Forms & Documents

Broker Materials

Appointment & Commission

	Broker-Agency Direct Deposit Authorization Form
	CoPower Producer Agreement CA
	MetLife SBS Commission Agreement and Acknowledgement

Enrollment Forms

Employee

	Benefit Waiver and Declination Form
	MetLife Beneficiary Designation Form
	MetLife Dental-Life Disabled Dependent Form
	New Group Enrollment/Waiver Form
	New Group Enrollment/Waiver Form (Spanish)

Employer

	AXA Assistance USA, Inc Service Agreement (only if group is enrolling in Supplemental Life Plan)
	MetLife Application for Group Insurance
	MetLife Conversion Form
	MetLife Copower Group Administration Form
	MetLife DHMO Group Application (only if group is enrolling in DHMO Plan)
	MetLife eCensus Format - All Coverages
	MetLife New Group Submission Form
	MetLife Statement of Health Form
	W-9 Form

In-Force Group Materials

Employee Forms

	Existing Group Enrollment and Change Form
	Existing Group Enrollment and Change Form (Spanish)

Employer Administration

CoPower Contact Sheet

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

Sales Guides & Flyers

Value Add Programs

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

Brochures/Flyers: Broker/Employer

	CoPower Portfolio
	Empower Group Flyer