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Mercer Health & Benefits Administration LLC fax number

(515) 365-1520

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Group Universal Life & Supplemental Term Life

Used for: Submitting Owner/Insured Transaction Requests for Group Universal Life policies (withdrawal, surrender, loan) and related enrollment/benefit forms.

Fax destination details

Department
Group Universal Life & Supplemental Term Life
Purpose
Submitting Owner/Insured Transaction Requests for Group Universal Life policies (withdrawal, surrender, loan) and related enrollment/benefit forms.
Form
Transaction Request Instruction Form — Owner Transaction Request Instruction Form
Address
Mercer Health & Benefits Administration LLC, PO Box 9122, Des Moines IA 50306-9122
Voice phone
1-888-788-8626

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This form must be completed to request a withdrawal, surrender or loan from your certificate.

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