Get Group Life Insurance Individual Application Form

Completing the Group Life Insurance Individual Application Form online is an essential step towards securing life insurance coverage. This guide will provide you with clear, step-by-step instructions to help ensure a smooth application process.

Follow the steps to effectively complete your application form.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Select the transaction type by indicating whether you are a new or existing member and choose the type of insurance coverage you are applying for, either Group Term Life or Group Health Insurance.
3. Complete the personal details section, providing all mandatory information, including your social security number, sex, first and last name, mailing address, civil status, nationality, date of birth, place of birth, email address, mobile number, and payroll or bank account number.
4. Designate beneficiaries by listing up to four individuals, ensuring to specify their relationship to you and follow any applicable rules pertaining to beneficiary designation.
5. If applicable, provide information about dependents who will be covered under your policy, including their relationship to you, names, dates of birth, sex, and civil status.
6. Review and agree to the general declarations, confirming the accuracy of the submitted information, your health status, and authorizations. Make sure to provide your signature and the date signed.
7. If you are an authorized representative, you will need to fill out the section designated for HR representatives, including company details and necessary signatures.
8. Once all fields are completed, save any changes you have made before proceeding to download, print, or share the form as required.

Start filling out your Group Life Insurance Individual Application Form online today to secure your coverage.