AXA Employee Benefits Group 2026

1. Click ‘Get Form’ to open the AXA Employee Benefits Group Enrollment Form in the editor.
2. Begin with Section 1, where you will provide your proposed insured information. Fill in your employer's name and address, group number, and personal details such as your name, social security number, and date of birth.
3. In Section 2, select the coverages you wish to elect. Check the appropriate boxes for life insurance options and enter the requested amounts if applicable.
4. Proceed to Section 3 for dental and vision coverage selections. Indicate whether you are applying for employee-only coverage or family coverage.
5. Complete Section 4 if applying for disability insurance by entering the desired amounts for short-term and long-term disability.
6. In Section 5, provide information about any dependents you wish to insure. Fill in their names, dates of birth, and select their coverage options.
7. Designate beneficiaries in Section 6. Ensure that you list their names, relationships, and percentage shares accurately.
8. Finally, review Section 7 for acknowledgments before signing the form in the designated area at the end of the document.

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