Start of Coverage
newborn Child. Late Enrollment Additional Coverage
If you do not apply for coverage during an Insured's Initial Enrollment or you voluntarily cancelled coverage for an Insured and are re-applying, you may apply for any Coverage Amounts available during an annual Enrollment Period or within 30 days of a Qualifying Life Event. Life Coverage Amounts may be subject to Evidence of Insurability Requirements. Additional Coverage You may increase coverage for an Insured subject to the Coverage Amounts available during an annual Enrollment Period or within 30 days of a Qualifying Life Event. Life Coverage Amounts may be subject to Evidence of Insurability Requirements. Any change in Coverage Amounts applied for as the result of a Qualifying Life Event, must be appropriate and consistent with the Qualifying Life Event. You may also decrease coverage for an Insured subject to the Coverage Amounts available at any time during the Policy Year. Applies to Basic Coverage Only Evidence of Insurability is not required for any Basic Coverage; however, if you previously declined this coverage, Evidence of Insurability will be required for the full amount. Applies to Additional Coverage Only Evidence of Insurability is required for any life Coverage Amounts greater than: Evidence of Insurability Amounts For you For your Spouse For your Children $300,000 $50,000 Evidence of Insurability is not required. Evidence of Insurability is also required for life Coverage Amounts if: For you: - you do not enroll for life insurance coverage during your Initial Enrollment Period; - you voluntarily cancel or decline all or part of your life insurance coverage and reapply; - you are currently enrolled and increase your life insurance coverage by more than one level during an annual Enrollment Period; - you are currently enrolled and increase your life insurance coverage by more than one level due to a Qualifying Life Event; or - remain covered for the same additional benefit option, and you receive an increase in your annual Earnings that causes your life insurance coverage to exceed the Evidence of Insurability amount above by more than $50,000. However, if you previously were declined life insurance coverage, Evidence of Insurability is required for any increases in your life insurance coverage due to an increase in your annual Earnings. For your Spouse: - you do not enroll your Spouse for life insurance coverage during your Spouse's Initial Enrollment Period; - you voluntarily cancel or decline all or part of life insurance coverage for your Spouse and reapply; - you are currently enrolled and you increase your Spouse's life insurance coverage by more than one level during an annual Enrollment Period; or - you are currently enrolled and you increase your Spouse's life insurance coverage by
Applying for Changes in Coverage
Evidence of Insurability Requirements
UA-GTLC21-1
Group Life and Accidental Death and Dismemberment Certificate
(1/1/2025) 26
Unum Life Insurance Company of America
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