Add employee benefits for LIFE & HEALTH

Immediate benefits
No medical questions
ONE single requirement: “Currently employed”
Portable – get benefits while employed, continue even after retirement.

ENROLL NOW

Enrollment form

Get access to your employee benefits.

First Name

Middle

Last Name

Gender

Smoker?

Yes

Address

City

State

Zip

Phone

SSN#

Mother's maiden name

Height

in.

Annual income

Occupation

Employer

Are you actively at work on a full time basis and able to perform the regular duties of your occupation?

YES

No (If "No", you are not eligible for Employee Benefits- ask us for Guaranteed Issue plans)

Comments / Questions

Benefits available:

LIFE INSURANCE – Lifetime coverage “Universal Life” designed to last your WHOLE LIFE. It grows cash value over time. You can use the cash value or benefit for things such as paying college tuition, mortgage costs, or use it to pay for final expenses. This benefit is PORTABLE – coverage can continue even after retirement.