Tampa-Administered Forms for Florida

Forms are separated in three categories:

  • Pre-Sale Forms—Licensing, Master Applications, Statement of Insurability, etc.
  • Post-Sale Forms—Enrollment, Individual Applications, Refusal of Insurance, Reporting Summary etc.
  • Post-Policy Forms—Claim, Change of Beneficiary, Reinstatement, etc.
Pre-Sale Back To Top

. 06670220-2000FL Master Application for Employee Benefits FL
.06673131-1005FL Master Application for Critical Illness Insurance Policy
.06673131-1006FL Master Application for Group Accident & Sickness Indemnity Insurance Policy
. 06673571-1005FL Statement of Insurability for Group Programs FL
. 06673571-1098FL Application for Group Voluntary Programs All FL
. 06673571-1496FL Application for Group Voluntary Programs Life & AD&D FL
. AGLC101519FL Application for Life Insurance FL

The above are the only state-specific forms. Additional forms can be found on the the General Forms page.

Post-Sale Back To Top

. 06673571-1003FL Individual Application for Group Critical Illness Insurance FL
.  06673571-1003FL-GCA Individual Application for Group Cancer Indemnity Insurance FL
.06673571-1004FL Individual Application for Group Accident and Sickness Indemnity Insurance FL
. 06673571-1005FL Statement of Insurability for Group Programs FL
. 06673571-1098FL Application for Group Voluntary Programs All FL
. 06673571-1496FL Application for Group Voluntary Programs Life & AD&D FL

The above are the only state-specific forms. Additional forms can be found on the the General Forms page.

Post-Policy Back To Top

There are no state-specific forms. Use forms located on the General Forms page.