EVIDENCE OF INSURABILITY FORM - MGM Benefits Group
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EVIDENCE OF INSURABILITY FORM Attached you will find the carriers required Evidence of Insurability (EOI) form. This form must be completed and processed before your elected coverage can be approved and payroll deductions can be started. Please complete all fields required for you and your dependent(s) and fax it to MGM Benefits Group at 972.881.2251. If you would prefer to mail in your completed form, you can send it to the following address: MGM Benefits Group Attn: Group Administration 2121 N. Glenville Drive Richardson, TX 75082 For any questions regarding this form or the Medical Underwriting process, call us at 866.881.2255.
Transcript of EVIDENCE OF INSURABILITY FORM - MGM Benefits Group
EVIDENCE OF INSURABILITY FORM
Attached you will find the carriers required Evidence of Insurability (EOI) form. This form must be completed and processed before your elected coverage can be approved and payroll deductions can be started. Please complete all fields required for you and your dependent(s) and fax it to MGM Benefits Group at 972.881.2251.
If you would prefer to mail in your completed form, you can send it to the following address:
MGM Benefits Group Attn: Group Administration 2121 N. Glenville Drive Richardson, TX 75082
For any questions regarding this form or the Medical Underwriting process, call us at 866.881.2255.
