Enrollment

Membership Benefits

Member Information

Dependents/Beneficiaries

Life Coverage

Apply for Coverage

Select a Membership Option/Tier:

Term Life

Life insurance is one of the most cost-effective ways to safeguard the dreams of future generations. Life insurance can help your family weather the financial burden resulting from a loss of income due to your death.

$10,000-$50,000 Guaranteed Issue term Life and AD&D insurance
NSBA Membership
Access to Benefit Hub
Access to EPIC Hearing Discount Hearing Service Plan
Access to Consumer Medical Bills Solution

Member - $
Member + Spouse - $
Member + Children - $
Member + Family - $

Select

The following plans are Underwritten by Amalgamated Life Insurance Company (ALIC), Home Office: 333 Westchester Avenue, White Plains, NY 10604. All active Employees Only that are members of the National Small Business Association are eligible. 26AZ13 Group Term Life and ADD Benefits is issued under Policy Form ALTLP-05* and will terminate at Age 70 or if the group policy is terminated sooner. Coverage amounts can be converted, prior to age 70, as a result of termination from the group, age reductions, or retirement.

*Features & form numbers may vary by state.

Member Information

First Name

Last Name

Phone Number

E-Mail

You cannot enroll before your date of hire.

Date of Birth

Gender

Start Date

SSN

Employment is required for eligibility.

Are you actively working
or self employed?

Name of Company

Date of Hire

Member Address

Address

Address 2

City

State

Zip

Agreements

I agree to receive notifications via text message.

The parties to this Agreement intend and agree that this Agreement may be executed by electronic signature by any of the parties with the same effectiveness as a written signature, pursuant to the Texas Uniform Electronic Signature Act and the Federal E-Sign Act.

Back

Dependents

No Member Dependents Added

[+] Add a New Dependent

Name

First Name

Last Name

Demographics

Date of Birth

Gender

SSN

Is Dependent Disabled

Relationship

Beneficiaries

You can specify up to four

Warning : Failure to enter beneficiary information below

will result in all benefits being paid to your estate.

Beneficiary 1

Beneficiary Name

First Name

Last Name

Date of Birth

Relationship

Percent

Contact

City

State

Zip Code

Phone Number

SSN

Beneficiary 2

Beneficiary Name

First Name

Last Name

Date of Birth

Relationship

Percent

Contact

City

State

Zip Code

Phone Number

SSN

Beneficiary 3

Beneficiary Name

First Name

Last Name

Date of Birth

Relationship

Percent

Contact

City

State

Zip Code

Phone Number

SSN

Beneficiary 4

Beneficiary Name

First Name

Last Name

Date of Birth

Relationship

Percent

Contact

City

State

Zip Code

Phone Number

SSN

Back

Offered Through NSBA

Enrollment

Apply for Coverage

Term Life

Member Information

Member Address

Agreements

No Member Dependents Added

Name

Demographics

You can specify up to four

Beneficiary 1

Beneficiary 2

Beneficiary 3

Beneficiary 4