Beneficiary Designation/Change Instructions and Form

Benefit Form – Life Insurance

Principal Beneficiary Designation/Change Form


1) Download the form.

2) Fill in the form online by typing in your information.


  • Contingent beneficiaries only receive the life insurance payout if the primary beneficiaries are deceased
  • If you have Group Basic Term Life, complete pages 1 and 4
  • If you have Voluntary Term Life, also complete pages 2 and 3
  • If you do not wish to designate different beneficiaries on pages 2 and 3, just write “Same as Page 1”
  • Social Security Numbers are not required for your beneficiaries and they may reside outside of the U.S.
  • Consider the custodial appointment for minors as seen on page 4

3) Print the form and review for accuracy

4) Sign and date the form (this is required)

5) Mail the form to:

University Human Resources Benefits Office

3810 Beardshear Hall

515 Morrill Road

Ames, IA 50011-2103

OR Fax form to: 515-294-8226

OR Email to: (IMPORTANT: if sending by email, please ensure you name is at the top of the form but do NOT include your social security number or anyone else's.  If you can send this form from your Iowa State email account, it will help us to better identify you without your SSN.)

When the Benefits Office receives your form, it will be uploaded to your Workday documents. Within a week, you may view your form in Workday by following these directions:

  1. In Workday, click on the cloud (or your photo) in the upper right-hand corner
  2. Select View Profile
  3. In the blue bar on the left, click Overview
  4. Along the top menu, click on Documents which you’ll find on the far right

Please direct any questions about the beneficiary form to

You can change your beneficiary at any time by completing and submitting a new form.