USBA Comprehensive Accident Insurance Online Application

Apply For USBA Comprehensive  Accident Insurance

The security of comprehensive accident insurance has never been easier. Simply complete and submit the online application.

 

Group Comprehensive Accident Insurance
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Thank you for using our Online Application Process. Coverage for yourself, or eligible spouse, will become effective as soon as the application is approved/processed and first premium is paid.

Fields marked with * are required

Please complete so you can easily save and come back to this application. Once you click “Next”, we’ll send you an email with your information for future reference.

(If you’re not working with an agent, leave the field blank.)
IMPORTANT: If you are working with an agent, you have been provided with an agent number to use on this application. Please enter the number in the field above.
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Please note: This coverage is guaranteed acceptance for eligible USBA Members and their spouses ages 18-59 who are working at least 20 hours per week and not on active duty.