Thank you for your interest in PET-sponsored Insurance Coverage!

We have conveniently set up this site to handle all of your AD&D and Term Life needs.

Term Life Insurance, up to $500,000¹

Click here to enroll in Term Life coverage online on our secure server.

Application forms to print out and mail

• Application Form ($25,000 or $50,000 of Coverage)
• Application Form ($100,000 or More of Coverage)
• Notice of Information Practices

More information on the plan can be found below:

• Plan Description
• Rates
• Beneficiary Designation Form
• To Initiate a Claim

Form SRP-1153 A (HLA)(1687)

Overview: Coverage up to $300,000¹

Click here to enroll in AD&D coverage online on our secure server.

Click here to for an application form to print out and mail.

More information on the plan can be found below:

• Plan Description
• Rates
• Beneficiary Designation Form
• To file a Claim

*National Employee Benefit Companies, is the Plan Administrator that administers the insurance plan on behalf of the Hartford Life and Accident Insurance Company for the benefit of the Group Policyholder. National Employee Benefit Companies and Copeland Insurance Services Inc., are 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.

Form 7582 A2 (11037)

1. At age 65, or if your are already age 65, all coverage is reduced by 50%

Policies underwritten by the Hartford Life and Accident Insurance Company, Simsbury, CT 06089.

For information, including costs, exclusions, benefit reductions, limitations and terms of coverage, click on the links above or call Copeland Insurance Services at (800) 662-0390.