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.

Items on this page require Adobe Acrobat

Agent Sales Guide
Agent Guide
Answers to many of your questions.
Sales Brochure
Sample of glossy paper sales brochure.
"Paper" Application
All State application.
Employer List Bill
List Bill
Employers can list bill for voluntary participation.
Multi-State Cert
Includes TTD (DI)
Limited State Cert
Does NOT include TTD (DI)
Sample 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 payment form for ACH, Credit or Debit

Wholesale Benefits Association
Marketed by
Comprehensive Insurance Agency, LLC
3601 Algonquin Rd. - Suite 605
Rolling Meadows, IL 60008