FLTCIP 2.0 Applications for the Federal Long Term Care Insurance Program

Download an Application

Please read the materials in the Information Kit before you apply for coverage under the Federal Long Term Care Insurance Program (FLTCIP). If you have already read these materials, you will need to determine which application you can use . Then you can download that application below.
 

		Full Underwriting Application
		Supplemental Answers for Full Underwriting Application
		Declaration of Domestic Partnership form
		Abbreviated Underwriting Application
		Supplemental Answers for Abbreviated Underwriting Application

In order to download the applications/forms above, you need the free Adobe Acrobat Reader.