You must be a full or part-time Federal Employee, or a retired Federal Employee under the age of 65, and residing in the United States (except Vermont), to apply for 10-Year Level Group Term Life Insurance.

For complete details about the plan including eligibility, rates, exclusions, limitations, and renewal provisons, please click on the links to the left.

Please click here to download the application for Face Amounts of $100,000 or more (or click on the Download Application button below).

For Face Amounts of less than $100,000 please click here to download the application.

Complete and return the signed application to the plan administrator at the address listed on the form. Be sure to answer all questions on the application and initial any changes you make.

Residents of Puerto Rico:
Please send your completed application to:
Global Insurance Agency, Inc.
P.O. Box 9023918
San Juan, PR 00902-3918

Send No Money Now. You will be billed once you are approved for coverage.

30 Day “No Obligation” Free Look
Once approved for coverage, you will be sent a Certificate of Insurance. If you are not completely satisfied with the terms of your certificate of insurance, you may return it, without claim, within 30 days of receipt. Your coverage will be invalidated and you will receive a full refund of any premium paid, no questions asked.

If you have any questions during the application process, please call 800-424-9801 for assistance.