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»  Eligibility
»  Term Life Insurance

Application Forms:

  • basic life application form (160K pdf)
  • basic life application / enrollment form
(173K pdf)
  • spouse life application form (190K pdf)
  • voluntary life application form (191K pdf)

Census Forms:

  • basic life online census form
  • basic life census form
(295K pdf)
  • voluntary / dependent life online census form
  • voluntary / dependent life census form
(379K pdf)

Brochure:

  • brochure (807K pdf)
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Term Life Insurance Program

It makes sense to seek financial protection against the hazards that we all face everyday. You can help protect your family's financial security with PIA's Basic, Voluntary And Dependent Term Life Insurance Programs

Who is Eligible to Apply?

An eligible person resides in the United States, is under age 65 and is actively at work at the Member's place of business for at least 20 hours per week and has been continuously employed for at least one month. Eligible person means:
  1. Proprietor, partner, corporate officer, limited liability partner, or manager of Member Agency who maintains current membership status.
  2. Full-time employee of a Member Agency.
  3. Independent producer who maintains current membership status receiving commissions of at least 150 hours per month times the minimum wage.
  4. Trustee, Trust Manager or Employee of PIA Services Group Insurance Fund.
  5. Executive Director or other officer, department or division head or senior staff or employee of National Association of PIA, or its local PIA affiliates, or PIA Services, Inc.
Eligible Dependents are your spouse under age 65 if not divorced or legally separated from you; your unmarried children who are dependent on you for support and not employed full-time, and are under age 19 (or 25 if a full-time student). Eligible dependents must reside in the United States. You must have Basic or Voluntary Life coverage in order to apply for Dependent Life Insurance.

Basic Life Insurance

Coverage is only available if there is 100% participation of eligible employees and the employer contributes 100% of the premium. There is no medical underwriting. If these requirements are not satisfied, employees can apply under the Voluntary Life Insurance Program which is medically underwritten. The Voluntary Life Insurance Program is also available to all members and emloyees who would like additional Life coverage.

Voluntary & Dependent Life Insurance

A choice of a minimum of 1 unit to 30 units of insurance is available. Each unit is equal to $10,000.

Eligible persons may apply for up to $300,000 or 30 units of insurance. (Medically underwritten.)
Eligible Spouses may apply for up to $100,000 or 10 units of insurance. (Medically underwritten.)
Dependent children from ages 6 months to 19 years are eligible for $3,000 of insurance. Children age 14 days to 6 months are eligible for $500. (Not medically underwritten.)

Michigan residents are only eligible for a maximum benefit amount of $180,000 when combining basic & voluntary life coverage.

For complete highlights of this coverage, please download the Term Life Insurance Program brochure (807K pdf)

PIA National membership, when required, must be current at all times. Please see the Eligibility section in the brochure for membership exceptions.

The complete listing of your coverage including exclusions and limitations can be found in the group policy/certificate. If differences exist between this summary and the policy/certificate, the policy/certificate will govern.

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