What is evidence of insurability (EOI) and when is it required?
EOI means that you must provide medical information (which may include medical records and a physical exam) that requires review and approval by Fort Dearborn Life before coverage becomes effective. The effective date of coverage will be later than the approval date. The types of optional coverages that may require EOI are Life, Disability Insurance and Dependent Life. EOI is required when enrolling in Optional Term Life Elections III and IV at anytime.
How soon can I submit my EOI application?
During Annual Enrollment, check the ERS website for application deadlines. During the plan year, you can submit your EOI application two weeks prior to your qualifying life event.
As a new employee, you must submit your application for Optional Term Life Elections III and IV within the first 31 days of hire.
Where can I obtain an EOI application?
The EOI application is located under Resource Center in the Forms section of this website. Completion and filing instructions are also located on this page. EOI applications must be submitted by mail; Fort Dearborn Life cannot accept faxed applications.
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Do I have to send anything with my EOI application?
No, Fort Dearborn Life will request additional information from you, if necessary.
Why do you sometimes return my EOI application to me?
Applications are returned for completion of missing information such as height/weight and questions that are not answered or explained. When your application is returned, you must complete the information requested in our letter and return the completed application to the Dearborn National Medical Underwriting Department:
P. O. Box 655403
Dallas, TX 75265-5403
1 (855) 377-5433
Upon receipt, further determination of eligibility will be made for the coverages applied.
Who is responsible for obtaining medical records, when requested, and payment of any associated fee?
You, your spouse, or your dependent child(ren) age 18 or older are responsible for signing the Authorization to Release Medical Information on the Attending Physician's Statement form and delivering it to the physician or medical facility listed on the form for completion. You are responsible for any fee charged for release of medical records.
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What is the time frame for processing my EOI application?
Your EOI application will remain active in the review process for 90 days. If no action is taken on your application due to non-receipt of requested underwriting information or medical records within 90 days from our original request for information, your file will be closed and you must reapply for the coverage you want. This may require that you have another qualifying life event or wait for the next Annual Enrollment.
If I complete an EOI application, when will my insurance coverage become effective?
If your application meets established criteria and is approved, the coverage will begin the first of the month following the receipt of an approval letter by your benefits coordinator if you are an active employee or by ERS if you are a retiree. If you apply during Annual Enrollment and are approved, your coverage will begin the first of the month following the approval, but no earlier than September 1, the first day of the new plan year.
What is the appeal process if I am denied coverage through EOI?
The letter you receive from Fort Dearborn Life will explain your appeal rights. You may ask for reconsideration of the decision by submitting a request in writing along with any additional information to the Fort Dearborn Life Medical Underwriting Department. The underwriting file and any additional information submitted for reconsideration will be reviewed a second time. If Fort Dearborn Life determines that your EOI warrants a second denial, you will be notified in writing of the decision and Fort Dearborn Life will provide you with instructions on how to file a grievance with ERS.
Grievances must be submitted in writing to ERS within the time stated in your denial letter. Upon receipt of your appeal, ERS will provide you with notification of receipt and obtain all information regarding your claim from Fort Dearborn Life in order to review your grievance. ERS will notify you in writing of their decision.
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Who should I contact about the status of my EOI application?
For underwriting questions or the status of your EOI application for health, term life or disability coverages, contact Fort Dearborn Life Customer Service during regular business hours, Monday - Friday, 8:00 a.m. - 4:30 p.m., at 1 (855) 377-5433.
What types of information can I obtain from the Dearborn National Customer Service representatives about my EOI application?
The Customer Service representatives can assist you with general status information such as whether or not your EOI application has been received, pending information requested and/or received, underwriting decision and decision date. If you have a specific question as to the type of additional information being requested by the Dearborn National Medical Underwriting Department or the reason for the underwriting decision, the Customer Service representative will forward your call to the Medical Underwriting Department for handling.
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