Policy & Billing Information
Need to update your billing information or submit a payment authorization form? Find the appropriate form below and follow the instructions to submit your request.
Choose the Form You Need
Select the appropriate form below to download and complete your billing request.
Employer Bank Draft Authorization
For employers who need to establish or authorize automatic bank draft payments.
Bank Draft / Authorization Change
Need to change your existing bank draft or payment authorization information? Contact our team and we’ll help you with the next steps.
How to Submit Your Form
Submitting a billing form takes three straightforward steps.
Download the Form
Choose the appropriate billing form above.
Complete Your Information
Fill out all required information and include your policy number where required.
Submit the Form
Follow the submission instructions provided for your billing request.
Submitting a New Era Life form? Completed forms should be emailed to [email protected]. Be sure to include your Policy Number with your submission.