​INSURANCE GUARANTEES 

• Guaranteed Renewal

Only you can discontinue this insurance once you are covered.  As long as the Group Master Policy stays in effect and the premiums are paid when due, you can never be singled out for cancellation no matter what happens to your health.  You can renew this coverage up to age 80, for as long as you choose, even if your health deteriorates.

• Guaranteed Level Benefit

The benefit amount you choose will never go down, regardless of any change in your health.

• Guaranteed Payment With A Covered Claim

Your beneficiaries will get the benefit amount you selected for a covered loss with no waiting periods or partial payments.  Once in effect, you are covered.

• Guaranteed Spouse Eligibility

Your spouse, age 18-74, is guaranteed to be eligible to apply even if you don’t apply and even if they are not a AAA member.  The definition of spouse includes Registered Domestic Partner, Civil Union Partner, or party to a domestic partnership between two adults, as recognized by state law.
 
​"LIVING BENEFIT" 
Your AAA Exclusive Members Only Group Term Life Insurance allows you to collect benefits while you’re alive thru the “Accelerated Death Benefit”.  This means if you’re ever diagnosed with a terminal illness, and death is anticipated within 12 months or less, you can get up to half of your benefits early to help with expenses.
 
​CONVERSION PRIVILEGE 
At any time before you turn 65, you can convert your Exclusive Members Only Group Term Life Insurance coverage to a permanent life insurance policy from AAA.    Conversion is guaranteed regardless of your health at the time.

• You must be a AAA member ages 18-74 to purchase.  The policy can be renewed until it expires at age 80.
• There are 4 Benefit Amounts to choose from.  $50,000, $100,000, $200,000, & $300,000.
• There are different monthly premiums for nicotine vs. non-nicotine users.
• The premiums are banded into age brackets.   Ages 18 to 34 the premium stays the same.  At age 34 the premiums start to increase and will increase every 5 years until the policy expires at age 80.   Although you cannot be singled out for a rate increase, the premiums are NOT guaranteed.   Your premiums may change only if they are changed for all other insureds with the same age, gender, nicotine use, coverage amount, and year of issue.
• Premiums payments can be made from a checking account or credit card.  A $3 charge will be added to your premium if you wish to receive a monthly bill.

Step 1.  Member Information & Spouse Information – if applying.

• Name
• Home Address
• Phone #
• Email Address
• Beneficiary Name
• Beneficiary Relationship
• Amount of Coverage Desired
• In the last 12 months, have you used nicotine in any form?  Yes or NO
• Gender
• Date of Birth (Must be 18-74 to apply)
• Height & Weight

​Step 2.  Provide Payment Method

• Deduct payment from checking account each month.  Will need to provide account & routing number as well as a copy of a voided check.

OR

• Charge payment to a credit/debit card each month.  Visa, MasterCard Discover and AmEx accepted. Need to provide card number, expiration date, and the name as it appears on the account or card.

​Step 3. Statement of Health
Each of the following questions are answered by checking the box yes or no.

1. In the past 12 months, have you been admitted to a hospital or had diagnostic testing performed or recommended by a doctor for an diagnosed condition?
2. In the past three years, have you been treated OR diagnosed by a doctor as having heart trouble, cancer, stroke, lung disease, liver disease, kidney disease, AIDS, lupus, diabetes treated with insulin, ALS, or dementia?
3. In the past three years, have you been confined to a nursing home, or special treatment facility OR convicted of a felony or driving under the influence?

​Step 4. Other Insurance
Yes or No.  Is there insurance applied for intended to replace, discontinue, or change any existing insurance or annuity?
​
Step 5. Read, Sign, and Date

• All answers in the application are, to the best of my knowledge and belief, true.  I understand the answers will be used to determine if coverage will be issued, and the application will be part of the Certificate of Insurance.
• In accordance with its incontestability provision, if I misstate any of the information on this application, the Certificate my be voidable for 24 months from the effective date by AAA Life Insurance Company.
• I authorize the Company to use the payment method I indicated on this application.  This authorization will remain in effect until I notify the Company in writing to cancel it.
• Coverage will take effect on the Effective Date shown on the Certificate, provided the first premium has been paid and there has been no change in my health since the date of the application.  If my health changes prior to the Effective Date of the Certificate, I must promptly inform the Company in writing.
• I authorize any licensed physician, medical  practitioner, hospital, clinic, pharmacy, pharmacy benefit manager or other medical relate facility, consumer reporting agency, insurance company, or other organization that has any records or knowledge of my medical or prescription history, credit attributes, public records, driving record, or social security number, to give any such information to the Company, its re-insurers or any entity retained by the Company to collect and transmit such information.
• The company will not use or disclose medical information for any purpose other than stated above except as may be required or permitted by law.  Such medical information may be subject to re-disclosure and may no longer be protected by federal privacy regulation.
• The authorization shall be valid for 24 months from the date signed.  I understand I or my representative have a right to a copy of this authorization.
• I may revoke this authorization at any time by writing to the Company, and if I do, the Company may decline my application.