Employer Group Life Insurance Claims Under ERISA (2026)

If a loved one had employer-provided group life insurance, the claim usually starts with the employer's HR or Benefits team, the Plan Administrator, or the insurance carrier. Ask for the Summary Plan Description, the carrier and policy number, the claim packet, and any conversion, portability, or waiver-of-premium records. Under ERISA, life insurance death benefit claims are generally decided within 90 days after the claim is received, with one 90-day extension for special circumstances.

Employer group life can be hard to track because the policy may not be in the person's files. This guide explains how to use W-2s, paystubs, ERISA document rights, and Form 5500 filings to find the right plan and file the claim. This is general information for families and executors, not legal advice.

Start by calling HR or the Plan Administrator

For an employer group life policy, the first call should usually go to the Plan Administrator listed in the Summary Plan Description, often called the SPD, or the HR or Benefits department. If you do not have the SPD yet, HR can usually tell you where to send a written request.

Use this short script when you call:

"Hello, I'm [Your Name], beneficiary of [Decedent]. I'm calling about [Employer]'s ERISA group life plan. Could you please confirm the carrier and policy number, send the claim packet and required proofs, and advise if conversion/portability or waiver-of-premium applied at termination? I can email a formal ERISA §1024(b)(4) request today."

If you reach voicemail, use a shorter version:

"Hello, I'm [Your Name], beneficiary of [Decedent], former employee of [Employer]. I'm requesting, under ERISA, the group life plan's SPD, insurance certificate, claims procedures, and any conversion/WOP notices. Please confirm the Plan Administrator's mailing/email address for a written request. My call-back is [number]. Thank you."

After the call, write down the date, the person you spoke with, the carrier name, any claim number, and the documents they asked you to send. Estate settlement often takes months, and a simple date log can prevent missed deadlines later.

Look for a W-2 Box 12 code C clue

Before you spend hours searching files, check the decedent's recent W-2s. IRS Form W-2 Box 12 code "C" means the taxable cost of employer-provided group-term life insurance over $50,000 was reported for that tax year, for an employee or former employee.

That does not prove the policy was still active at death, but it is a strong sign that group life coverage existed with that employer. Use the employer name and EIN from the W-2 to aim your SPD request and Form 5500 search.

Also look for the last paystub. Many paystubs show imputed income for group-term life or list life or AD&D deductions.

A fast first-pass checklist:

• Identify employers from the last 2 to 3 years.
• Pull W-2s and last paystubs.
• Look for W-2 Box 12 code C.
• Ask HR for the SPD, certificate, claim packet, and appeals procedures.
• Search Form 5500 if the employer is large enough to file.
• Flag any 31-day conversion or portability window.
• Check for waiver-of-premium if the person stopped working because of disability.
• Submit the claim packet and track the 90-day ERISA decision period.

For a broader overview of workplace benefits after a death, see Sunset's guide to claiming employer life insurance after death.

Request the SPD and plan documents in writing

ERISA gives participants and beneficiaries the right to request plan documents. The plan administrator must furnish the latest SPD and other governing instruments, such as the insurance policy or certificate, within 30 days of a written request. A court may impose penalties of up to $110/day under ERISA §502(c)(1) if the plan administrator fails to furnish required documents.

Send the request to the "Plan Administrator" named in the SPD or on the Form 5500. This is often the employer.

Ask for:

• Summary Plan Description, also called the SPD.
• Any Summary of Material Modifications, also called SMMs.
• Group life and AD&D insurance policy or certificate booklet.
• Claims and appeals procedures under 29 CFR 2560.503-1.
• Evidence of coverage at the date of death.
• Any conversion or portability notices sent at termination or reduction.
• Any waiver-of-premium, or WOP, due-to-disability terms and forms.

Here is a written request you can adapt:

Subject: ERISA document request for group life benefits (29 U.S.C. §1024(b)(4))

To: Plan Administrator, [Plan Name] ([Employer EIN if known])

"Pursuant to 29 U.S.C. §1024(b)(4), I request copies of: (1) the current SPD and any SMMs; (2) the group life/AD&D policy and certificate; (3) claims and appeals procedures; (4) evidence of coverage for [Decedent] at date of death; (5) any conversion/portability or waiver-of-premium notices issued. Please furnish these within 30 days. Failure to furnish may subject the Plan Administrator to penalties under ERISA §502(c)(1) (29 C.F.R. §2575.502c-1). Please deliver PDFs by email to [address] and confirm receipt."

Send the request by email if HR allows it, and consider certified mail so you have proof of delivery.

Use Form 5500 to find the plan and carrier

If the employer is large, generally 100+ participants in its welfare plan, or otherwise files, Form 5500 can help identify the Plan Administrator, plan number, and insurance details. Schedule A can show the carrier and policy or contract numbers. Smaller unfunded or fully insured welfare plans are often exempt.

You can search the Department of Labor's EFAST2 Filing Search without a login:

1. Go to the DOL's EFAST2 Filing Search and choose "Form 5500 Series Search."
2. Search by Employer or Plan Sponsor name, or by EIN.
3. Use plan-year filters if needed. Welfare plan numbers typically begin at 501.
4. Open the most recent welfare filing. Welfare plan numbers usually fall from 501 to 999.
5. Review Part II for the Plan Sponsor or Plan Administrator and mailing addresses.
6. Review Part I for the plan year.
7. Download Schedule A attachments, if available, to look for the group life carrier, policy or contract numbers, and premiums or commissions.
8. Check Line 8 or Line 9 for plan characteristics. Welfare codes start with "4." Life insurance is code 4B, dental is 4D, and death benefits are 4L.

If nothing appears, the plan may be exempt, such as a plan with under 100 participants that is insured or unfunded. It also may be filed under a different wrapped plan name. Try the employer's legal name, trade name, EIN, parent company name, and prior plan years.

The EFAST2 portal also posts help for filtering and DCG filings. Form 5500 is generally due on the last day of the 7th month after the plan year ends, such as July 31 for calendar-year plans, with available extensions.

Check conversion and portability rules

Many families miss employer life insurance because the person died after leaving work, retiring, or losing coverage. Do not stop at "they no longer worked there." Group life plans often have conversion or portability rules.

Most states require at least a 31-day window to convert group life coverage to an individual policy after employment ends or coverage reduces. Many policies also allow portability, meaning the person may move the group term coverage to an individual term plan, often on a similar timeline.

Look for these items in the SPD or certificate:

• Conversion period, including the minimum 31 days after coverage ends or reduces.
• Portability option, if offered.
• Portability deadlines and age limits.
• Notice rules.
• Any state rules extending or tolling a conversion deadline when notice is late.
• Rules for death during the conversion period.

Some states extend the conversion period if notice is not given on time. New York, for example, extends the window if notice is given more than 15 but less than 90 days after the event, with an outer cap.

Many statutes also require the group policy to pay the amount eligible for conversion if the insured dies within the conversion window, even if no application or premium was submitted. If the death happened soon after employment ended or coverage reduced, flag this in the claim cover letter and compare the certificate with state law where the policy was delivered.

Screen for waiver-of-premium due to disability

Group life often includes a waiver-of-premium feature, usually shortened to WOP. If total disability begins before a stated age and continues through a waiting period, premiums may be waived and coverage may continue without conversion.

Review the certificate for:

• The definition of "total disability."
• Age thresholds, often 60.
• The waiting period.
• Maximum WOP duration, such as to age 65.
• Notice deadlines.
• Proof deadlines.
• Periodic proof requirements.

If the decedent stopped working because of disability, ask HR and the carrier whether WOP was approved, pending, or never filed. Late-notice terms may excuse delay if proof was not reasonably possible and is provided as soon as possible.

If the insured converted coverage but also qualified for WOP, some standards allow the insurer to pay "continued" life insurance and void the individual policy if returned. Confirm the rule in the certificate before assuming the converted policy is the only possible claim.

Submit the claim and track ERISA timing

Once you have the carrier and claim packet, send the required proofs. The carrier or plan may ask for a certified death certificate, beneficiary identification, a claim form, and employer certification.

For non-health, non-disability welfare benefits such as life insurance death benefits, ERISA claim procedure rules generally require an initial benefit decision within a reasonable time, not later than 90 days after claim receipt. One 90-day extension is allowed for special circumstances if written notice is provided. Appeals must follow the plan's full and fair review rules under 29 C.F.R. §2560.503-1.

Document production has a separate clock. The plan administrator must furnish requested SPDs and governing instruments within 30 days of a written request. Courts may impose up to $110/day for failure.

One practical detail matters: ERISA time periods run from when a claim is filed under the plan's reasonable procedures, regardless of whether the insurer has all information. The plan may toll timing only in narrow circumstances described in the regulation. Keep dated copies of the claim form, cover letter, email, fax receipt, upload confirmation, and any mailing proof.

For help with the insurance claim process itself, see Sunset's guide on how to claim life insurance after a death.

Evidence to gather before you file

How Sunset helps with employer group life claims

Sunset helps families find employer-provided group life, submit claim forms, and follow up with carriers. That work can happen alongside the rest of the estate settlement, including asset discovery, probate paperwork, estate account setup, and transfers.

For employer group life, Sunset can help:

• Identify the plan or carrier using payroll records, W-2 Box 12 code C, HR portals, and Form 5500 Schedule A.
• Prepare and transmit claim packets and follow-ups to the insurer.
• Track deadlines and coordinate with HR if employer certification is needed.
• Search 2,500+ financial institutions to find accounts and assets.
• Generate state- and county-specific probate packets for all U.S. counties when required.
• Refer families to a local probate attorney when counsel is needed.
• Set up an FDIC-insured estate account to receive estate funds when appropriate.

Any Sunset fee counts as an estate administration expense the executor can reimburse from the estate, and all assets go to the beneficiaries and heirs. Sunset has helped 15,000+ families settle estates, and our security program includes SOC 2 Type II. Most families find all assets within a week.

For asset searches beyond employer life insurance, you can also read Sunset's guide to the best estate asset discovery tools.

ERISA sources behind these steps

The main legal and agency references for employer group life claims include:

• ERISA reporting, disclosure, and SPD rights: 29 U.S.C. §§1021 to 1024.
• Written document request rights: 29 U.S.C. §1024(b)(4).
• ERISA penalty provision: ERISA §502(c)(1).
• Related penalty regulation: 29 C.F.R. §2575.502c-1.
• DOL Reporting & Disclosure Guide.
• Form 5500 search, Schedule A, and welfare coding: EFAST2 portal, DOL Schedule A instructions, and IRS/DOL code lists.
• Claims procedure timing: 29 C.F.R. §2560.503-1.
• Conversion, portability, and WOP framework: state statutes and Insurance Compact uniform standards.
• W-2 Box 12 code C: IRS 2025 W-2/W-3 instructions.

Because state insurance law and the plan certificate can change the answer, use the certificate and applicable state law where the policy was delivered. If there is a dispute or denial, consider speaking with an attorney who handles ERISA benefits claims.

FAQ

How do I find out if my loved one had employer group life insurance?

Start with recent W-2s and paystubs. W-2 Box 12 code C is a strong clue because it reports taxable cost for employer-provided group-term life insurance over $50,000. Then call HR or Benefits, ask for the carrier and policy number, and send a written ERISA §1024(b)(4) request for the SPD, certificate, and claim procedures.

What is the deadline for an ERISA life insurance claim decision?

For non-health, non-disability welfare benefits such as life insurance death benefits, the initial decision is generally due within a reasonable time, not later than 90 days after claim receipt. One 90-day extension may be used for special circumstances if written notice is provided.

What if the person died after leaving the job?

Check the group life certificate for conversion, portability, and waiver-of-premium terms. Most states require at least a 31-day conversion window after coverage ends or reduces. Many statutes require payment of the amount eligible for conversion if the insured dies within that window, even if no application or premium was submitted.

Can HR refuse to send the SPD or certificate?

Participants and beneficiaries may request plan documents under ERISA. The plan administrator must furnish the latest SPD and other governing instruments within 30 days of a written request. A court may impose penalties of up to $110/day under ERISA §502(c)(1) for failure to furnish required documents.

What does waiver-of-premium mean for employer life insurance?

Waiver-of-premium means coverage may continue without premium payments if total disability began before a stated age and continued through a waiting period. Look for the definition of total disability, age threshold, maximum duration, notice rules, proof deadlines, and any periodic proof requirements.

Sunset can help you look for employer group life coverage, file claims, follow up with carriers, and handle the related estate tasks in one place. Start with Sunset's life insurance search at https://www.hellosunset.com/life-insurance-search.