Group Term Life Insurance - ausa

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Group Term Life Insurance Plan

How secure is your family's future?

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Group Term Life Insurance Plan

In today's busy and fast-paced world, it's hard enough meeting your family's day-to-day demands … let alone looking at long-term needs.

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It's important for you to take care of your family's day-to-day needs — now and after you're gone.

Will there be enough money to pay your final expenses? To pay for the family home, utilities, day to day living costs and educational expenses?

According to a recent survey, a majority of households in the United States who currently have group insurance need more life insurance to meet their financial needs.1

Through your AUSA Membership, you can apply for $10,000 up to $500,000 coverage ... whatever you determine your family would need in the event of your death.

When applying for coverage under $150,000, you'll be prompted to verify your good health by answering three health questions. There's no physical exam involved and no blood work necessary.

Your spouse may also apply for the same amount of protection as you. If you are currently insured under this plan, your spouse may apply for coverage on their own. And your spouse's coverage won't terminate in the event of your death.

Plus you pay an affordable group rate, thanks to the group purchasing power of AUSA. Please click the 'Rates' tab to view the rates chart.

1Fact About Life, Facts from LIMRA Life Insurance Awareness Month, September 2016

Life Form Series includes GBD-1000, GBD-1100, or state equivalent.


Apply for up to $500,000* in Coverage

This coverage is a convenient addition to the life coverage you may already have, either through an employer plan or a policy you purchased on your own. As a member of the Association of the United States Army, you may apply for this coverage, as long as you are under age 65 and reside in the United States. (Not available in all states.) Your coverage will terminate once you reach the age of 85.  


Your Spouse is Eligible for Coverage

Your spouse can also take advantage of this same offer to request up to 100% of your coverage as long as your spouse is under age 65, is not legally separated or divorced from you, and resides in the U.S. Your spouse will also be able to keep their coverage in the event you pass away. Spouse coverage terminates at age 85.


Pays a "Living Benefit" if You're Terminally Ill

If you or your spouse is Terminally Ill — having a life expectancy of 12 months or less — and you are covered for at least $10,000, you may request that a portion of the death benefit be paid early. This is the accelerated death benefit. The minimum benefit is $6,000 and the maximum benefit is $250,000, not to exceed 60% of the covered person's benefit amount. This option may be exercised only once.

For example, if you are covered for $100,000 and are Terminally Ill, you can request any portion from $6,000 to $60,000 to be paid now instead of to your beneficiary upon death. However, if you only receive $6,000 now, you cannot request the additional $54,000 in the future.

You must request in writing that a portion of the Terminally Ill person's Amount of Life Insurance be paid as an Accelerated Benefit. Any benefits received under this benefit may be taxable. You should consult a personal tax advisor for further information.**


Accidental Death & Dismemberment (AD&D) Benefit

Should you or your dependents sustain an injury in a covered accident, you or your beneficiary are eligible to receive your selected benefit amount, or a portion of it. You will be paid the injured person’s amount of Principal Sum, or a portion of the amount, as shown in the chart below.

For Loss of: Benefit:
Life Principal Sum
Both Hands or Both Feet or Sight of Both Eyes Principal Sum
One Hand and One Foot Principal Sum
Speech and Hearing in Both Ears Principal Sum
Either Hand or Foot and Sight of One Eye Principal Sum
Movement of Both Upper and Lower Limbs (Quadriplegia) Principal Sum
Movement of Both Lower Limbs (Paraplegia) Three-Quarters of Principal Sum
Movement of Three Limbs (Triplegia) Three-Quarters of Principal Sum
Movement of the Upper And Lower Limbs of One Side of the Body (Hemiplegia) One-Half of Principal Sum
Either Hand or Foot One-Half of Principal Sum
Sight of One Eye One-Half of Principal Sum
Speech or Hearing in Both Ears One-Half of Principal Sum
Movement of One Limb (Uniplegia) One-Quarter of Principal Sum
Thumb and Index Finger of Either Hand One-Quarter of Principal Sum

Loss means with regard to:

  1. hands and feet, actual severance through or above wrist or ankle joints;
  2. sight, speech and hearing, entire and irrecoverable loss thereof;
  3. thumb and index finger, actual severance through or above the metacarpophalangeal joints; or
  4. movement, complete and irreversible paralysis of such limbs

Injury means bodily injury resulting:

  1. directly from an accident; and
  2. independently of all other causes; which occurs while You or Your Dependents are covered under The Policy."


Spouse & Child Education Benefit

If you or your spouse are injured in a covered accident that results in loss of life, your dependents may receive up to $500 per year to cover educational expenses. Your dependents must be a post-high school, full-time student, enrolled in an accredited institution, at the time of or 365 days after you or your spouse's death. Your spouse is also covered under this benefit, should a covered injury result in a loss of your life. Your spouse may receive up to $500 per year to cover occupational training expenses within one year of your death.


Choose Your Beneficiary

Please designate your beneficiary on the application. You may designate anyone you would like. If you do not designate a beneficiary, your benefits will be paid to the executors or administrators of your estate, your spouse, equal share to your children, or your parents, if no child survives you, in that order. If you have selected insurance for your spouse you will automatically be designated as the beneficiary.


Apply Today

You can download, complete, sign and return the application. Send no money now. Application is subject to approval of the underwriting company.


30-day FREE Look

When you receive your Certificate of Insurance, please read it carefully. If you're not completely satisfied, simply return your Certificate, without claim, within 30 days. If you've paid any premium, it will be promptly refunded. No questions asked.



*At age 70 the benefit amount will reduce to the lesser of $20,000 or 50%; at age 75 the benefit amount will reduce to lesser of $10,000 or 50%.

**This information is written in connection with the promotion or marketing of the matter(s) addressed in this material. The information cannot be used or relied upon for the purpose of avoiding IRS penalties. These materials are not intended to provide tax, accounting or legal advice. As with all matters of a tax or legal nature, you should consult your own tax or legal counsel for advice.

Life Form Series includes GBD-1000, GBD-1100, or state equivalent.

Monthly Term Life Group Rates

Age $50,000 $100,000 $250,000 $500,000
Under 24 $3.00 $6.00 $15.00 $30.00
25-29 $3.50 $7.00 $17.50 $35.00
30-34 $5.00 $10.00 $25.00 $50.00
35-39 $6.00 $12.00 $30.00 $60.00
40-44 $8.50 $17.00 $42.50 $85.00
45-49 $11.50 $23.00 $57.50 $115.00
50-54 $18.00 $36.00 $90.00 $180.00
55-59 $31.50 $63.00 $157.50 $315.00
60-64 $50.50 $101.00 $252.50 $505.00
65-69* $67.50 $135.00 $337.50 $675.00


Age $10,000 $20,000
70-74*† N/A $40.60
75-79*† $33.70 N/A
80-84*† $57.70 N/A


*Premium rates for persons 65 or older are renewal only.

†At age 70 the benefit amount will reduce to the lesser of $20,000 or 50%; at age 75 the benefit amount will reduce to lesser of $10,000 or 50%.

Rates and/or benefits may be changed on a class basis. Rates are based on the attained age of the Insured person and increase as you enter each new age category. You will be billed monthly.


Life Form Series includes GBD-1000, GBD-1100, or state equivalent.


When Coverage Begins:
Coverage for you and your spouse will become effective on the first day of the month following the Administrator's receipt of your application, approval and first premium payment.
When Coverage Ends:
As long as you pay your premiums when due, remain an active member of the Association of the United States Army, and the Master Policy remains in force, you may keep this coverage until you reach age 85. Coverage for you will terminate on the premium due date coinciding with or next following your attainment of age 85, or when you cease to be an Eligible Person as defined in the policy. In addition, spouse coverage will terminate when they no longer meet the eligibility criteria as outlined above.


Suicide: If You or Your Dependent commit suicide: 1) during the first two years of coverage under The Policy, We will only pay the deceased person's Life Insurance Benefit in an amount equal to the premium paid for coverage to the date of death; or 2) during the two years immediately following an increase in coverage under The Policy, We will only pay the deceased person's Life Insurance Benefit in an amount equal to the amount of Life Insurance in force prior to the increase, plus an amount equal to the premium paid for the increase to the date of death. The full Life Insurance Benefit amount for the deceased person is payable if he or she is covered under The Policy and commits suicide after the two year period.

Accidental Death and Dismemberment Benefit Exclusions:  (Applicable to all benefits except the Life Insurance Benefit and the Accelerated Benefit.)
The Policy does not cover any loss caused or contributed to by: 1) intentionally self-inflicted Injury; 2) suicide or attempted suicide, whether sane or insane; 3) war or act of war, whether declared or not; 4) Injury sustained while on full-time active duty as a member of the armed forces (land, water, air) of any country or international authority except Reserve or National Guard Service. (We will refund the pro rata portion of any premium paid for You or Your Dependents while You or Your Dependents are in the armed forces on full-time active duty, for a period of two months or more. Written notice must be given to Us within 12 months of the date You or Your Dependents enter the armed forces.); 5) Injury sustained while on any aircraft except a Civil or Public Aircraft, or Military Transport Aircraft; 6) Injury sustained while on any aircraft: a) as a pilot, crewmember or student pilot; b) as a flight instructor or examiner; c) if it is owned, operated or leased by or on behalf of the Policyholder, or any Employer or organization whose eligible persons are covered under The Policy; or d) being used for tests, experimental purposes, stunt flying, racing or endurance tests; 7) Injury sustained while taking drugs, including but not limited to sedatives, narcotics, barbiturates, amphetamines, or hallucinogens, unless as prescribed by or administered by a Physician; 8) Injury sustained while riding or driving in a scheduled race or testing any Motor Vehicle on tracks, speedways or proving grounds; 9) Injury sustained while committing or attempting to commit a felony; or 10) Injury sustained while Intoxicated.

Intoxicated means: 1) the blood alcohol content; 2) the results of other means of testing blood alcohol level; or 3) the results of other means of testing other substances; that meet or exceed the legal presumption of intoxication, or under the influence, under the law of the state where the accident occurred.

Reserve or National Guard Service means You or Your Dependents are:1) attending or en route to or from any active duty training of less than sixty (60) days; 2) attending or en route to or from a service school of any duration; 3) taking part in any authorized inactive duty training; or 4) taking part as a unit member in a parade or exhibition authorized by official orders.


This website explains the general purpose of the insurance described, but in no way changes or affects the policy AGL-1978 as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.

Acceptance into this plan is subject to medical evidence of insurability as determined by The Hartford1. Depending on your age, the amount of coverage you request, and your answers on the application, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you.

This is private insurance.  This insurance is not associated with SGLI.
Approved by:
AUSA Group Insurance Plans
PO Box 9947, Phoenix, AZ 85068
Underwritten by:
Hartford Life and Accident Insurance Company
One Hartford Plaza, Hartford, Connecticut 06155
1The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.
Administered by:
AGIA, Inc.
PO Box 9947, Phoenix, AZ 85068
AGIA, Inc is the Plan Administrator and Insurance broker that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder. AGIA, Inc  is compensated for the placement of insurance and for the services it provides to customers on behalf of the insurance company, in addition to other compensation it may receive. AGIA, Inc. is licensed/authorized to transact business in all 50 United States, and the District of Columbia. Their state of domicile is California.
J. Christopher Burke's Texas Agent License Number is 1446907.



Life Form Series includes GBD-1000, GBD-1100, or state equivalent.

Download, print and mail in your application today!


Here are the instructions to select the right application for your needs:

  1. Decide how much coverage you will need: You may add up to $500,000 in benefits. If you decide to select between $10,000-$150,000 in coverage, download the "Simplified Issue" Application. If you decide to select between $160,000-$500,000 in coverage, download the "Fully Underwritten" Application.
  2. California Residents: Be sure to select the California specific application
  3. Download and Print: Click on the button to download the form and print
  4. Complete the form: Please complete all fields on the application.
  5. Mail in your application: Address your envelope to the AUSA Group Insurance Plans at PO Box 9947, Phoenix, AZ 85068


For Coverage between $10,000-$150,000:
Simplified Issue Application
California Simplified Issue Application



For Coverage between $160,000-$500,000:
Fully Underwritten Application
California Fully Underwritten Application


Life Form Series includes GBD-1000, GBD-1100, or state equivalent.

Group Term Life Sidebar Content

Apply for Your AUSA Group Term Life Coverage Now


You're under no obligation today because you're fully backed by a 100% Satisfaction Guarantee.

Your official Certificate of Insurance outlines the full terms and conditions of this AUSA plan. Take up to 30 days to look it over. If it's not what you had in mind, mail back the Certificate for a 100% refund; less any claims paid.


Questions? Call AUSA's Customer Service and Claims Phone number at 1 (800) 882-5707.


Policy Number AGL-1978

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