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Electronic Evidence Of Insurability


									Employee Benefits

Electronic Evidence Of Insurability

Save Time: Provide Medical History Statements Online
Standard Insurance Company’s Medical History Statement Web form
is designed to make employee submission of medical evidence as easy
as possible. The online application presents a series of questions about
demographics, employment and medical history, then automatically
transfers the answers to a Medical History Statement. Users may view,
print or save a copy for their records using the free Adobe® Reader®.

Employees can save themselves from possible delays due to returned
paper forms by submitting online with the Medical History Statement Web
form. The online application guides the employee through the process
by gathering the necessary information and populating the form prior
to submission. This ensures that the information submitted is complete,
allowing The Standard to begin the underwriting process immediately.

The Web form is secure, confidential, fast and efficient. Employees who
submit their Medical History Statement via the web get faster decisions —
sometimes by as much as a week.

The Advantages Are Clear:

•	   Employees can submit forms immediately, increasing speed and accuracy
•	   Employers save time, conserve resources and control costs when the
     process is automated rather than paper-bound
•	   Employers can easily access information about the status of medical
     evidence applications through AdminEASESM                                                             To learn more about
                                                                                                           The Standard’s online
Trust Your Data To The Standard                                                                            Medical History Statements,
                                                                                                           please contact the Employee
Our Medical History Statement Web form is protected by encryption
technology to ensure confidentiality. Only those who process the application                               Benefits Sales and Service
have access to the information, further ensuring privacy and security.                                     Office for your area at
Note: E-signatures are not accepted in New York. Participants in New York may use the system to complete
their Medical History Statement, but are required to print the form and mail it to The Standard.

                                                                                                           Standard Insurance Company
                                                                                                           1100 SW Sixth Avenue
                                                                                                           Portland OR 97204


                                                                                                           Electronic Evidence of Insurability
                                                                                                           SI 13859 (8/10) PR/ER

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