1. Review Your Plan Details
Familiarize yourself with the details of your plan.
2. Important Information About Your Enrollment
Read and print for your records. These are for information only. Nothing in this section needs to be completed and sent into Unum.
3.
Employee Enrollment
Print out the forms below. Complete, save a copy for your records, and submit these forms to:
Your Employer.
Please note, the Long Term Care Insurance Application (medical questionnaire) can be returned directly to Unum at the address
listed on the form.
4.
Spouse Enrollment
All spouse coverage is medically underwritten. The Long Term Care Insurance Application must be completed along with the Enrollment Form.
To apply for coverage, print and complete these forms, and mail to:
The Employer.
Please note, the Long Term Care Insurance Application (medical questionnaire) can be returned directly to Unum at the address listed on the form.
Spouse Enrollment Form
Choose your plan options and submit the form.
5.
Family Enrollment
Family coverage is medically underwritten. The Long Term Care Insurance Application must be completed along with the Enrollment Form.
To apply for coverage, print and complete these forms, and mail to:
Group Long Term Care, Unum Life Insurance Company of America, 2211 Congress Street, Portland, ME 04122.
Family Enrollment Form
Choose your plan options and submit the form.
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