- Complete a Life Insurance Enrollment Form (PDF).
- Administrators: keep a copy in the employee's permanent personnel file.
- You can return the form via
- fax: (617) 948-6487
- mail:UUA GIP, 24 Farnsworth St Boston, MA 02210-1409.
- email: Only after emailing email@example.com to request a secure email link.
- Do not send enrollment forms to Guardian; this is a group plan.
Enrollment Time Frame
New employees must enroll within 60 days of their date of hire to avoid medical underwriting for long-term disability (LTD) insurance.
If you have been employed for longer than 60 days, please contact the Unitarian Universalist Group Insurance Plan Administrator at firstname.lastname@example.org for forms and instructions to apply for medical underwriting approval and we will send you an Evidence of Insurability (EOI) Form.
Effective Date of Coverage
The effective date of your coverage is the day after we receive the properly completed enrollment form, as per the terms of our contract with the insurance company.