fbpx

State Applications

Please visit the Getting Started page and select your state application using Step 1.
If you prefer to print and mail an application, click here.

online applications

Pulse Claim Submission

submit a claim

check claim status 

If you prefer to print and mail a claim, please choose your carrier below. Note: Turnaround time for claims submitted electronically is significantly faster. 
Pan-American Life printable claim form
Unified Life printable claim form

Update Eligibility in Pulse

Log into Pulse and select "My Profile" from the drop-down menu in the top right corner (it will appear when you hover over your name). Here you can update your contact information, add or term dependents, and make other eligibility changes.

update eligibility

Update Group Information in Pulse

First, log into Pulse.

To update contact information and benefit levels, select "My Profile" from the drop-down menu in the top right corner (it will appear when you hover over your name).

To update your banking information, select "My Banking" from the same drop-down menu.

To add/edit/delete participants or dependents, select "User Manager" on the left-hand column of your screen.

update group

Privacy Rule Authorization

This form is the participant's signed permission to allow a covered entity to discuss or disclose the participant's protected health information (PHI).

privacy authorization

Agent Information

Unified Life - Producer Application

Pan-American Life - Producer Application

Pan-American Life Insurance Group - "How We Do Business" brochure

Direct Deposit: Electronic Funds Transfer (EFT) Form

This form is the participant's signed permission to allow BeniComp to reimburse claims directly into their bank account electronically.

eft form