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VERSION DATE: JANUARY 201820PLUSAPPLICATION FOR GROUP INSURANCEPolicies are issued by:The EmpireLife Insurance Company EmpireLife 259 King Street East Kingston ON K7L 3A8 www.empire.caG0001EN01/18APPLICATION

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How to fill out application for group insurance

01

Step 1: Obtain the group insurance application form from the insurance provider.

02

Step 2: Read the instructions carefully before filling out the form.

03

Step 3: Provide the necessary information about the group, including the group name, address, and contact details.

04

Step 4: Indicate the desired coverage options for the group, such as health, life, disability, or dental insurance.

05

Step 5: Provide the personal information of the group representative or administrator responsible for managing the insurance policy.

06

Step 6: Fill out the details of the group members who will be covered under the policy, including their names, dates of birth, and relationship to the group.

07

Step 7: Review the completed application form for any errors or missing information.

08

Step 8: Sign and date the application form to acknowledge the accuracy of the provided information.

09

Step 9: Submit the filled-out application form to the insurance provider as per their instructions.

10

Step 10: Keep a copy of the completed application form for reference.

Who needs application for group insurance?

01

Employers or organizations who want to provide insurance coverage to a group of individuals.

02

Group members or employees who want to enroll in a group insurance policy provided by their organization.

03

Group insurance brokers or agents who assist in facilitating the application process for group insurance.

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What is application for group insurance?

An application for group insurance is a form that must be completed by a group or organization seeking insurance coverage for a group of individuals.

Who is required to file application for group insurance?

The employer or administrator of the group is usually required to file the application for group insurance.

How to fill out application for group insurance?

The application for group insurance can typically be filled out online or through a paper form provided by the insurance provider. It will require information about the group, such as the number of members and their demographics.

What is the purpose of application for group insurance?

The purpose of the application for group insurance is to provide the insurance provider with necessary information to assess the risk of the group and determine appropriate coverage and pricing.

What information must be reported on application for group insurance?

Information such as the name and contact information of the group, the number of members to be covered, their ages and genders, and any pre-existing health conditions may need to be reported on the application for group insurance.

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