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Compare coverage options for group life or disability insurance. See how cost-effective coverage can be.
Group Life Insurance
Think about what your family would need to maintain their current standard of living if you were no longer there to help provide for them. Your income is most likely critical to meeting monthly expenses. Apply for coverage up to $2 million in term life insurance with options to choose a 10- or 20-year term. We have choices that will meet your budget today while still providing peace of mind for your family's future.
10-Year Level Term Life Insurance | 20-Year Level Term Life Insurance
Group Disability Insurance
If you're sidelined by an accident, injury, or illness that prevents you from working, don't be tempted to take your paycheck for granted. Over 50% of Americans don't have enough savings to cover three months of living expenses if they're not earning any income. Take advantage of our coverage options for the most affordable plan.
Covered by New York Life Insurance Co.
At the heart of New York Life is a commitment to be there for our customers when they need us—whether today or decades into the future. Today, no U.S. life insurer has a higher financial strength rating than New York Life. For our customers, that means promises kept, and peace of mind for the millions of families and businesses who rely on us.
A++
A.M. Best
AAA
Fitch Ratings
Aaa
Moody's Investors Service
AA+
Standard & Poor's
Applying is simple.
1
Begin here.
Get a quote and submit your application online. It's never been easier.
2
Provide medical info.
For certain plans, ExamOne will call you to review your health history and possibly schedule a medical exam. Learn more
3
Get a decision.
Decisions are made after all information is received. Your plan administrator will mail details upon approval.
Let's start with the basics.
This will determine your plan options and estimated cost.
This insurance is for:*
Your Information
We need to collect certain information about you even if you are applying for dependent-only coverage.
Spouse Information
Add insurance to your application.
If you already have insurance inforce, select only the additional amount needed.
Group Life Insurance
This is where high-level coverage category information will go. Information found here applies to all plans within this coverage category.
10-Year Level Term Life Insurance
This is where marketing information about the plan will go. This should have a high-level gist about the plan and plan features.
- Something about a plan feature
- Something about a plan feature
Your 10-Year Level Term Life Insurance
This is where plan information about the applicant will go.
Add Insurance
Benefit Amount
$15/mo.
Optional Benefit(s):
CIR Benefit Amount
Chronic Illness Rider (CIR): Accelerate up to 50% of the portion of your life insurance subject to the Chronic Illness Rider should you be permanently unable to perform 2 out of 6 activities of daily living or require substantial care due to permanent cognitive impairment.
Waiver of Premium (WP): Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.
Spouse 10-Year Level Term Life Insurance
This is where plan information about the applicant will go.
Add Insurance
Benefit Amount
$15/mo.
Optional Benefit(s):
CIR Benefit Amount
Chronic Illness Rider (CIR): Accelerate up to 50% of the portion of your life insurance subject to the Chronic Illness Rider should you be permanently unable to perform 2 out of 6 activities of daily living or require substantial care due to permanent cognitive impairment.
Waiver of Premium (WP): Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.
Child 10-Year Level Term Life Insurance
Add Insurance
Benefit Amount
$2/mo.
Group Disability Insurance
This is where high-level coverage category information will go. Information found here applies to all plans within this coverage category.
Disability Income Insurance
This is where marketing information about the plan will go. This should have a high-level gist about the plan and plan features.
- Something about a plan feature
- Something about a plan feature
Your Disability Income Insurance
This is where plan information about the applicant will go.
Add Insurance
Monthly Benefit Amount
$18/mo.
Option A (5-Year Plan): Benefits are payable up to five years for total disabilities starting before age 60. For total disabilities starting at ages 60 through 62, benefits may continue up to age 65. For total disabilities starting at ages 63 through 74, benefits may continue for up to two years.
Option B (Career Plan): If you are totally disabled before age 63, benefits are payable up to age 65. There is a two-year maximum benefit for total disabilities starting at ages 63 through 74.
Waiting Period: The number of consecutive days you must be totally disabled by illness or injury before benefits commence. Coverage with a longer waiting period is less expensive.
Spouse Disability Income Insurance
This is where plan information about the applicant will go.
Add Insurance
Monthly Benefit Amount
$18/mo.
Option A (5-Year Plan): Benefits are payable up to five years for total disabilities starting before age 60. For total disabilities starting at ages 60 through 62, benefits may continue up to age 65. For total disabilities starting at ages 63 through 74, benefits may continue for up to two years.
Option B (Career Plan): If you are totally disabled before age 63, benefits are payable up to age 65. There is a two-year maximum benefit for total disabilities starting at ages 63 through 74.
Waiting Period: The number of consecutive days you must be totally disabled by illness or injury before benefits commence. Coverage with a longer waiting period is less expensive.
1Estimated cost is for illustrative purposes only and may differ from the actual premium. Rates current as of 2020.
Nice job! You're almost done.
Please provide the following information to complete your application. You'll be able to review everything before submitting.
Contact Information
A representative of New York Life or ExamOne will call you to collect your health information and schedule any appointments. Your prompt responses will help speed up the review of your application. Learn more
Your Contact Information
Home Address
Business Address
Spouse Contact Information
Personal Information
We make sure your information is secure. You may find more details about your privacy and safety with us in our privacy policy.
Your Personal Information
Health Care Information (optional)
Information provided here will help expedite the underwriting process.
Spouse Personal Information
Health Care Information (optional)
Information provided here will help expedite the underwriting process.
Other Coverage
Your Other Coverage
Group Life Insurance
IMPORTANT REPLACEMENT INFORMATION
It may not be in your best interest to replace existing life insurance policies or annuity contracts in connection with the purchase of a new life insurance policy, whether issued by the same or different insurance company. A replacement will occur if, as part of your purchase of a new life insurance policy, existing coverage has been, or is likely to be, lapsed, surrendered, forfeited, assigned, terminated, changed or modified into paid-up insurance or other forms of benefits, loaned against or withdrawn from, reduced in value, by use of cash values or other policy values, changed in the length of time or in the amount of insurance that would continue or continued with a stoppage or reduction in the amount of premium paid. Prior to completing a replacement transaction, you may want to contact the insurance company or agent who sold you the life insurance or annuity contract that will be replaced to help you decide whether the replacement is in your best interest.
You have indicated that existing life insurance is being replaced. New York State requires that the Important Notice Regarding Replacement or Change Of Life Insurance Policies or Annuity Contracts (SM-NY60-IN-ND) form be completed and returned to the Plan Administrator within 10 days of this application for new insurance. If not received, the New York State Insurance Department requires that your application be automatically declined.
Please download/print this form, read and provide the requested information on the current insurance policy you intend to replace, sign and date the SM-NY60-IN-ND form, and mail back one copy of the form to - Plan Administrator at the address indicated below. Remember to keep a copy for your records!
Group Disability Insurance
Please indicate company name, monthly benefit amount, benefit period, and waiting period below:
Spouse Other Coverage
Group Life Insurance
Group Disability Insurance
Please indicate company name, monthly benefit amount, benefit period, and waiting period below:
Beneficiary Information
A beneficiary can be a person or a trust. If naming more than one person as beneficiary, the percentage of death proceeds to be distributed to each must total 100%. If naming a trust as beneficiary 100% of proceeds will be paid to the trust.
You may add up to four primary and four contingent beneficiaries online. If no beneficiary is named proceeds will be paid in accord with policy provisions. If you wish to add beneficiary information at a later time, or need to add more, please contact the plan administrator at (800) 368-3484.
The beneficiary for dependent child(ren) coverage is the member.
Your Beneficiary Information
10-Year Level Term Life Insurance
I make the following beneficiary designation with respect to new insurance issued on the basis of this application. If you currently have insurance and wish to change your beneficiary, contact the plan administrator for the proper form.
Spouse Beneficiary Information
10-Year Level Term Life Insurance
I make the following beneficiary designation with respect to new insurance issued on the basis of this application. If you currently have insurance and wish to change your beneficiary, contact the plan administrator for the proper form.
Payment Information
Adding payment information now can speed up the application process. You won’t be billed until and unless you are approved for coverage. Payment applies to all individuals within each product.
Your Payment Information
10-Year Level Term Life Insurance
Payment Frequency*
Estimated Cost1
$0
Self: $0 Spouse: $0 Child(ren): $0
Disability Income Insurance
Payment Frequency*
Estimated Cost1
$0
Self: $0 Spouse: $0 Child(ren): $0
Bank Account Details
Based on the billing frequency which I selected above, I request and authorize American Bar Endowment to make withdrawals against the account specified above or any other account subsequently named by me, and such bank to process these withdrawals as if I had signed them, for the purpose of collecting premium contributions due under each insurance plan indicated as AutoPay(EFT) in this Application Form.
1Estimated cost is for illustrative purposes only and may differ from the actual premium. Rates current as of 2020.
Please review your application.
Check the information below and correct any mistakes. If you need to make changes, click the Edit button.
Basic Information
Coverage Information
Other Coverage
Beneficiary Information
Payment Information
Your Payment Information Edit
Get ready to e-sign your application.
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Read & Sign
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Electronic Consent
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Your Consent
Spouse Consent
Thank you! Your application has been submitted.
Confirmation #100001234567
Next Up: A Call from ExamOne
Based on the plan(s) applied for, you will receive a call from ExamOne, our medical services provider, to review health history and possibly schedule a medical exam.
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