Key Words / Phrases

• Don’t remember signing up
• Did not authorize
• My parent or spouse wouldn’t have signed up for this

Process

Select F15

Find ADD / ARTENROLL and enter “S”, then enter

Or look for Conversion, UBTOS, or CHCOV (if a customer increases their supplemental coverage amount, there will be an additional proof of enrollment for the increase).

Takeovers

Franklin Madison does not hold the original enrollment. Refer the customer back to their financial institution to determine which company was the plan administrator at the time of enrollment. The customer can contact the original plan administrator to obtain a copy of their enrollment.

Frequently Asked Questions

Can I get a copy of the enrollment form I signed?

“I can request a copy of the signed enrollment form or you can go to fmservice.com and create a log-in to access your policy information. You can request our original enrollment form, see your policy information, make a payment, and do other things as well.”

fmservice.com

Customers can request a proof of enrollment on fmservice.com.