Long-term Disability Insurance Application
Long-term disability insurance application. Please submit the application via Fax to (314) 589-8110 or e-mail at benefitssection@stlouis-mo.gov. Also please remember to remove Social Security Numbers, or to only include the last four digits.
Publication Date: 12/11/2019
Document Type: Printed Forms and Templates
Sponsor:
Employee Benefits
Download
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LTD Application (English) (3.54 MB)
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LTD Flyer (English) (503.79 KB)
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LTD Application (Spanish) (4.29 MB)
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LTD Flyer (Spanish) (998.63 KB)
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