It is easy to get started.  Complete the on-line application, submit and allow for processing time. You should print a copy for your records.

To begin the process, please complete the information below. Click start and you will be guided through the remaining questions.

You may cancel this application at any time. You may complete the application by hand and fax to 877-573-6177. To complete the application by hand please click here

Completion of this application does not guarantee approval of coverage.

Thank you for choosing Lincoln Financial to meet your insurance needs.    If you have any questions or need assistance, please call 1-800-423-2765 or see your Plan Administrator.

Group Policyholder Domicile State
Reason for submitting EOI

Have Questions? Please review our FAQs

  • Who is an Applicant?
  • When is Evidence of Insurability required?
  • What is Guarantee Issue?
  • What is a Late Applicant?
  • Are there any fees involved? If so, who pays them?
  • How much are the late applicant fees?
  • Once submitted how do I check the status of an evidence of insurability form?
  • Once submitted how long does the evidence of insurability process take?
  • What additional information may be needed?
  • How is a paramedical exam and/or laboratory testing completed?
  • How will the Evidence of Insurability decision be communicated?
  • If I am declined for coverage will I know the reason?
  • If I don't want to complete this information on-line what other options do I have?
  • Is my information secure and confidential?