Life Insurance Convert Port

Convert or Port Your Life Insurance

Please answer the questions below so that we can send the relevant life insurance document to the email address you provide on this form.
You may maintain your life insurance coverage after employment guaranteed issue by porting or converting your policy. Please request and complete the applicable form to do so.
First Name
Last Name
Email
Please use your City email address if you have one. example@example.com
Department
What would you like to do with your life insurance benefit?
Convert: Convert your policy into an individual whole life policy to be maintained after employment. Port: Transition your policy into an individual term life policy after employment.
Please verify that you are human
Next Steps

After you click the Submit button below, we will send the relevant life insurance document to the email address you provided on this form. It will come from "City of Cambridge Benefits Team via Adobe Acrobat Sign".

Once you complete and sign the document, the form will be sent to Human Resources for eligibility review and processing. You will be given an option to download your completed form.

If you don't see the form in your inbox within 10 minutes of submitting this form, please check your spam/junk folders. If you still do not see the form, please contact the Benefits office benefits@cambridgema.gov or call 617-349-1770.
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Convert or Port Your Life Insurance