Get Group Membership Application - Tdcj State Tx

This guide provides step-by-step instructions on how to complete the GROUP MEMBERSHIP APPLICATION for Texas Legal Protection Plan (TLPP) online. Whether you are a first-time applicant or updating your information, this resource aims to simplify the process.

Follow the steps to successfully complete the application.

1. Click ‘Get Form’ button to obtain the form and open it in your browser.
2. Select the type of coverage you wish to apply for by checking the appropriate box under 'One - Type of Coverage'. You can choose 'New Enrollment' for first-time coverage, 'Change Coverage' for updates, or 'Change Payment Method'.
3. Provide your enrollment information in 'Two - Enrollment Information'. Enter the name of the group through which you are obtaining this benefit.
4. In 'Three - Personal Data', fill out all required personal information. This includes your name, email address, social security number, date of birth, gender, contact numbers, and mailing address.
5. Choose your coverage option in 'Four - Coverage Option'. Indicate whether you want a 'Single' or 'Family' plan. If selecting family coverage, ensure to proceed to the next section.
6. In 'Five - Family Information', if you selected the family plan, list all eligible dependents who will be included. This section includes information such as names, genders, relationships to you, and dates of birth.
7. For 'Six - Payment Method', choose either the single annual premium or the family premium and provide relevant payment details, including bank account information for bank draft options, or credit card details for annual payments.
8. Finally, sign and date the application in 'Seven - Signature and Authorization' to confirm your agreement with the terms. Ensure that all information is accurate before submitting.
9. To complete the process, review your application. Save any changes made, and then download or print the completed form for your records. Ensure it is sent to TLPP by fax, mail, or email.

Begin filling out your GROUP MEMBERSHIP APPLICATION online today to secure your benefits with TLPP.