Group Accidental Death & Dismemberment Insurance Plan Enrollment Form​ ​

Group Basic Care Hospital Insurance Plan Application Form

Group Legal Services Plan Enrollment Form 

Group Hospital Indemnity Insurance Plan Enrollment Form​  

Group Long Term Disability Income Insurance Plan Application Form

Group Short Term Disability Income Insurance Plan Application Form ​ 

Group Term Life Insurance Plan Application Form​

 

Plan Rates for Active & PSE APWU Member Plans

​Group Basic Care Insurance Plan Bi-Weekly Rates​​​

Group Dental Plan Bi-Weekly Rates  

Group Dental Plan Monthly Rates for Associate Members​​

Group Long Term Disability Insurance Plan Bi-Weekly Rates ​

Group Short Term Disability Insurance Plan Bi-Weekly Rates​​ 

Group Hospital & Home Care Recovery Insurance Plan Bi-Weekly Rates

Group Term Life Insurance Plan Bi-Weekly Rates​

Group Retiree Accidental Death & Dismemberment Insurance Plan Enrollment Form​​

Retiree Dental Plan Activation Form ​ 

Retiree Group Legal Services Plan Enrollment Form  

Group Retiree Hospital Indemnity Insurance Plan Application​

Group Retiree Basic Care Insurance Plan Application

Group Retiree Term Life Insurance Plan Application​​

 

Rates for Retiree Member Plans

Group Dental Plan Monthly Retiree Rates​

​Group Retiree Hospital Indemnity Plan Monthly Rates​

Group Retiree Term Life Insurance Plan Monthly Rates​

Group Retiree Basic Care Insurance Plan Monthly Rates​​

Cancer Plan Insurance Certificates

Click on your State of Residence below to view or print out your applicable Cancer Plan Certificate of Insurance*

Alaska ($30,000)

California

Delaware

Florida

Georgia

Hawaii

Idaho ($15,000)

 

Idaho ($30,000)

Iowa

Louisiana ($15,000)

Louisiana ($30,000)

Maryland

Maine

Michigan

Minnesota

Mississippi

North Carolina

New Mexico

Nevada

Oklahoma

Pennsylvania

South Carolina

Texas

Vermont

West Virginia

Wyoming​

If you reside in one of the following states, click on the Certificate below to view or print out your Certificate of Insurance*

AL, AR, AZ, CT, CO, DC, IL, IN, KS, KY, MA, MO, ND, NE, NJ, NY, OH, RI, TN, WI

Cancer Plan Certificate​

*PLEASE NOTE:  The Cancer Plan Certificate of Insurance, is only applicable for coverage if you're currently paying premiums towards the Cancer Insurance Plan.