Get Bunzl Distribution

Filling out the Bunzl Distribution Benefit Election Form is an essential step for users seeking long term care benefits. This guide provides clear, step-by-step instructions to ensure accurate completion of the form, catering to a wide audience.

Follow the steps to accurately complete the Bunzl Distribution form online.

1. Click ‘Get Form’ button to obtain the form and open it in the necessary format for filling out.
2. Begin by entering your name in the format of Last Name, First Name, and Middle Initial.
3. Provide your Social Security Number in the format of XXX-XX-XXXX.
4. Indicate your gender by selecting either Male or Female.
5. Fill in your home telephone number.
6. Enter your street address, followed by your city, state, and zip code.
7. If you are not the employee, complete the section for the employee's name and Social Security Number.
8. Record your date of birth and date of hire in the specified MM/DD/YYYY format.
9. If applicable, include the employee's date of birth and date of hire.
10. Select your relationship to the employee from the provided options, ensuring the correct designation.
11. Choose one of the plans by checking the appropriate box to indicate your preference.
12. Select the desired Facility Monthly Benefit Amount by checking the corresponding option.
13. Choose the Facility Benefit Duration by checking the appropriate box.
14. Be aware that selections exceeding guarantee issue limits require additional documentation.
15. For premium payment, select the preferred method based on eligibility.
16. Sign and date the form, ensuring your signature is included where necessary.
17. For family members, ensure forms are mailed to Unum, while employees send theirs to their employer.
18. Retain a copy of the completed form for your own records.

Complete your Bunzl Distribution documents online today.