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| TASC - FlexSystem (Total Administrative Services Corporation) | |
| Employees - Access Your Account Online click here | |
| Employers - Access Your Account Online click here | |
American Fidelity Assurance Company
Well Check Claim Form
Cancer Claim Form
Beneficiary Change Request
Name Change Request
Bank Draft Authorization
Address
Change Form
Assurant Employee Benefits/Union Security Ins.Co.
Assurant Disability
Claim Form & Instructions
ASI
Educator Service Request Form
Life Claim Statement
Employee/Employer
Term Life
Claim Form for Beneficiary
Assurant Term Life Beneficiary Change Form
Voluntary Life Portability Request
Voluntary Life Conversion
Request
Bay Bridge Administrators, LLC
Hartford/AIG/Nat’l Union Fire Ins. Co.
Well Check Claim Form
Cancer, Specified Disease & Intensive Care Claim Form
Service & Change Request
Conseco/Jefferson National Life Ins. Co.
Cancer, Specified Disease & Intensive Care Claim Form
Cancer Bank Draft Authorization
Change Request Form
Add or Remove Family
Members
HIPAA Authorization Form
Delta Dental -
click here
Reliance Standard AD&D
Change of Beneficiary
AD&D Application
Transamerica
Cancer, Specified Disease & Intensive Care
Claim Form
Instructions
Service Change Form
Bank Draft Authorization
Vision Service Plans (VSP) – click here
| ING Reliastar (formerly Northern Life & Annuity) | |
| Service and Beneficiary Change Request |
New Mexico’s Buyer’s Guide To Annuities |
| Variable Annuity Allocation Change & Transfer Request | |
| ING Loan Request for Section 403(b) Tax Sheltered Annuity | Q&A on TSA Loans |
ING Retirement Plans – 457 Deferred
Comp. Plans
457 Participation Agreement
457 Deferred Comp. Disbursement Request
Jefferson National (formerly Conseco)
Name or Address Change
Change of
Beneficiary
Fund
Transfer Request
TSA
403(b) Loan Request
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*Claude Burba,
Shirley Burba and Brady Barham Registered Representatives of Legend Equities Corporation
Securities Offered Through Legend Equities Corporation, Member,
FINRA/SIPC
http://www.finra.org
4600 East Park Drive, Suite 300, Palm Beach Gardens, FL. 33410, (561) 694-0110
Investments are not FDIC insured, not guaranteed by any bank. Subject to risk
and may lose value.
© 2002-2008 Burba Insurance Services. All rights reserved.
Burba Insurance Services is not an affiliate of Legend Equities Corporation.
Burba Insurance Services,
Legend Equities Corporation and its affiliates do not endorse these sites,
their sponsors,
or any of the policies, activities, products, or services offered on the
sites or any advertiser on the sites.
