View Application for Group Insurance 2026

1. Click ‘Get Form’ to open the View Application for Group Insurance in the editor.
2. Begin by filling out the Employer Information section. Enter the legal name of your company, select the type of business entity (corporation, sole proprietorship, etc.), and provide your street address, city, state, telephone number, ZIP code, and fax number or email address.
3. Next, move to the Employee Eligibility section. Specify the total number of eligible and ineligible employees based on the criteria provided. If there are any excluded classes of employees, describe them here.
4. In the Employers with Participating Units section, list any affiliated entities along with their addresses and employee counts. Indicate whether to include or exclude these units from coverage.
5. Complete the Waiting Period section by selecting how long employees must wait before becoming eligible for insurance. Choose from options like 1 month or 3 months.
6. Proceed to fill out sections regarding Medical Insurance, Dental Insurance, Vision Insurance, Term Life Insurance, and Disability Insurance as applicable. Provide details about prior carriers if replacing existing insurance.
7. Finally, review the Agreement and Signatures section. Ensure that all required signatures are obtained from authorized personnel before submitting your application.

Start using our platform today to easily complete your View Application for Group Insurance online for free!