To complete this process, you may need to provide:
- Group ID/Plan Number
- Coverage(s) being requested
- Health history/Doctor information
- Current insured amount
- Additional amount being requested
If applying for dependent coverage, you may need to provide their:
- Date of Birth
- Height
- Weight
- Health history/Doctor information
- Current insured amount
- Additional amount being requested
To help you understand the Online Evidence of Insurability process, please read our FAQ's. haga clic aquí para 'preguntas más frecuentes' en español
To complete a paper version of the Evidence of Insurability Form, please select this link to obtain the proper form. y seleccione este enlace para obtener una guía de instrucción en español para ayudarle
If your employer is located in New York or New Hampshire; your group is not eligible for Online Evidence of Insurability. Please complete a paper version of the Evidence of Insurability Form.