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Before you enroll, be sure to visit Build A Plan to determine the plan design you want. If you are unclear about eligibility, visit Learn More. Once you are ready to enroll, please follow the directions below.

	Employees who are eligible for other insurance are eligible for long-term care insurance. Newly-hired employees can enroll using an Employee Enrollment Form (PDF, 208 kb) without showing evidence of good health providing they enroll within 35 days of becoming eligible and are actively at work when their coverage goes into effect. Employees who do not enroll when first becoming eligible may apply for coverage at any time, but provide evidence of good health by answering health questions on the Short Form Application (PDF, 208 kb). Please follow the directions on the instruction sheet.
	Spouses of employees must complete a paper Short Form Application (PDF, 181kb).
	Retirees, spouses of retirees and parents of employees must complete a paper Long Form Application (PDF, 257kb).