Apply For USBA Life Insurance

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

 

Group Life Insurance Application for Individuals

Thank you for using our Online Application Process. Please be aware this is only an invitation to apply for USBA life insurance and is not a guarantee of approval of coverage. Coverage for yourself and/or any dependents is not effective until approved by USBA and New York Life.

Do you need coverage for you and your spouse? Click here to start a USBA TWO for ONE® Application.

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.