Get the free Assurant Employee Extended Application - Gardner & White

Extended Employee Application (Please complete the health questions on the second page of this application.) Group policy/participant no. Account no. Cert. No. Employer Employee name (last, first,

How to fill out assurant employee extended application

How to Fill Out Assurant Employee Extended Application:

1. Start by obtaining the application form from your employer or through your HR department. The assurant employee extended application form is typically provided to employees who are opting for additional coverage beyond their standard employee benefits.
2. Carefully read through the entire application form and make sure you understand all the sections and requirements. Familiarize yourself with the terms and conditions of the extended coverage, as well as any eligibility criteria that may be mentioned.
3. Begin filling out the application form by providing your personal details such as your full name, date of birth, contact information, and social security number. Ensure that you provide accurate information to avoid any issues later on.
4. Proceed to enter your current employment details, including the name of your employer, your job title, and your length of service with the company. This information helps Assurant determine your eligibility for the extended coverage as it may be tied to your employment status.
5. Next, carefully review the coverage options available and select the specific plan or plans that best suit your needs. Some common coverage options may include life insurance, disability insurance, critical illness coverage, accidental death and dismemberment insurance, and more.
6. Fill in the requested information for each coverage option you have selected. This may include additional personal details, beneficiary information, and any optional riders or add-ons you want to include with your coverage (e.g., spouse or child coverage).
7. If required, you may need to provide additional documentation or evidence of insurability. This could include medical records, health questionnaires, or other supporting documents depending on the type of coverage you are applying for.
8. Once you have completed all the required sections of the application form, review it thoroughly to ensure accuracy and completeness. Make sure you have signed and dated the form where necessary.
9. Submit the filled-out application form to the designated authority, following the instructions provided by your employer or HR department. Keep a copy of the completed application for your records.

Who Needs Assurant Employee Extended Application?

1. Employees seeking additional insurance coverage beyond their standard employee benefits may need to fill out the Assurant employee extended application.
2. It is particularly relevant for individuals who wish to protect themselves and their loved ones with additional financial security in case of unforeseen events such as accidents, disabilities, critical illnesses, or death.
3. The Assurant employee extended application is for employees who want to take advantage of the extended coverage options provided by the insurance company, ensuring that they have comprehensive protection tailored to their specific needs.

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What is assurant employee extended application?

Assurant employee extended application is a form that allows employees to apply for extended coverage benefits offered by Assurant.

Who is required to file assurant employee extended application?

All employees who wish to enroll in extended coverage benefits provided by Assurant are required to file the employee extended application.

How to fill out assurant employee extended application?

To fill out the Assurant employee extended application, employees need to provide personal information, select the desired coverage options, and sign the form.

What is the purpose of assurant employee extended application?

The purpose of the Assurant employee extended application is to allow employees to extend their coverage benefits beyond the standard offerings provided by the employer.

What information must be reported on assurant employee extended application?

On the Assurant employee extended application, employees must report their personal information, desired coverage options, and signature.