Because you are applying outside of a 60-day open window, medical underwriting is required for Life, LTD, and ADD&D coverage.

Please complete Form 3.

Optimum Coverage (Enhanced Option)

Looking for a higher level of coverage? The Optimum plan offers enhanced protection with a few additional steps:

• Requires a Statement of Health (Form 2)
• Approval is based on medical history
• In some cases, coverage may include exclusions related to pre-existing conditions
• You’ll be enrolled in a guaranteed plan of your choice while your application is reviewed
• Rates will be adjusted if applicable at the time of approval
• If Optimum isn’t approved, your guaranteed coverage remains unchanged

Optional Increases

You may increase Life Insurance and Long-Term Disability or add coverage for a spouse and/or children. Forms 3, 4, 5, and 6 are required. Optional increases are subject to medical underwriting.

For full details on coverage options and required forms, click “Additional Plan Details” above.

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