Neptune-Administered Forms for West Virginia

The below forms are specific to this state. Non-state specific forms can be located on the General Forms page.

Administration Back To Top

There are no state-specific forms. Use forms located on the General Forms page.

Claims Back To Top

There are no state-specific forms. Use forms located on the General Forms page.

Group Statement of Insurability Back To Top

American General Life Insurance Company of Delaware

.06673571-1005USLWV Statement of Insurability for Group Programs WV

Voluntary Statement of Insurability Back To Top

The United States Life Insurance Company

00305101-1098USLWV Application for Group Voluntary Programs All Coverages WV

American General Life Insurance Company of Delaware

06673571-1098USLWV Application for Group Voluntary Programs All Coverages WV
06673571-1496USLWV Application for Group Voluntary Programs Life & AD&D Only WV