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/.

  • ny-important-replacement-notice.pdf
  • beneficiary-information-form-ny-residents.pdf
  • coa-long-term-disability-application-ga.pdf
  • coa-long-term-disability-application.pdf
  • notice-of-insurance-information-practices.pdf
  • medicare-replacement-notice.pdf
  • coa-group-term-life-insurance-100k-50k-application-california.pdf
  • coa-add.pdf
  • coa-group-term-life-insurance-100k-50k-application.pdf
  • coa-group-term-life-insurance-100k-50k-application-new-york.pdf
Form Product Form Type Download
ny-important-replacement-notice.pdf Notice Download
beneficiary-information-form-ny-residents.pdf Notice Download
coa-long-term-disability-application-ga.pdf Application Download
coa-long-term-disability-application.pdf Application Download
notice-of-insurance-information-practices.pdf Notice Download
medicare-replacement-notice.pdf Notice Download
coa-group-term-life-insurance-100k-50k-application-california.pdf Application Download
coa-add.pdf Enrollment Download
coa-group-term-life-insurance-100k-50k-application.pdf Application Download
coa-group-term-life-insurance-100k-50k-application-new-york.pdf Application Download

Mail all claim forms to the following address:

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