Term Life Insurance Enrollment Form - UNUM Forms ... 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your Policyholder Name and Policy Number. Ensure all fields are filled out legibly to avoid processing delays.
  3. Fill in your Employee Social Security Number, Gender, First Name, Middle Initial, and Last Name. Provide your Street Address, City, State, and Zip Code.
  4. Indicate your Original Date of Hire and Annual Salary. Specify your Occupation and whether you are Exempt or Non-Exempt.
  5. Complete the Coverage Elections section by checking 'Yes' or 'No' for each coverage option available to you.
  6. Provide Beneficiary Information including their Name, Relation to You, and Benefit Percentage.
  7. Finally, sign and date the form at the bottom. Review all entries for accuracy before submission.

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If you cannot file online, you can get a claim form at unum.com/claims or contact your HR department at work. Follow the instructions on the form to mail or fax your completed form, but for fastest results, file online if you can.
Employees may add or change coverage for themselves or their dependents as a result of a qualified life event such as marriage or a birth/adoption. The employee will need to elect this coverage within 31 days of the event.
Term Life Insurance provides flexible coverage during an employees working years to provide protection for the loved ones who depend on them. Employees can increase coverage at enrollment events and may be able to take the protection with them if they change jobs.
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