Life Insurance – Evidence of Insurability (EOI)

Instructions to Submit Evidence of Insurability (EOI).

Plan Features

Everything You’ll Need to Know

What is it? Evidence of Insurability (EOI) is required when you are enrolling as Late Entrant (anytime outside of your New Hire enrollment or Qualifying Life Event)

When is it due? EOI is due 30 days after your effective date of coverage.

What do I submit? Complete the form provided below. Once you complete your portion please submit it to your HR admin to complete their portion.

What do I do with my completed form? Email to: [email protected]


**IMPORTANT** Wet/Physical Signatures are required. Electronic signatures are INVALID and will be returned. 

Plan Documents


No information currently available.


Completed EOI Form

[email protected] 

Submission Email