Get the free Benefit Election Form

This form is used to elect benefits for Long Term Care insurance coverage under Unum Life Insurance Company of America. It requires personal and demographic information of the applicant and the employee,

How to fill out benefit election form

How to fill out Benefit Election Form

1. Read the instructions carefully before starting.
2. Fill out your personal information at the top of the form, including your name, address, and employee ID.
3. Indicate your enrollment choices for each benefit category by checking the appropriate boxes.
4. Review the coverage options and premiums associated with each benefit to make informed choices.
5. Sign and date the form at the bottom to validate your selections.
6. Submit the completed form to your HR department by the given deadline.

Who needs Benefit Election Form?

1. Employees who are eligible for benefits offered by their employer.
2. New hires who are enrolling in a benefits program for the first time.
3. Employees looking to make changes to their existing benefits during open enrollment.
4. Employees who experience qualifying life events that affect their benefits.

For pdfFiller’s FAQs

What is Benefit Election Form?

The Benefit Election Form is a document used by employees to select their benefits options during the enrollment process, often related to health insurance, retirement plans, and other employee benefits.

Who is required to file Benefit Election Form?

Typically, all employees who are eligible for benefits must file a Benefit Election Form, especially during open enrollment periods or when they experience qualifying life events.

How to fill out Benefit Election Form?

To fill out the Benefit Election Form, an employee should provide personal information, review available benefits options, select the desired coverage, and submit the completed form to HR or the benefits department within the specified timeframe.

What is the purpose of Benefit Election Form?

The purpose of the Benefit Election Form is to ensure that employees formally indicate their choices regarding available benefits, allowing the employer to administer these selections correctly.

What information must be reported on Benefit Election Form?

The Benefit Election Form typically requires information such as the employee's name, contact information, selected benefits options, and possibly dependent information if family coverage is chosen.