Get the free Benefit Election Form

This form is used to elect benefits for long-term care insurance coverage provided by Unum Life Insurance Company of America for employees, spouses, or domestic partners. The form requires personal

How to fill out benefit election form

How to fill out Benefit Election Form

1. Obtain the Benefit Election Form from HR or the company's benefits portal.
2. Read the instructions carefully to understand the options available.
3. Fill in your personal information, including name, employee ID, and contact details.
4. Review the list of available benefits and check the boxes for the benefits you wish to elect.
5. If applicable, provide any dependent information that may be required.
6. Choose the coverage levels for each benefit where options are provided.
7. Sign and date the form to verify that the information is accurate.
8. Submit the completed form to HR by the designated deadline.

Who needs Benefit Election Form?

1. All employees who are eligible for benefits offered by the employer
2. New hires who need to enroll in benefits for the first time
3. Employees who wish to make changes to their existing benefit selections during open enrollment or qualifying life events

For pdfFiller’s FAQs

What is Benefit Election Form?

The Benefit Election Form is a document used by employees to select or change their benefit options offered by their employer, such as health insurance, retirement plans, and other perks.

Who is required to file Benefit Election Form?

Employees who wish to enroll in, modify, or opt-out of benefit programs provided by their employer are required to file the Benefit Election Form.

How to fill out Benefit Election Form?

To fill out the Benefit Election Form, employees should provide their personal information, select their desired benefits from the available options, and sign the form to confirm their selections.

What is the purpose of Benefit Election Form?

The purpose of the Benefit Election Form is to document an employee's choices regarding benefits, ensuring that their selections are recorded and can be accurately administered by the employer.

What information must be reported on Benefit Election Form?

The information that must be reported on the Benefit Election Form typically includes the employee's name, identification number, selected benefits, and any dependents that may be covered under those benefits.