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Administered by Fully insured by 400 Field Drive Lake Forest, IL 60045-2581 To be completed by the EMPLOYEE ONLY Print legibly in ink only Note: If you make a mistake when completing an answer, please
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Fully insured by refers to being covered by an insurance policy that provides complete coverage for a particular risk or event.
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Employers or individuals who have obtained fully insured coverage are required to file fully insured by.
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The purpose of fully insured by is to report and document the insurance coverage that individuals or employers have obtained.
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Fully insured by should include details about the insurance policy, coverage limits, effective dates, and the insurance provider.
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