Get Symetra Lg-12009 2012-2025

Filling out the Symetra LG-12009 form online can streamline the process of enrolling in group life insurance and disability income insurance. This guide provides step-by-step instructions to ensure you accurately complete the form with confidence.

Follow the steps to effectively complete the Symetra LG-12009 online.

1. Click ‘Get Form’ button to access the Symetra LG-12009 form and open it in your preferred online editor.
2. Enter the policy number provided by your employer, followed by the employer or policyholder name and their street address. Ensure that the city, state, and zip code are accurately filled out.
3. Fill in your occupation or job title, along with your date of employment. Specify whether you are a full-time or part-time employee.
4. Indicate the effective date of coverage and input your basic earnings, specifying the amounts in the proper fields (e.g., hourly, weekly, monthly, yearly).
5. Complete the employee/enrollee information section, including your sex, full name, street address, city, state, zip code, home telephone number, date of birth, and marital status.
6. In the benefits section, check ‘Yes’ or ‘No’ for each benefit option you wish to enroll in. Provide the requested amount for employee life insurance, employee AD&D, employee supplemental life insurance, and dependent life insurance, if applicable.
7. For dependent life insurance, list the names and birthdates of each dependent in the designated area, using additional pages if necessary.
8. Designate primary and contingent beneficiaries for your life insurance benefit by filling in their names, addresses, dates of birth, relationships to you, and the percentage of the benefit they will receive.
9. In the selection/waiver of group insurance section, choose either to elect the insurance coverage or waive your right to choose. Sign and date the form to confirm your selections.
10. Review all entries for accuracy. Once satisfied, you may choose to save your changes, download, print, or share the completed form as required.

Complete your documents online today to ensure timely enrollment in your insurance coverage.