Request For Group Coverage/enrollment Form Page 4
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6Popular Beneficiary Designations
Be sure to use given names such as “Mary M. Doe”, not Mrs. John Doe”. The following sample designations
may be helpful to you.
Type of Beneficiary
Standard Wording
1.
insured’s estate
my estate
2.
one beneficiary
Anna L. Doe wife
3.
two beneficiaries
John A. Doe, father, and Mary I. Doe, mother, equally or to
the survivor
4.
three or more beneficiaries
John A. Doe, father, and Mary I. Doe, mother, and Henry J.
Doe, son, equally or to the survivor(s)
5.
one beneficiary and one contingent beneficiary
Anna L. Doe, wife, if living; otherwise, Henry J. Doe, son
6.
one beneficiary and two or more contingent
Anna L. Doe, wife, if living, otherwise Henry J. Doe, son,
beneficiaries
Alice G. Doe, daughter, equally or to the survivor
7.
one beneficiary and three or more contingent
Anna L. Doe, wife, if living, otherwise Henry J. Doe, Alice G.
beneficiaries
Doe and Charles B. Doe, children, equally or to the
survivor(s)
8.
two beneficiaries and one contingent beneficiary
John A Doe, father, and Mary I. Doe, mother, equally or to
the survivor; otherwise, Anna L. Doe, wife
9.
two beneficiaries in unequal portions
three-quarters of the proceeds to John A. Doe, father, if
living, and one-quarter to Anna L. Doe, mother, if living, the
share of a deceased beneficiary to be paid to the survivor, if
any
10. trust with individual trustees
Richard Doe and John Smith, trustees, or a successor in
trust under (trust name) established (date of trust
agreement)
11. present or living trust
ABC Bank and Trust Company, Des Moines, Iowa, trustee
or successor in trust under (trust name) established (date
of trust agreement), provided however that the company
has received within 180 days of the death of the insured,
evidence satisfactory to the existence of such trust;
otherwise to the estate of the insured.
12. testamentary trust
Trustee of the Mary L. Doe trust or successor in trust
established by the last will and testament of the insured
dated……..
Rev 6/13/2013
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