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SUPPLEMENTAL LIFE ENROLLMENT FORM Policyholder s Name: Union Benefits Trust Group Policy Number: LG-01049 ? New enrollment ? Change ? Terminate member coverage (includes spouse/children coverage)

How to fill out supplemental life enrollment form

How to fill out a supplemental life enrollment form:

1. Gather relevant information: Before beginning the form, make sure you have all the necessary information at hand. This may include personal details such as your full name, date of birth, social security number, and contact information.
2. Understand the options: Read through the form carefully to understand the different options available for supplemental life insurance coverage. This may include selecting a coverage amount, designating beneficiaries, and choosing any additional riders or features.
3. Provide personal details: Start by filling out the required personal information, such as your name, address, and contact details. Ensure that all the provided information is accurate and up to date.
4. Select coverage amount: Determine the coverage amount you wish to obtain through supplemental life insurance. This may depend on factors such as your financial responsibilities, future goals, and current insurance coverage.
5. Nominate beneficiaries: Indicate the beneficiaries who will receive the insurance benefits in the event of your death. Provide their full names, relationship to you, and their contact information. It's important to periodically review and update your beneficiaries as needed.
6. Review additional options: Some supplemental life enrollment forms may offer additional options such as disability coverage or survivor benefits. Evaluate these options and select any that align with your needs and preferences.
7. Signature and submission: Read through the form once again to ensure all the information provided is accurate. Sign and date the form as required before submitting it to the appropriate party, such as your employer or insurance provider.

Who needs a supplemental life enrollment form?

1. Employees: Many employers offer supplemental life insurance as part of their benefits package. Therefore, employees who wish to obtain additional life insurance coverage beyond their basic employer-provided policy may need to fill out a supplemental life enrollment form.
2. Individuals seeking extra coverage: Even if your employer does not provide supplemental life insurance, you may still choose to purchase it independently. In this case, you would need to fill out a supplemental life enrollment form as part of the application process.
3. Individuals with changing life circumstances: Life circumstances can change, such as getting married, having children, or purchasing a new home. Individuals experiencing significant life events may find it necessary to increase their life insurance coverage through a supplemental policy and, consequently, fill out an enrollment form.

For pdfFiller’s FAQs

What is supplemental life enrollment form?

Supplemental life enrollment form is a document that allows employees to enroll in additional life insurance coverage beyond what is provided by their employer.

Who is required to file supplemental life enrollment form?

Employees who wish to enroll in extra life insurance coverage are required to file a supplemental life enrollment form.

How to fill out supplemental life enrollment form?

To fill out the supplemental life enrollment form, employees must provide personal information, choose coverage amounts, and designate beneficiaries.

What is the purpose of supplemental life enrollment form?

The purpose of the supplemental life enrollment form is to allow employees to increase their life insurance coverage to meet their individual needs.

What information must be reported on supplemental life enrollment form?

The supplemental life enrollment form requires employees to report personal information, coverage amounts, and beneficiary designations.

Can I create an eSignature for the supplemental life enrollment form in Gmail?

It's easy to make your eSignature with pdfFiller, and then you can sign your supplemental life enrollment form right from your Gmail inbox with the help of pdfFiller's add-on for Gmail. This is a very important point: You must sign up for an account so that you can save your signatures and signed documents.

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How do I fill out supplemental life enrollment form on an Android device?

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