Enrollment and Claims Forms

Technicians Insurance

Effective Aug. 1, 2020, civilian employees under Title 5 are eligible for this program. All references to Technician includes Title 32 Technicians and Title 5 civilian employees.

Enrollment

Open Enrollment (excluding New York)

Standard Enrollment (excluding New York)

Open Enrollment (New York Only)

Standard Enrollment (New York Only)

Standard Enrollment (New Hampshire Only)

Claims

To file a Life or Disability claim, please contact NGAUS Insurance Trust at 1-800-499-1985 (weekdays 8 a.m. to 7 p.m. EST).  A Member Benefits associate will be happy to assist you with initiating your claim.

Additional Resources

Disability Claim Form

Brochure (excluding New York & New Mexico)

Brochure (New York Only)

Brochure (New Mexico Only)

Request for Change – Form NG76

Accidental Death & Dismemberment

Instructions

Claim Form

Beneficiary Form

AD&D Certificate

Note: Not available to New Hampshire and New Mexico residents per each state’s Department of Insurance.

Preferred Vision Care

Enrollment Form