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  • Portability Application - Ima

Get Portability Application - Ima

Enrollment form, make a copy for your records and then give this enrollment form to the employee or employee's dependents whose coverage is terminating on or before the date of group coverage termination. If you have any questions please call 1-877-320-0484. Important Note: The employee must submit the completed enrollment form and first quarterly premium to the address listed below within 31 days from the date of group coverage termination or 15 days from the employers signature date on this f.

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How to fill out the Portability Application - IMA online

Filling out the Portability Application - IMA online is a crucial step for individuals wishing to continue their group life insurance coverage after employment ends. This guide provides clear, step-by-step instructions to help users navigate the form accurately.

Follow the steps to complete the Portability Application - IMA online.

  1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
  2. Complete Part A of the enrollment form, which must be done by the employer. Enter the policyholder name and group policy number, then check the relevant coverage(s) that are portable.
  3. Fill out details regarding the employee or their dependents, including their names, genders, and the reason for coverage termination.
  4. In the applicant section (Part B), complete personal information including the employee's name, address, and contact numbers. Ensure accuracy as this information is crucial for processing.
  5. Indicate the desired percentage of insurance coverage to continue (100%, 75%, or 50%) for each eligible person listed. Remember that specific maximums apply.
  6. Calculate the portability cost per quarter based on the coverage amounts and your employer's provided rate. Ensure all calculations are accurate to avoid issues.
  7. Designate beneficiaries for the insurance coverage, ensuring to specify their relationship and share of the insurance proceeds. It is essential to understand the distinction between primary and contingent beneficiaries.
  8. Sign the form acknowledging that all information provided is accurate, and submit the completed enrollment form along with the first quarterly premium to the specified address.
  9. Once all sections are filled out correctly, users can save changes, download, print, or share the form as needed.

Start filing your Portability Application - IMA online today to ensure your insurance coverage continues seamlessly.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232