Supplemental LTD – Online EOI Instructions & Application

If your Supplemental Long-Term Disability benefit election requires Evidence of Insurability (EOI), please follow these steps:

  1. Using the printer icon (above right) PRINT THIS INSTRUCTION PAGE. Clicking on the link below will take you to another site and it will be easier to navigate with these instructions in hand.
  2. Click on the “Supplemental LTD EOI Online Form” link below to be directed to the UNUM Provident site for electronic submission of your EOI form.
  3. Read through the Getting Started and Instructions pages and advance by clicking “next”. The Employer or Sponsor Information page will be completed for you. Do not change this information.
  4. Complete all fields on the Employee Information page.
    1. In the Application Type (reason for filling out this form) field, select “electing coverage during yearly enrollment”.
    2. For the Elected Coverages Requiring EOI, check the box for Employee LTD Coverage. Do not check any other boxes.
    3. Your Group number will be filled in for you as 457913. Leave the second space for Group number blank.
    4. Fill in the correct Division number for your operating company as listed below:
      AGS Globe 0018
      Financial Times 0006
      NCS Pearson 0018
      PDL/PSS/PST 0018
      Pearson Assessments 0018
      Pearson Education 0011
      Pearson Educational Measurement 0018
      Pearson Inc. 0001
      Pearson Technology 0010
      Pearson VUE 0018
    5. In the Annual Salary field, enter your frozen salary. (Log into to Oracle HR, select Employee Self-Service > Benefits > View Elections. Enter the amount listed under Basic LTD – LTD – Company Paid.)
  5. Complete the remaining sections of the application and submit.
  6. After you have electronically submitted the form, print a copy of the summary for your records.

If you have any questions regarding Evidence of Insurability or your Long Term Disability Coverage, please contact Pearson People Services (PPS) via myHR (Ask HR a Question) or call 1-877-311-0948.

Supplemental LTD EOI Online Application