De 1378di 2025

See details

4 out of 5

37 votes

The document is an application form for Disability Insurance Elective Coverage under the California Unemployment Insurance Code. It outlines eligibility requirements, conditions for denial of coverage, and necessary information for self-employed individuals or partners wishing to elect coverage. The form requires personal details, business information, and financial disclosures to assess eligibility. It also includes instructions for submitting the application and subsequent reporting obligations.

Here's how it works

01. Edit your edd disability online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send edd disability extension form pdf via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out de 1378di with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the de 1378di application in the editor.
Begin by entering your Social Security Number in the designated field. Ensure accuracy as this is mandatory.
Fill in your Employer Account Number, First Name, Middle Initial, Last Name, and Year of Birth clearly.
Indicate your gender by selecting either Male or Female.
Provide your mailing address, including number and street or P.O. Box, city, and ZIP code.
Answer whether you have applied for elective coverage before. If yes, provide the month and year.
Complete sections regarding your business name, business address, email address, and phone number as applicable.
Respond to questions about your employment status and nature of business accurately to ensure eligibility.
Review all entered information for completeness and correctness before submitting the application.

Start filling out your de 1378di application today on our platform for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does DI stand for in insurance?

Disability Insurance, often called DI or disability income insurance, is a form of insurance that insures the beneficiarys earned income against the risk that disability will make working (and therefore earning) impossible.

What does DI mean in insurance terms?

Disability income insurance helps protect people from financial losses if an accident or illness renders them incapable of working and receiving regular income. DI insurance is available through employers, Social Security, or insurance companies and comes in short-term and long-term disability coverage.

What is DI-elective coverage?

For Disability Insurance claims: Fill out and sign Part B Physician/Practitioners Certificate on the Claim for Disability Insurance (DI) Benefits (DE 2501). Mail it to us within 49 days from the date your patients disability begins.

Why would an employee purchase disability insurance?

While the exact amount is determined by their salary and plan coverage, short-term disability insurance typically covers about 4070% of ones income, while long-term is 5070%.

Try more PDF tools