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Health Plan & Life Insurance 2026
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- Click ‘Get Form’ to open the Health Plan & Life Insurance application in the editor.
- Begin by selecting the reason for your application from the options provided, such as 'New hire' or 'Open enrollment'. Ensure you fill in any relevant dates.
- In Section 1, review the important enrollment guidelines for Specialty Benefits coverage. Make sure to understand the requirements for dental, vision, and life insurance enrollments.
- Proceed to Section 2 where you will select your desired medical benefits plan. Fill in the plan names as applicable and check any additional options like HRA or FSA.
- Complete Section 3 with your personal information including Social Security number, employment status, and contact details. Be thorough to avoid delays.
- If enrolling dependents, move to Section 4 and provide their information accurately. Indicate which plans they are enrolling in.
- In Section 5, designate your life insurance beneficiaries by providing their names and relationships. Ensure this section is completed correctly.
- Finally, review all sections for accuracy before signing in Section 7 to authorize your application.
Start filling out your Health Plan & Life Insurance application today on our platform for free!
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Related links
UC offers a basic level of life insurance at no cost. If you are eligible for Full or Mid-level benefits, you have the option to purchase additional coverage.Read more
Life and Health Insurance Plan is a self-insured plan that provides coverage for more than 197,000 active employees, dependents, spouses and retirees.