Voluntary Group Level Term Life Insurance
Underwritten by Metropolitan Life Insurance Company New York, NY
How To Enroll
Listed below are easy to follow step-by-step instructions to complete and submit the enrollment form which includes the Statement of Health (SOH) for the Group Level Term Life Insurance policy. Your forms will be sent onto MetLife to determine insurability and final rates.
You (and your non-IBO spouse) may apply:
- 10 Year Level Term if you are both under age 60;
- 20 Year Level Term if you are both under age 50.
If your spouse is also an IBO, he/she should complete their own form.
- Thoroughly read the details of the Group Level Term Life Insurance plan, including the coverage highlights, the limitations and exclusions located under the Eligibility link on this website. Some Non-Preferred Industries prohibit enrolling under this Group Level Term Life Insurance plan, please contact USI Affinity at 1-800-254-2327 for other options.
- Complete the entire enrollment form titled "Life Insurance Full SOH Enrollment Form".
- The fields are "fillable", you should be able to type on the form.
- Include your non-IBO spouse and dependent child(ren) elections on the same form. If your spouse is also an IBO, your spouse should complete their own form.
- You are the beneficiary for your non-IBO spouse and/or dependent child(ren).
- Once the entire form is complete, print it as you will need to provide a wet signature. In ink, please sign the Declarations and Signature (s) on page 7 AND sign the Authorization Page.
- Mail completed Enrollment Form and Authorization page to:
USI Affinity
14 Cliffwood Ave.
Suite 310
Matawan, NJ 07747
Enrollment Form (includes Statement Of Health)
Eligibility
View Rates - 10 Year Level Term Rates
View Rates - 20 Year Level Term Rates
Please do not submit payment with your enrollment form. Providing your enrollment is approved, you will be billed. Do not cancel any other coverage until you have been notified in writing that this enrollment has been approved and you have paid your initial premium as billed.
Questions:
If you have any questions or need assistance in completing your enrollment form, please contact USI Affinity at 1-800-254-2327 or email us with your questions.
Group Level Term Life Insurance underwritten by Metropolitan Life Insurance Company New York, NY. Group Policy Form: 162250-1-G
Like most insurance policies, MetLife policies contain certain exclusions, waiting periods, reductions, limitations and terms for keeping them inforce. All policies and riders may not be available in all states, at all issue ages and to all occupational classes. Coverage may be subject to underwriting approval. Please contact your plan administrator at 1-800-254-2327 for details.
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