Forms All forms are in Adobe® Acrobat® format. Click on the form you need and you should see the form appear in a new window. Print, complete and sign the form before submitting it to your employer or Boston Mutual Life Insurance Company.

GROUP ADMINISTRATION: At Boston Mutual Life Insurance Company, we strive to make our customers' lives easier. Below, you will find many of our administrative forms that can be downloaded for your convenience. Please select the link that best describes your needs. If you are unable to locate a required form, please call 1-800-669-2668 ext 382. Employers / Plan Administrators - please mail completed forms with your premium payment to the following address:     Boston Mutual Life Ins. Co. -G     PO Box 55154     Boston MA 02205-5154 The forms can also be mailed to:     Boston Mutual Life Insurance Company     Group Administration     120 Royall Street     Canton MA 02021 OR     Fax to 781-770-0490 OR     E-Mail GroupAdmin@bostonmutual.com The Boston Mutual Group Administration Toll Free number is 1-800-669-2668 EXT 700.

GROUP ADMINISTRATION FORMS

GROUP ENROLLMENT REFUSAL OF INSURANCE EVIDENCE OF INSURABILITY AUTHORIZATION OF RELEASE OF HEALTH RELATED INFORMATION NOTICE OF INFORMATION PRIVACY PRACTICE CONVERSION PORTABILITY GROUP INSURANCE REQUEST FOR CHANGE GROUP INSURANCE CERTIFICATE CHANGE FORM INCLUDES BENEFICIARY CHANGES GROUP INSURANCE SELF ADMINISTRATION PREMIUM REPORT