Get Security Mutual Enrollment Form - Advantage Benefits Group

Filling out the Security Mutual Enrollment Form is essential for securing the benefits you need from your employer. This guide provides you with a clear, step-by-step approach to complete the form online effectively.

Follow the steps to complete your enrollment form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the Employer Section. Enter the name of your employer, group ID number, unit name and number, policy numbers, and billing class. Ensure all entries are printed legibly.
3. In the Human Resources Department section, indicate your date of hire or rehire, hours worked per week, and your earnings, specifying the frequency (hourly, weekly, monthly, yearly, or other) as applicable.
4. Proceed to the Applicant Section. Enter your name (last, first, MI), street address, city, state, zip code, date of birth, and select your gender.
5. Complete the coverage elections section. Check all applicable boxes such as basic life/AD&D, short-term disability, and any supplemental coverage you wish to elect. For each type of coverage, specify the coverage amount selected for yourself, spouse, and child.
6. In the Beneficiary section, provide details for your chosen beneficiary, including their name, date of birth, social security number, and relationship to you. If naming more than one beneficiary, ensure to complete the Beneficiary Designation form.
7. If you choose to refuse any coverages, check the corresponding boxes. Acknowledge your understanding of the terms related to Evidence of Insurability for future coverage requests.
8. Lastly, sign and date the form to verify that the information provided is accurate. Your signature confirms your authorization for the necessary premiums to be deducted from your salary or wages.
9. After completing the form, save your changes, and then download or print the form for your records. Return the completed form to your Human Resources Department.

Complete your Security Mutual Enrollment Form online today to ensure you receive the appropriate benefits.