A variety of service forms are available to assist you with account management. For help in filling out the forms, please view the instructions.
For selecting your investment basis, payout method and frequency and tax withholding information.
For providing formal instruction from the Owner to Security Benefit Life that SBL should accept instructions from a third party to undertake certain actions of funds in certain Variable Annuity contracts.
For assigning or transferring over to an Assignee certain rights, title and interests of the policy as set forth by this document.
For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner or Joint Owner of the Contract.
For choosing how to handle proceeds, applying to receive payments electronically via Electronic Funds Transfer (EFT) and selecting federal income tax options. Note: Every beneficiary is required to complete his or her own form in the case of a death benefit.
This form can be used to accomplish a FULL or a PARTIAL Exchange of policies pursuant to Internal Revenue Code (IRC) Section 1035.
To add or change Required Minimum Distribution options, contact your Advisor or our Service Center (800.888.2461) to request a form.
For transferring assets internally from one Security Benefit Contract to another Security Benefit product (i.e., moving assets from your 403(b) TSA to your 401(k) Account. Please read Transfer Procedures carefully.
Please review these instructions before completing any of the forms online. The majority of our forms are designed in a fillable format so you may enter the required information online.
P.O. Box 750497
Topeka, KS 66675-0497
If you experience problems and need assistance, please call our Service Center at 800.888.2461.
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Product is not available in New York.
Security Benefit Life Insurance Company is not a fiduciary and the information provided is not intended to be investment advice. This information is general in nature and intended for use with the general public. For additional information, including any specific advice or recommendations, please visit with your financial professional.
Guarantees provided by annuities are subject to the financial strength of the issuing insurance company. Annuities are not FDIC or NCUA/NCUSIF insured; are not obligations or deposits of and are not guaranteed or underwritten by any bank, savings and loan, or credit union or its affiliates; and are unrelated to and not a condition of the provision or term of any banking service or activity.
The Security Benefit RateTrack® Annuity, form ICC15 5300 (12-15) and 5300 (12-15), a single premium deferred fixed annuity, is issued by Security Benefit Life Insurance Company. Product features, limitations, and availability vary by state.
The market data (“Information”) contained herein: (i) includes the proprietary information of Chicago Mercantile Exchange Inc. or its licensors, as applicable; (ii) may not be copied, sold, or further disseminated except as specifically authorized; (iii) does not constitute investment advice; (iv) is provided solely for informational purposes; and (v) is not warranted to be complete, accurate, or timely.
CME GROUP MARKET DATA IS USED UNDER LICENSE AS A SOURCE OF INFORMATION FOR CERTAIN SECURITY BENEFIT LIFE INSURANCE COMPANY (“SBL”) PRODUCTS. CME GROUP HAS NO OTHER CONNECTION TO SBL PRODUCTS AND SERVICES AND DOES NOT SPONSOR, ENDORSE, RECOMMEND, OR PROMOTE ANY SBL PRODUCTS OR SERVICES. CME GROUP HAS NO OBLIGATION OR LIABILITY IN CONNECTION WITH THE SBL PRODUCTS AND SERVICES. CME GROUP DOES NOT GUARANTEE THE ACCURACY AND/OR THE COMPLETENESS OF ANY MARKET DATA LICENSED TO SBL AND SHALL NOT HAVE ANY LIABILITY FOR ANY ERRORS, OMISSIONS, OR INTERRUPTIONS THEREIN. THERE ARE NO THIRD-PARTY BENEFICIARIES OF ANY AGREEMENTS OR ARRANGEMENTS BETWEEN CME GROUP AND SBL.
SB-10011-26 | Rev 2021-12-21