Long-Term Disability Insurance Documents

Long-term disability insurance application, flyer and privacy notice.

Publication Date: 04/21/2023
Document Type: Printed Forms and Templates
Sponsor: Employee Benefits

Summary
Please submit the application via Fax to (314) 622-4719 or e-mail at CityEmployeeBenefits@stlouis-mo.gov. Also please remember to remove Social Security Numbers, or to only include the last four digits.

Download

  1. pdf LTD Application (English) (2.34 MB)
  2. pdf LTD Flyer (English) (2.62 MB)
  3. pdf The Hartford Customer Privacy Notice (137.75 KB)

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