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Group Term Life Insurance Application

Fax: (410) 846-6420 | Email: | Mail: GEBA, 1362 Mellon Road, #100, Hanover, MD 21076

Before you begin to fill out GEBA's Group Term Life Application, we recommend that you have your medical records accessible for answering the health-related questions. You will be required to complete the entire application once you start since for security purposes we do not save the application for future access.

Group Term Life Insurance is underwritten by New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010

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