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This version of the form is not currently in use and is provided for reference only. Download this version of
Form SI4781
for the current year.
Form SI4781 Request for Long Term Disability Conversion Materials - South Carolina
What Is Form SI4781?
This is a legal form that was released by the South Carolina Public Employee Benefit Authority - a government authority operating within South Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form SI4781?
A: Form SI4781 is a request forlong term disability conversion materials in South Carolina.
Q: What is long term disability conversion?
A: Long term disability conversion refers to the process of converting a group long term disability policy to an individual policy when an employee leaves the group.
Q: Who can use Form SI4781?
A: Form SI4781 is typically used by employees in South Carolina who are leaving a group long term disability policy and want to convert it to an individual policy.
Q: Is there a deadline for submitting Form SI4781?
A: Yes, there is typically a deadline for submitting Form SI4781. It is important to check with your employer or the insurance company to determine the specific deadline.
Q: What information is required on Form SI4781?
A: Form SI4781 typically requires personal information such as name, address, contact information, and details about the group long term disability policy being converted.
Q: Are there any fees associated with long term disability conversion?
A: There may be fees associated with long term disability conversion. It is important to review the conversion materials provided by the insurance company for details on any applicable fees.
Q: What happens after submitting Form SI4781?
A: After submitting Form SI4781, the insurance company will provide you with the necessary information and documentation to convert your group long term disability policy to an individual policy.
Q: Can I cancel the long term disability conversion process?
A: It is important to review the conversion materials provided by the insurance company for information on whether the conversion process can be canceled.
Form Details:
- Released on July 1, 2017;
- The latest edition provided by the South Carolina Public Employee Benefit Authority;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form SI4781 by clicking the link below or browse more documents and templates provided by the South Carolina Public Employee Benefit Authority.
