Enrollment and Claims Forms

Technicians Insurance

Effective Aug. 1, 2020, civilian employees under Title 5 are eligible for this program. All references to Technician includes Title 32 Technicians and Title 5 civilian employees.

Enrollment

Please note Life coverage is temporarily not available in the following states: MT, UT

Please note Disability coverage is temporarily not available in the following states: MT, UT

Open Enrollment (excluding New York)

Standard Enrollment (excluding New York)

Open Enrollment (New York Only)

Standard Enrollment (New York Only)

Standard Enrollment (New Hampshire Only)

Claims

To file a Life or Disability claim, please contact NGAUS Insurance Trust at 1-800-499-1985 (weekdays 8 a.m. to 7 p.m. EST).  A Member Benefits associate will be happy to assist you with initiating your claim.

Additional Resources

Please note Life coverage is temporarily not available in the following states: MT, UT

Please note Disability coverage is temporarily not available in the following states: MT, UT

Disability Claim Form

Brochure (excluding New York & New Mexico)

Brochure (New York Only)

Brochure (New Mexico Only)

Request for Change – Form NG76

Accidental Death & Dismemberment

Instructions

Claim Form

Beneficiary Form

AD&D Certificate

Note: Not available to New Hampshire and New Mexico residents per each state’s Department of Insurance.

Preferred Vision Care

Enrollment Form