Get Unum 1073-06 2016-2025

Filling out the UNUM 1073-06 enrollment form online is a straightforward process. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the UNUM 1073-06 enrollment form online.

1. Click ‘Get Form’ button to obtain the form and open it in your editor.
2. Select the appropriate enrollment type by checking either 'Initial Enrollment' to make new elections, or 'Annual Enrollment' to modify existing elections. Note that completing this form is unnecessary if you do not wish to change any prior elections.
3. Enter your Employee Social Security Number in the designated field. Make sure to provide the correct number as it is important for identification purposes.
4. Indicate your gender by selecting either 'M' for male or 'F' for female.
5. Fill in your date of birth using the format mm/dd/yyyy.
6. Indicate your employee email address and enter the date you were originally hired by your employer.
7. Input your annual salary and specify your occupation, selecting either 'Exempt' or 'Non-Exempt'.
8. If applicable, indicate the date you entered an eligible class or the rehire date and any waiting periods specified.
9. If you wish to select coverage for a spouse, fill in their first name and date of birth. Also, answer whether you or your spouse have used tobacco products in the past 12 months.
10. Choose the coverage amounts for yourself, your spouse, and children if applicable under the coverage elections section. Be aware that blank fields will result in a $0 coverage amount.
11. Review the coverage options and if medical underwriting is necessary for any selected amounts, note that you will need to complete an Evidence of Insurability form.
12. Complete the beneficiary information section carefully, providing the names, relations, and benefit percentages.
13. Read and certify the Request for Signature and Certification section. Enter your signature and the date of signing.
14. Finally, verify that all fields are filled out correctly before saving your changes, then save, download, or print a copy of the form for your records.

Complete the UNUM 1073-06 enrollment form online today for efficient processing of your insurance coverage.