$4,000 ACCIDENTAL DEATH & DISMEMBERMENT BENEFIT

Online Response Form

Your Information

* Please fill out all required fields

* First Name:

Middle Initial:

* Last Name:

Date of Birth
(mm/dd/yyyy):

Preferred Language:

Contact Information

Home Phone:

Cell Phone:

Address

* Street Address:

*City:

*State/Province:

* Zip/Postal Code:

Other Information

Beneficiary:

Beneficiary Date of Birth
(mm/dd/yyyy):

Relationship:

Number of Child I.D. Kits :

An AIL representative, who is a member of OPEIU Local 277, will call on you to deliver your certificate of coverage, witness your beneficiary designation, register you for the AIL Plus program and provide your Child Safe Kits. AIL has other supplemental insurance programs, presented in the spirit of “Be Union – Buy Union,” available strictly on a voluntary basis.

If you have questions, please call American Income Life Insurance Company at 1-800-495-1213.

The AMERICAN INCOME LIFE Difference

American Income Life Insurance Company (AIL), an international company, has been serving union members for more than 60 years. AIL's commitment to the labor movement and working families makes AIL an outstanding insurance company.

AIL is a 100% union-label company; from knowledgeable representatives in the field to skilled staff in the Home Office, they work under collective bargaining agreements. AIL believes in the union label and operates in the spirit of Be-Union, Buy-Union, Build-Union.

Visit our website to learn more

No cost and supplemental insurance benefits

To Learn More About The American Income Life Benefits Offered Through TWU 250 A, Please Download The Letter.

Download Group Letter (PDF)

To view the letter, you will need the Adobe Acrobat Reader.