Long-Term Care Insurance Enrollment Form
About this free form template

Secure Your Future with Long-Term Care Insurance

Long-term care insurance is an essential benefit that helps protect your financial security by covering costs associated with extended care services, whether at home, in an assisted living facility, or in a nursing home. This Long-Term Care Insurance Enrollment Form makes it simple for employees to enroll in their employer-sponsored plan and customize their coverage to meet individual needs.

Why Use Paperform for Benefits Enrollment?

HR teams and benefits administrators need efficient, accurate ways to collect employee elections during open enrollment or life events. With Paperform, you can create professional, on-brand enrollment forms that:

  • Guide employees through complex decisions with conditional logic that shows relevant options based on previous answers
  • Calculate premiums in real-time so employees understand exactly what their selections will cost
  • Sync directly with your HRIS via integrations with BambooHR, Workday, or payroll systems through Stepper (stepper.io)
  • Maintain compliance with SOC 2 Type II certification and secure data handling for sensitive employee information

This template includes all the essential components of a long-term care insurance enrollment: employee identification, coverage level selection, elimination period choice (the waiting period before benefits begin), inflation protection options, beneficiary designation, and premium payment method selection. The clean, professional design ensures employees can complete enrollment confidently, while built-in validation prevents errors and incomplete submissions.

Streamline Benefits Administration with Stepper

Once an employee submits their enrollment, you can use Stepper (stepper.io) to automatically route the information to your benefits carrier, update employee records in your HRIS, send confirmation emails, and create follow-up tasks for your HR team. This automation eliminates manual data entry and ensures every enrollment is processed quickly and accurately.

Whether you're managing annual open enrollment for hundreds of employees or processing individual life event changes, Paperform gives you the flexibility and reliability you need to run modern benefits administration efficiently.

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HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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