Get the free Benefit Election Form

This form is used to request coverage for Long Term Care insurance from Unum Life Insurance Company of America. Applicants are required to review important disclosures and information before submission.

How to fill out benefit election form

How to fill out Benefit Election Form

1. Obtain the Benefit Election Form from your HR department or company website.
2. Read through the instructions carefully to understand your options.
3. Fill in your personal information at the beginning of the form.
4. Select the benefits you wish to elect by marking the appropriate boxes.
5. Input any additional information required for each chosen benefit.
6. Review the form to ensure all information is accurate and complete.
7. Sign and date the form at the bottom.
8. Submit the completed form to your HR department by the provided deadline.

Who needs Benefit Election Form?

1. Employees who are eligible for benefits offered by their employer.
2. New hires who need to select their benefits during onboarding.
3. Employees experiencing changes in their personal situation (e.g., marriage, childbirth) that require updating benefit selections.

For pdfFiller’s FAQs

What is Benefit Election Form?

The Benefit Election Form is a document used by employees to choose their benefit options provided by their employer, such as health insurance, retirement plans, or other employee benefits.

Who is required to file Benefit Election Form?

Typically, all new employees and those making changes to their benefit choices during open enrollment periods are required to file the Benefit Election Form.

How to fill out Benefit Election Form?

To fill out the Benefit Election Form, individuals should read the instructions carefully, select their desired benefits, provide any required personal information, and submit the form to their HR department.

What is the purpose of Benefit Election Form?

The purpose of the Benefit Election Form is to allow employees to formally declare their selections for various employee benefit programs and ensure that their choices are documented for payroll and administrative purposes.

What information must be reported on Benefit Election Form?

The Benefit Election Form generally requires reporting personal information such as employee name, Social Security number, selected benefit plans, dependent information, and any necessary authorizations or signatures.