Get Po Box 20, Mail Stop 4-s, Minneapolis, Mn 55440

This guide provides step-by-step instructions for completing the PO Box 20, Mail Stop 4-S, Minneapolis, MN 55440 form online. Understanding how to accurately fill out this form is essential for applying for insurance coverage. Follow these instructions to ensure a smooth and successful submission.

Follow the steps to fill out the form effectively.

1. Press the ‘Get Form’ button to access the form. This action will allow you to open the form in an editor where you can begin filling it out.
2. In the Employee Information section, provide your name, Social Security Number (SSN), home address, and contact numbers. Ensure accuracy in your entries, as these details are critical for identification.
3. Complete the Insurance Details section. Indicate if you are submitting this form due to a family status change by selecting 'Yes' or 'No.' Fill in the total amount desired, current amount, and guaranteed issue amount for each type of coverage you are applying for.
4. In the Spouse Information section, enter the required details about your spouse if applicable. This includes their name, SSN, contact information, and health practitioner details if they share the same practitioner.
5. For the Child Information section, list the details for each child you are applying for coverage. Include their names, birth dates, and any relevant health questions as necessary.
6. Respond to the Employee and Spouse Health Questions. Ensure that all applicable questions are answered accurately as they pertain to you and your spouse's health history.
7. Review the Authorization and Acknowledgment section. Sign and date the form to confirm that all information is truthful and complete.
8. Finally, submit your completed EOI form by either faxing it to the number provided or mailing it to the address listed, ensuring it is sent directly to the insurer for efficient processing.

Complete your documents online today to ensure you receive the insurance coverage you need.