Get Njea Endorsed Disability Insurance Program - Educators Insurance ...

Completing the NJEA Endorsed Disability Insurance Program enrollment form is an important step for educators seeking disability coverage. This guide provides a clear and supportive approach to filling out the form accurately and efficiently online.

Follow the steps to complete your enrollment form online.

1. Click the ‘Get Form’ button to obtain the NJEA Endorsed Disability Insurance Program enrollment form and open it for editing.
2. In the NJEA member information section, clearly print your last name, first name, middle initial, home address, date of birth, city, home phone number, email address, and employment date. Make sure this information is accurate to avoid delays.
3. Continue by filling out your annual salary, occupation, present school district name, county, and social security number. Also, indicate your sex and supply your last year’s school and county information.
4. Answer the questions regarding your employment status, ensuring to select 'Yes' or 'No' for whether you are employed at least 15 hours per week, actively at work, and a member of NJEA.
5. In the plan information section, select whether this is a new enrollment, a plan change, or a district transfer. Choose the applicable PruProtect option and indicate your desired monthly benefit amount, ensuring it aligns with the minimum and maximum allowed limits.
6. Select your elimination period from the available choices. Ensure you understand the implications of each period on your coverage.
7. Review the authorization section. By signing, you are enrolling in the program and authorizing your employer to deduct contributions from your pay. Ensure that you understand the exclusion regarding pre-existing conditions.
8. After completing all sections, save your changes. You can then download or print the filled form for submission. Ensure you send the completed enrollment form to Educators Insurance Services by mail or fax as instructed.

Start completing your NJEA Endorsed Disability Insurance enrollment form online today for efficient processing and peace of mind.