Agent Document Site

AccidentShield is available in all states and DC except Arkansas, Kansas, Maine, Maryland, New Mexico, North Carolina, Oregon, South Dakota, Utah or Washington.

The TTD (DI) benefit is not available in CA, CT, FL, MN, NJ, NY or VT.

An active contract is required to market this plan. Please contact your MGA for details and contract paperwork.

AccidentShield can be sold using paper applications or through our online enrollment site.

Most questions about the plan are answered by visiting the FAQ section of the online enrollment web site.
Please do not hesitate to contact us for other questions or clarification.

Agent Sales Guide	Agent Guide	Answers to many of your questions.
Sales Brochure	Brochure	Sample of glossy paper sales brochure.
"Paper" Application	Application	All State application.
Employer List Bill	List Bill	Employers can list bill for voluntary participation.
Multi-State Cert	Cert	Includes TTD (DI)
Limited State Cert	Cert	Does NOT include TTD (DI)
Sample Booklet	Booklet	Sample of the client fulfillment booklet
Rx Card	Rx Card	Prescription Discount Card
Claim Form Accident Medical Expense	Medical Claim	Client claim form
Claim Form Accident Disability Income	DI Claim	Client claim form
Client Payment Change Form	Change	Change payment form for ACH, Credit or Debit