Life and AD&D coverage applicable to policy form GLIF AO L20, or state equivalent. Life insurance product is underwritten by Nationwide Life Insurance Company, Columbus, OH, marketed by Beam Insurance Services LLC (Beam Benefits Insurance Services LLC, in CA) and administered by Beam Insurance Administrators LLC (Beam Dental Insurance Administrators LLC in Texas). Vision insurance products administered by Vision Service Plan Insurance Company. Vision insurance products underwritten by Vision Service Plan (VSP) in WA. Dental and vision products administered by Beam Insurance Administrators LLC (Beam Dental Insurance Administrators LLC, in Texas). Dental coverage applicable to policy form GDTL AO L20, or state equivalent and vision policy form GVIS AO L20, or state equivalent. Dental and vision products underwritten by Nationwide Life Insurance Company, Columbus, OH in NY, DE, ID, LA, UT, OH, TX and NM. Dental policy form number NDNGRP 2020 and vision policy form number NVIGRP 2020. The Licensee User Access form will ensure only authorized users will have the appropriate access to Guardian.Dental and vision insurance products underwritten by National Guardian Life Insurance Company (NGL), Madison, WI, marketed by Beam Insurance Services LLC (Beam Benefits Insurance Services LLC, in CA). The form is to be completed under penalty of perjury that all information provided is true and correct. If you have already submitted your Licensee User Account Access form, please refrain from sending in another copy as they are being processed in the order they are received. If a new or additional license or facility number needs to be added to an existing Guardian user account please complete a Licensee User Account Access form and submit to accordance with PIN-20-20-CCLD, a Licensee User Access Form has been sent to all licensee mailing addresses, requesting information to create a unique Guardian user account. Licensee User Access forms, as outlined in PIN 20-20-CCLD are still being accepted.
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