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/.

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