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Life Insurance Election of Portability Coverage
UNM Life Insurance Company of America
Portability Unit
2211 Congress Street, Portland, ME 04122
18003435406
If your group coverage ends due to employment
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How to fill out if your group coverage

How to fill out if your group coverage:
01
Start by gathering all the necessary information about your group coverage, such as the policy number, plan details, and any paperwork provided by your employer or insurance provider.
02
Carefully review the application form or enrollment materials provided by your employer or insurance provider. Make sure you understand the questions and requirements before proceeding.
03
Begin by filling out personal information, including your full name, date of birth, and contact details. Provide accurate and up-to-date information to ensure smooth processing.
04
Next, provide information about your employment status, such as the name of your employer and your job position. This is crucial as group coverage is typically offered through employers.
05
If applicable, indicate any dependents or family members who will be covered under your group policy. Provide their full names, dates of birth, and relationship to you.
06
Carefully review the coverage options available and choose the plan that best suits your needs. Consider factors such as deductibles, copayments, and coverage limits.
07
If required, provide additional information, such as your Social Security number or any specific health conditions that need to be disclosed.
08
Once you have completed the form, review it for any errors or missing information. Ensure all sections are filled out accurately and completely.
09
If necessary, attach any supporting documents requested, such as proof of employment or dependent verification.
10
Finally, sign and date the application form, certifying that the information provided is true and accurate to the best of your knowledge.
Who needs group coverage?
01
Employees: Group coverage is primarily designed for employees as it is typically offered by employers. It provides a way for employees to access healthcare benefits at a potentially more affordable cost compared to individual plans.
02
Small business owners: If you own a small business, offering group coverage to your employees can be a valuable benefit that helps attract and retain talented employees.
03
Dependents: Group coverage often extends to dependents, such as spouses and children, allowing them to access healthcare services. This can be particularly beneficial for families who want to ensure their loved ones have adequate coverage.
04
Self-employed individuals: While group coverage is commonly associated with employer-sponsored plans, some professional associations or organizations offer group coverage options for self-employed individuals, providing access to healthcare benefits at potentially more affordable rates.
05
Non-profit organizations: Some non-profit organizations can qualify for group coverage options, helping to provide healthcare benefits to their employees and eligible members.
Ultimately, anyone who wants access to comprehensive healthcare benefits at potentially more affordable rates may consider group coverage as a viable option.
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What is if your group coverage?
Group coverage is health insurance provided by an employer or organization for eligible members of a group.
Who is required to file if your group coverage?
The employer or organization offering the group coverage is required to file.
How to fill out if your group coverage?
You can fill out the necessary forms and submit them electronically or by mail.
What is the purpose of if your group coverage?
The purpose of group coverage is to provide health insurance benefits to eligible members of a group.
What information must be reported on if your group coverage?
Information such as the names of covered individuals, policy numbers, and dates of coverage must be reported.
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