Get Comprehensive Accident Insurance Plan

The Comprehensive Accident Insurance Plan form is essential for securing coverage that protects you in the event of an accident. This guide provides a clear, step-by-step approach to help you fill out the form accurately and efficiently online.

Follow the steps to complete the form with ease:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing your member information, including the association name, your first name, middle initial, last name, date of birth, social security number, height, weight, and contact information.
3. If you are applying for coverage for your spouse or domestic partner, fill out their information including first name, middle initial, last name, date of birth, social security number, height, weight, and contact numbers.
4. Select the coverage amounts you wish to apply for by checking one of the provided options, such as Option 1, Option 2, or Option 3, and indicate whether you want member-only coverage or coverage that includes your spouse.
5. Complete the beneficiary information section by providing the first name, middle initial, last name, address, relationship, date of birth, and the percentage share for each beneficiary.
6. Choose your payment basis for the insurance contribution, selecting between annual, semi-annual, or monthly electronic fund transfer (EFT). If you opt for EFT, make sure to prepare a voided check or confirm your savings account eligibility.
7. Authorize the electronic fund transfer by filling in the required details related to your bank account and signing where indicated. Ensure to provide your bank's transit routing number if you're using a savings account.
8. Finally, review all your entries for accuracy before proceeding to save changes, download, print, or share the completed form as necessary.

Complete your Comprehensive Accident Insurance Plan form online today!