer
	Unum Voluntary Life Plan Benefit Rate Sheet
	Unum Voluntary Term Life and AD&D Insurance
	Unum Why Buy AD&D Insurance Employee Flyer
	Unum Why Buy Term Life Insurance Employee Flyer
	What Would Your Family Do Without Your Income
	Worldwide Travel Assistance Employee Wallet Card
	Worldwide Travel Assistance Flyer

Summary of Benefits (SOB)

Life: Unum

Unum Group Term Life Plan Highlights

LTD: Unum

	Unum LTD Benefit Summary 10-Life+ 180 Day EP
	Unum LTD Benefit Summary 10-Life+ 360 Day EP
	Unum LTD Benefit Summary 10-Life+ 90 Day EP