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Continental Casualty Company K Group Long-Term Care Fairfax County Public Schools Policy Number: 9580-IS Long Form Application For use by parents, grandparents, retirees, and spouses of retirees.

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How to fill out the Continental Casualty Company Long Term Care Forms online

Filling out the Continental Casualty Company Long Term Care Forms online is an important step for individuals seeking long-term care insurance. This guide provides step-by-step instructions to help you navigate the application process with ease.

Follow the steps to complete your application effectively.

  1. Press the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin with Section 1 – Applicant Information. Fill in your full name, gender, date of birth, and address. Ensure that the Social Security Number, daytime, and evening phone numbers are accurately provided.
  3. Move to Section 2 – Benefit Selections. Choose one daily benefit and lifetime maximum option, a home-based care benefit, and an inflation option. Make sure to read the descriptions provided in the enrollment brochure for complete details.
  4. In Section 3 – Eligibility, check the appropriate box indicating your relationship to the employee or retiree referenced. Provide their name and ID or Social Security Number.
  5. Proceed to Section 4 – Statement of Insurability. Complete the fields regarding your height, weight, and respond to the medical questions carefully. Provide details where necessary, especially if any condition applies to you.
  6. Move to Section 5 – Payment Method. Indicate your preferred billing cycle by selecting either direct bill options or monthly electronic funds transfer.
  7. In Section 6 – Alternate Billing Designee, designate at least one individual to receive notice before coverage terminates due to nonpayment. Fill in their name and address details or elect not to designate anyone.
  8. Complete Section 7 – Authorization. Sign and date the document, ensuring all information is complete and true. Understand that this signature grants permission to obtain relevant information necessary for your application.
  9. After completing all sections, review your form thoroughly. Ensure all fields are filled out accurately and any necessary attachments are included.
  10. Finally, save your changes, and choose to download, print, or share your completed form as needed.

Begin your application process online today and secure your long-term care insurance.

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Continental Casualty Company® (CCC) underwrites property and casualty insurance for a broad range of businesses and professionals. Businesses have been counting on CCC insurance for more than a century. In 1897, the company was founded to provide accident and disability insurance for railroad workers.

CNA is one of the largest U.S. commercial property and casualty insurance companies. Backed by more than 125 years of experience, CNA provides a broad range of standard and specialized insurance products and services for businesses and professionals in the U.S., Canada and Europe.

CNA Financial's competitors and similar companies include Arch Capital Group, Loews, W.R. Berkley, Swiss Re, Fidelity National Financial and The Warranty Group.

Continued Monthly Residence (CMR) Form The CMR form must be completed for facility claims by an authorized representative of the facility on a monthly basis and submitted with the bill(s) after the end of each month.

CNA was initially called the Continental Assurance Company and later changed to the Continental Casualty Company Inc. after a merger. It later renamed to CNA, which stands for Continental National American Group, also known as the CNA Financial Corporation.

NAIC #: 20443 FEIN #: 36-2114545.

CNA Financial Corporation is a financial corporation based in Chicago, Illinois, United States. Its principal subsidiary, Continental Casualty Company (CCC), was founded in 1897. CNA, the current parent company, was incorporated in 1967.

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