Thank you for submitting your Supplemental Life/AD&D Form

If you elected coverage above the Guarantee Issue amount for you and/or your spouse, please click the following buttons to complete and submit UHC's Evidence of Insurability (EOI) form(s).

​

​

IMPORTANT:  

You will need to supply the

Policy # and the Group # when you fill out the EOI.

Enter 370282 in both instances.