Get Lml Group Life Insurance Transmittal Form

Filling out the LML Group Life Insurance Transmittal Form accurately is essential for providing the right information for your group life insurance needs. This guide offers a clear, step-by-step approach to completing the form online effectively.

Follow the steps to complete your insurance transmittal form with ease.

1. Press the ‘Get Form’ button to access the LML Group Life Insurance Transmittal Form and open it in your preferred online editor.
2. Fill in the date when you are submitting the form in the ‘Date Submitted’ field.
3. Enter the name of your group in the ‘Name of Group’ field, ensuring that it matches the official group designation.
4. Provide the health group roll number in the designated section.
5. Complete the address and zip code fields to accurately reflect your group's location.
6. Indicate the life insurance company and association related to your group.
7. Specify the requested effective date for the insurance coverage.
8. Note the anniversary month for the group insurance.
9. Select whether combined billing is required by marking 'Y' for yes or 'N' for no.
10. Detail the employee contribution amount for the insurance plan.
11. State the waiting period associated with the insurance plan.
12. Fill in the group leader’s name and their contact phone number.
13. Indicate if life insurance was sold with health coverage by marking yes or no.
14. Provide the total number of employees in the group.
15. Indicate the number of enrolled employees.
16. Specify if all transfers of health coverage are included.
17. Complete the consultant’s name, if applicable, in the designated field.
18. Identify the existing health group related to your insurance.
19. If a broker was involved, indicate yes and then provide their name and company details.
20. Fill in the volume amounts for Life and Accidental Death & Dismemberment (AD&D) insurance related to the named insured.
21. Complete the fields for dependent life and supplemental life insurance volumes.
22. Specify the standard weekly amount for short-term disability (STD) and the monthly salary for long-term disability (LTD).
23. Continue to list any additional insured individuals and their respective coverage details.
24. Attach the roster or any copy relevant to group billing as needed.
25. Add any comments related to this transmittal in the comments section.
26. Review your entries for accuracy before finalizing the form.
27. Once complete, save the changes you made to the form.
28. Download, print, or share the form according to your needs.

Complete your LML Group Life Insurance Transmittal Form online today for a smoother insurance process.