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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 800.633.8575. 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 www.standard.com Electronic Evidence of Insurability SI 13859 (8/10) PR/ER
"Electronic Evidence Of Insurability"