Get the free Portability Benefit Request Form

This form is used to request the continuation of Employee Optional Group Term Life Insurance under the Portability option after termination of employment.

How to fill out portability benefit request form

How to fill out Portability Benefit Request Form

1. Obtain the Portability Benefit Request Form from your employer or benefits provider.
2. Read through the form carefully to understand all required fields.
3. Begin filling out your personal information such as your name, address, and contact details.
4. Provide information about your current benefits plan, including policy numbers.
5. Complete the section that asks about your new plan or provider.
6. Attach any necessary documentation that supports your request, such as proof of employment or enrollment in a new plan.
7. Review the form to ensure all information is correct and complete.
8. Sign and date the form where indicated.
9. Submit the form to the appropriate department or address provided in the instructions.

Who needs Portability Benefit Request Form?

1. Employees who are transitioning to a new job and wish to retain their benefits.
2. Individuals who have changed their residency but want to maintain their existing benefit coverage.
3. Any person eligible for benefits who needs to transfer their coverage from one provider to another.

For pdfFiller’s FAQs

What is Portability Benefit Request Form?

The Portability Benefit Request Form is a document used by eligible individuals to request the transfer of their housing benefits from one jurisdiction to another.

Who is required to file Portability Benefit Request Form?

Individuals who are relocating and wish to retain their housing assistance benefits while moving to a different area must file the Portability Benefit Request Form.

How to fill out Portability Benefit Request Form?

To fill out the Portability Benefit Request Form, individuals should provide their personal information, details about their current housing assistance, and the new location where they intend to move.

What is the purpose of Portability Benefit Request Form?

The purpose of the Portability Benefit Request Form is to facilitate the transfer of housing assistance benefits to individuals relocating to a new area, ensuring they maintain their eligibility for the benefits.

What information must be reported on Portability Benefit Request Form?

The information that must be reported includes the applicant's name, current address, new address, details of current housing assistance, and any relevant supporting documentation.