Welcome to Evidence of Insurability

Before You Begin

For help with Group Life Insurance Evidence of Insurability

For help with Group Disability Insurance Evidence of Insurability

Option 1 - Online Submission
First, identify the form you wish to complete:	Application for Group Life Insurance Application for Group Disability Insurance
Second, identify the state your employer is headquartered in:

Third, click "Submit" to begin the online Evidence of Insurability process:

Option 2 - Traditional Submission (Print and Mail)

If the online submission option isn't for you, you can complete a paper version of the Evidence of the Insurability form. Use this link to access the proper form.

The form you access will be a "fillable" form, which means you can type information into the form before you print it, or you can simply print a blank form to complete by hand. The form must be signed and dated, then mailed to the address provided.

Adobe Acrobat Reader 7.0 or higher is required to use this enrollment system. Download the latest version for free here.

|
|
|

Mutual of Omaha respects the privacy of your personal information; all data transmitted from you to our Web site is secure.