Evidence of Insurability Information

Evidence of Insurability forms (“EOIs”) will be needed for any of the following situations:

    • Any employees outside of their new hire eligibility period who are newly entering the plan. EOI is required for any amount requested.
    • Any changes to spouse coverage after the initial enrollment as a new hire will require EOI for any amount requested.
    • Existing employees are able to increase the employee benefit by up to $10,000 subject to the Guarantee issue of $250,000. If the increase will take them over the GI, they will need to complete EOI.

Click the applicable button below to complete the Evidence of Insurability for Mutual of Omaha. If completing online, please use the following group identifiers:

Group ID: G000 B M 6 Q

Subgroup ID: FL, PA, CA – 001A
Subgroup ID: OH – 002A
Subgroup ID: TX – 003A

Upon completion, please forward PRINTED COPIES to: Lisa.Thompson@TheMeehanAgency.com

Evidence of Insurability – Complete Online

Evidence of Insurability – PRINT (FL, PA, CA)

Evidence of Insurability – PRINT (Ohio)

Evidence of Insurability – PRINT (Texas)

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