GMP Death Benefit Plan and Forms

SUMMARY OF MEMBER DEATH BENEFIT PLAN

Click here to read the summary of the GMP member death benefit plan.

FINANCIAL FORMS

• Self-pay Payment Form

FILING A CLAIM

To report a death, please complete the materials that pertain and return them to the GMP Council office with the ORIGINAL death certificate and any additional supporting documents.

• Notice of Death Form
• Claimant's Statement: completed by the designated beneficiary, by each surviving child or by the estate representative
• W9 Form: completed by each beneficiary, by each surviving child or by the estate representative; no checks will be issued without a completed W9 Form
• Surviving Children Affidavit (if applicable)

When filing a claim without a designated beneficiary or the named beneficiary is deceased, the claim will be paid in the following order.

1. Surviving spouse (must provide marriage certificate)
2. Surviving children in equal shares (must provide a copy of each child's birth certificate; EVERY child must complete a Claimant's Statement Form and W9 Form along with a Surviving Child Affidavit)
3. The estate (must provide Letters of Administration)

Send completed forms to:

GMP Council Office
608 E. Baltimore Pike
Media, PA 19063
Office: (610) 565-5051 Ext. 4963
Fax: (610) 565-0983

*Claims will only be paid to one of the above in the order in which they are listed.