Get Illinois Mutual Disability Application Form

Filling out the Illinois Mutual Disability Application Form online can be a straightforward process. This guide provides step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with Part A, which includes information about the proposed insured. Fill in the name, marital status, address, phone numbers, email address, Social Security number, date of birth, place of birth, citizenship status, primary occupation, and current monthly earned income. Make sure to double-check the accuracy of every detail provided.
3. Ask if the person is applying for or plans to become eligible for other disability income or business expense coverage, and also note if they have used tobacco products in the last year.
4. If the owner of the policy is different from the proposed insured, provide the owner's name, Social Security or Tax I.D. number, and address.
5. Proceed to Individual Plan Information, indicating the desired base monthly benefit amount, plan, occupational class, elimination period, and benefit period options. Clearly mark any optional benefits or riders that you wish to include.
6. Continue filling out the Special Risk Plan Information and Business Expense Plan Information sections if applicable, indicating any relevant benefit amounts and optional benefits.
7. Complete the Billing and Payment section by choosing the effective date, preferred method of premium payment, and indicate if any portion of the premium is being paid by an employer.
8. Review the Agreement and Declaration section. Users must confirm that all information recorded is true and complete. Ensure the proposed insured and owner sign this section.
9. Finally, after completing all sections, save your changes. You can choose to download, print, or share the form for submission.

Complete your Illinois Mutual Disability Application Form online today for a smooth and supported process.