A Statement of Health [PDF] is a medical questionnaire that MetLife uses to review certain life insurance elections. Here’s when you do — and don’t — need to complete one.
When a Statement of Health is NOT Required*
- New hires enrolling in supplemental life insurance up to $250,000 for yourself
- Anyone electing spouse or same-sex domestic partner coverage at the $10,000 or $20,000 level
- Anyone electing child coverage for $10,000
When a Statement of Health IS Required*
- New hires enrolling in supplemental life insurance over $250,000 for yourself, or over $20,000 for your spouse or same-sex domestic partner
- Increasing your coverage amount during Open Enrollment
- Increasing coverage due to a qualifying family status change – unless you are electing dependent spouse/same-sex domestic life up to $20,000 or child life of $10,000
How to Submit your Form
Download the Statement of Health [PDF] and submit it directly to MetLife — by mail, fax or email:
- Mail: Metropolitan Life Insurance Company, Statement of Health Unit, P.O. Box 14069, Lexington, KY 40512-4069
- Fax: 859-225-7909
- Email: SOHSubmissions@metlife.com
If you have any questions or need an accommodation to access information on this webpage, please contact HR Shared Services at 315.443.4042.
* Part-time faculty eligible for Modified Benefits will need to complete a Statement of Health form for any amount elected over $20,000.
Every effort has been made to ensure that the information contained within this website is accurate. However, benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information in this website and the official documents, the official documents will control. As is the case with all of Syracuse University’s employee benefit plans, the University reserves the right to modify or terminate these benefits at any time.