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1. Review Your Plan Details

Familiarize yourself with the details of your plan.

2. Important Information About Your Enrollment

Read 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
Choose your plan options and submit the form.

Long Term Care Insurance Application (7045-04)
(medical questionnaire)
If you enroll after the Guarantee Issue enrollment period, or choose benefits over the Guarantee Issue limits, you will be required to fill out Unum's Long Term Care Insurance Application (medical questionnaire).

4. Spouse Enrollment

All spouse 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 Enrollment Form
Choose your plan options and submit the form.

Long Term Care Insurance Application (7045-04)
Required to be returned to insurer.

5. Family Enrollment

Family 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

Family Enrollment Form
Choose your plan options and submit the form.

Long Term Care Insurance Application (7045-04)
Required to be returned to insurer.

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):
Personal Worksheet (7625-04-WA)
3rd Party Notice of Prem Lapse (7606-04)