Evidence of Insurability

	Long Term Care Insurance Plan

	The Plan at a Glance

	Participating in the Plan

		Eligible Employees

		Eligible Spouses and Domestic Partners

		Eligible Family Members

		Enrollment

		Evidence of Insurability

		Cost of Coverage

		When Coverage Starts

		When Coverage Ends

	How the Plan Works

	What Is Not Covered

	Filing a Claim

	Glossary

Evidence of Insurability

Evidence of Insurability needs to be provided by:

employees who do not enroll within 90 days of employment

your eligible family members