PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
the document
for the current year.
Application for Continuation of Insurance Due to Incapacity - Arkansas
Application for Continuation of Insurance Due to Incapacity is a legal document that was released by the Arkansas Department of Transformation and Shared Services - a government authority operating within Arkansas.
FAQ
Q: What is an application for continuation of insurance due to incapacity?
A: An application for continuation of insurance due to incapacity is a form that allows individuals in Arkansas to continue their insurance coverage while being unable to work due to incapacity.
Q: Who can apply for continuation of insurance due to incapacity in Arkansas?
A: Individuals in Arkansas who are no longer able to work due to incapacity can apply for continuation of insurance.
Q: How long can insurance coverage be continued due to incapacity in Arkansas?
A: The duration of insurance coverage that can be continued due to incapacity in Arkansas depends on the specific policy and its terms.
Q: What benefits does the continuation of insurance due to incapacity provide in Arkansas?
A: Continuation of insurance due to incapacity in Arkansas provides medical, dental, and vision coverage to eligible individuals.
Form Details:
- Released on December 18, 2019;
- The latest edition currently provided by the Arkansas Department of Transformation and Shared Services;
- Ready to use and print;
- Easy to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Arkansas Department of Transformation and Shared Services.
Download Application for Continuation of Insurance Due to Incapacity - Arkansas
1
2
3
4
