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2016-17 Student Accident/Sickness Insurance Coverage Application

This year coverage’s will be provided by National Guardian Life Insurance Company and 2016-17 claims will be processed through Guarantee Trust Life Insurance Company. Claim form is attached.

The 24 Hour combined Accident/Sickness coverage must be purchased within 75 days of the start of the new school year or within 75 days of entering the school district as a new student. The other exception will be if a parent loses their insurance, they would be eligible to purchase this coverage.

Football coverage is for the football season only. If a parent wishes to purchase coverage to go beyond the football season, they will need to purchase the At-School 24 Hour coverage in addition to.

The parents may purchase the additional coverage when they purchase the football coverage or at a later date.

Please remember the student’s effective date of coverage will be the date we receive the completed application along with payment.

Contact Information
Joyce Menart
Love Insurance Agency


Click here to download application form