Downloads

Welcome to the downloadable forms resource page. Files are available in PDF format to be downloaded, printed and mailed accordingly. Acrobat Reader is a free application that can be downloaded at adobe.com/reader/.

  • Short Term Disability Application.pdf
  • Group Term Life Application.pdf
  • SecureStart Plan Application
  • Long Term Disability.pdf
  • Group-Business-Overhead-Expense-Application.pdf
Form Product Form Type Download
Short Term Disability Application.pdf Download
Group Term Life Application.pdf Download
SecureStart Plan Application SecureStart Plan Enrollment Application Download
Long Term Disability.pdf SecureStart Plan Enrollment Application Download
Group-Business-Overhead-Expense-Application.pdf SecureStart Plan Enrollment Application Download

Mail all claim forms to the following address:

AGIA Affiliate Services
Claims Department
P.O. Box 9060
Phoenix, AZ 85068