Please call Selman & Company, the plan administrator, for more information including cost, exclusions, limitations and terms of coverage at 1.800.556.7614, Monday-Friday 9:00 a.m.- 5:00 p.m. EST or click on the Plan Description link below.

This plan is underwritten by The United States Life Insurance Company in the City of New York, a member company of American International Group, Inc. NAIC No. 70106, domiciled in the state of New York with a principal place of business of 70 Pine Street New York, NY 10270. It is currently authorized to transact business in all states plus DC, except PR. This summary is a brief description of benefits only and is subject to the terms, conditions, exclusions and limitations of Group Policy Nos. E-233, 619 and E-233, 701, Form No. G-19000. Coverage may vary or may not be available in all states.

The underwriting risks, financial obligations and support functions associated with the products issued by The United States Life Insurance Company in the City of New York are its responsibility. The United States Life Insurance Company in the City of New York is responsible for its own financial condition and contractual obligations.

Not available in the following states: AZ, KY, ME, MA, NJ, OR, VT, and WA
 

• Click here for New York Plan Description.

• Click here for the Plan Description for all other states.

Your state department of insurance may require a specific application:

• Enrollment Form for Florida Residents
• Enrollment Form for Iowa Residents
• Enrollment Form for Kansas Residents
• Enrollment Form for North Carolina Residents
• Enrollment Form for New York Residents
• Enrollment Form for South Carolina Residents
• Application for all other states

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