Get Sbd_enrollment_form_app. Blueoptions Plan 5040 5041 Without Rx

This guide provides detailed, step-by-step instructions to help users complete the SBD_Enrollment_Form_APP for the BlueOptions Plan 5040 5041 Without RX online. By following these instructions, users will find the process straightforward and manageable.

Follow the steps to fill out the form accurately.

1. Click the ‘Get Form’ button to obtain the SBD_Enrollment_Form_APP and open it in your preferred online editor.
2. Begin by entering your personal information in the 'Employee Information' section. This includes your name, social security number, mailing address, birth date, gender, employment details, email address, and phone number.
3. Complete the eligibility details by indicating whether you have a spouse, civil union partner, or children. If applicable, provide their names, birth dates, genders, and social security numbers.
4. In the 'Coverage' section, select 'Elect' or 'Decline' for each type of coverage offered — including dental, vision, group term life, and disability — based on your needs.
5. If applicable, fill out the beneficiary designations for both group term life and voluntary term life coverage. Ensure to include all necessary information such as names, percentages, and relationships of beneficiaries.
6. Provide information if you are declining any coverage, including the reason for your decision. If you are covered under another insurance plan, indicate that as well.
7. Read the 'Employee Agreement' section carefully, understanding all conditions before signing. Confirm that you acknowledge the information is accurate.
8. After completing the form, save any changes and download the document. Print the original, as well as make two copies for your records.
9. Submit the original form to Principal Life Insurance Company, keeping one copy for yourself and providing one to your employer.

Complete your enrollment form online today to ensure your coverage needs are met.