Evidence of Insurability

Transcription

1 Evidence of Insurability User Guide About This Guide The links and functionality described in this guide assume you are logged into the secure portal and are on the MyLibertyConnection employee homepage. Introduction This guide helps you complete online an Evidence of Insurability (EOI) application for new insurance coverage or when changes in coverage have been made. Click the Complete Evidence of Insurability / Statement of Health button to begin this process. This brochure is a general description of coverage and/or services offered. See your policy or service contract for actual te rms and conditions. Group products and services are offered by Liberty Life Assurance Company of Boston, a Liberty Mutual company. Home Office: Boston, MA

2 Gathering Your Information Before starting, please take a few minutes to collect all the necessary information about the applicant you wish to add or manage. Getting Started The Getting Started screen provides important information about the EOI application, why we need this information, what you will need for each applicant applying for coverage, and help information. In this screen, you will verify your identity and begin the application.

3 Applicant Information Enter information about why you are filling out the application, which coverage/benefits are applicable, and your personal and contact information. Some information for you and your dependents may be pre-filled, if already provided by your employer. Note that at any point during the application, you may click the Save for Later button to save the information entered to that point, log out, and return later to complete the application. If at any point you wish to end the process and permanently discard everything you entered, click the Delete Application button. When finished entering applicant information, click the Continue button.

4 My Family Information If Dependent Life coverage is included in the application, enter information about your dependents and click the Continue button.

5 Qualifying Information For each applicant, answer a series of Yes/No questions. If dependent children are included, they are grouped together. Answer Yes if applicable to any child. When finished, click the Continue button.

6 Medical Information In some cases, you will be asked to enter information about existing medical conditions and/or prescribed medications. Click the +Add a Condition button to add additional medical conditions for an applicant or the Delete Condition button to remove one. Click the +Add a Medication button to add an additional medication for an applicant or the Delete Medication button to remove a medication. Click the condition library button in the Quick Tip box to access a sample list of medical conditions. Once all medical conditions and prescribed medications are entered, click the Continue button.

7 Based on the medical conditions you entered in the Medical Information screen, you may need to provide more detail in the Additional Information screen. If so, answer the questions for each required applicant and medical condition. Review Please review your responses to ensure completeness and accuracy, as you will not be able to change your responses after submitting your application. If changes are necessary, click the Edit button next to the section you need to change. You will be returned to the original screen. You may click the circles with check boxes in the Progress Bar to go back to a previously entered screen. Once you are satisfied that all information is correct, click the Continue button to go to the Signature screen.

8 Signature Provide an electronic signature and click the Continue button to submit your EOI application.

9 Confirmation Once your application has been submitted, the Confirmation screen will display an acknowledgement and next steps. Click the Download Application for Your Records button to open and save a copy of your application for your records. Note: You also will receive a separate acknowledgement from the Liberty Mutual Insurance Underwriting team. If you have questions about this process or next steps, please review the Questions and Answers section within MyLibertyConnection. Approved insurance coverage will be administered in accordance with your employer's benefit plan. Insurance is underwritten by Liberty Life Assurance Company of Boston.