Forms & Documents

Broker Materials

Appointment & Commission

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

Calculators

	CoPower Landmark Rate Calculator (January 2025 to December 2025)
	CoPower ONE New York Cost Comparison Calculator
	CoPower UNUM Supplemental Life Premium Census Calculator - New York
	CoPower UNUM Voluntary Life Premium Census Calculator 2025

Enrollment Forms

Employer

	AXA Assistance USA, Inc Service Agreement (only if group is enrolling in Supplemental Life Plan)
	CoPower Enrollment Census - New York
	CoPower Enrollment Census (All Carriers) - California
	CoPower ONE Employer Application - California
	CoPower ONE Employer Application - New York
	CoPower ONE Open Enrollment Request Form
	CoPower SELECT Employer Application with Delta Dental, VSP, UNUM, & Landmark
	MetLife Accelerated Benefit Option Form (ABO)
	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