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1. Review Your Plan DetailsFamiliarize yourself with the details of your plan.2. Important Information About Your EnrollmentRead and print for your records. These are state required documents to assist with long term care insurance decisions. Nothing in this section needs to be returned in order to apply during your initial enrollment.3. Employee Enrollment
Print out the forms below. Complete, save a copy for your records, and submit these forms to:
ATTN: Customer Service LTC Solutions, Inc. 16310 NE 80th St. Suite 300 Redmond WA 98052 Please note, the Long Term Care Insurance Application (medical questionnaire) can be returned directly to Unum at the address listed on the form. Employee Enrollment Form Long Term Care Insurance Application (7019-04) 4. Spouse/Domestic Partner EnrollmentAll spouse/domestic partner coverage is medically underwritten. The Long Term Care Insurance Application must be completed along with the Enrollment Form. To apply for coverage, print and complete these forms, and mail to:ATTN: Customer Service LTC Solutions, Inc. 16310 NE 80th St. Suite 300 Redmond WA 98052 Please note, the Long Term Care Insurance Application (medical questionnaire) can be returned directly to Unum at the address listed on the form. Spouse/Domestic Partner Enrollment Form Long Term Care Insurance Application (7019-04) Domestic Partner Statement Form (1434-97) 5. Family EnrollmentFamily coverage is medically underwritten. The Long Term Care Insurance Application must be completed along with the Enrollment Form. To apply for coverage, print and complete these forms, and mail to: Group Long Term Care, Unum Life Insurance Company of America, 2211 Congress Street, Portland, ME 04122.Family Enrollment Form Long Term Care Insurance Application (7019-04) Be sure to read the documents in section two above. Eligible family members who would like to apply for coverage require these additional form(s): 
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