Group Policy Installation Form
Employee Enrollment & Waiver
E-Service Election Form for groups electing paperless administration.
Copy of the Principal quote.
Broker: must be licensed with Principal Life. If not licensed, licensing paperwork must be submitted with the case.
Group Plans: Minimum of 3 participating employees for standalone as long as Employer Contribution is a minimum of 50%. Minimum of 3 participating employees if multiple lines of coverage are sold. Minimum 10 enrolling when quoting Ortho.
Voluntary Dental: Minimum of 10 eligible employees (available through the local Principal Financial sales office).
Employee Benefit Choice: Minimum 10 enrolled employees. At least one employee must be enrolled in each benefit offering.
No prior carrier bill needed.
Waivers are needed on Employer-paid dental. Valid waivers do not reduce participation. Invalid waivers reduce a group’s participation rate. Please contact your Word & Brown representative for more details. Not applicable to Voluntary dental.
Health Statement required for all employees electing over the Voluntary Term Life guarantee issue amount of $50,000.
Vision Claim: Employees can submit a vision claim simply by taking a photo of their receipt.
Broker Licensing: Must be licensed with Principal Life. If not licensed, licensing paperwork must be submitted with the case. Consumer Report Authorization, Agent Appointment Information Sheet and copy of license (if applicable).
Authorization Agreement for Direct Deposit