Building & Business Personal Property Business Overhead Expense Group Term Life Health Individual Life Insurance Individual, Non-Cancellable Disability Income Long-Term Care Professional & Business Liability Workers' Compensation

Please print out the PDF file of the form/application you need, complete the form/application, and either fax it to TDIC Insurance Solutions, Inc. at: 952/698-1202 or mail it to us at: TDIC Insurance Solutions, Inc. P.O. Box 201001 Bloomington, MN 55420-9828. Please note that you may now key in the data on some of these forms directly from your computer. After completing an interactive form, you will still need to print it out, sign the document, and fax it or mail it to TDIC Insurance Solutions, Inc. Building & Business Personal Property Building & Business Personal Property Application Business Overhead Expense Business Overhead Expense Application Group Term Life Group Term Life Benefit Summary and Application Group Term Life Evidence of Insurability Form Health Application to Add Chemical Dependency to an Individual Health Plan Authorization for Electronic Transfer of Funds Aware Care Application Aware Care Change Form Continuation/Waiver of Coverage Application Group Coverage Change Form Insta-Care Application Medicare Supplement/Medicare Select Plan Application with Health History Medicare Supplement/Medicare Select Plan Application without Health History Medicare Supplement Insurance Suitability Form Portability Plan Application Small Group Health Plan Application and Change Form Small Employer Non-Reform Application Small Employer Reform Application (2-50 Employees) Individual Life Insurance Life Insurance Application for One Life Life Insurance Application for Two Lives Capital Needs Analysis Application Supplement - Aviation Questionnaire Application Supplement - Non-Smoker Questionnaire Application Supplement - Children's Insurance Rider Personal Supplement to Life Insurance Application HIPAA Authorization Release Form Individual, Non-Cancellable Disability Income Individual, Non-Cancellable Disability Income Application HIPAA Authorization Release Form Long-Term Care GE Capital Assurance LTC HIPAA Authorization Form Lincoln Benefit Life HIPAA Authorization Form Professional & Business Liability Professional & Business Liability Application Workers' Compensation Workers' Compensation Application