Here is the Link to The Standard’s EOI form provided to those requiring a Statement of Health (EOI)

Helpful hint:

• EOI is typically needed when an applicant enrolls above the non-medical maximum (or guaranteed issue) amount, enrolls outside their initial enrollment window, or was previously declined.  Please refer to your Contract for EOI rules specific to your plan(s).

What information do you need to get started?

· Types and amounts of coverage you are requesting

· Physician names and addresses

· Personal identification information (Social Security Number, Date of Birth, etc.)

· Your group name and six-digit policy number: School District of Indian River County; 638521

If you have questions, please call the Medical Underwriting Department to assist you at 800-843-7979.