Group Accident Enrollment Forms

Please use the form specific to state of enrollment or generic if your state is not listed.

The following states are not yet approved for enrollment: CT, HI, ME, MD, MA, MN, NH, NJ, NY, OR, PA, PR, WA, WY 

The forms are provided in the Adobe Acrobat (PDF) format. In order to open the files you need Adobe Reader installed on your computer. Download the latest version of Adobe Reader®.


Want more information?

New Statutory Office
Effective December 18, 2017, 5Star Life Insurance Company (5Star Life) moved its statutory Office from Baton Rouge, Louisiana to Lincoln, Nebraska.
There are no changes to 5Star Life insurance contracts and life insurance contracts offered by Armed Forces Benefit Association (“AFBA”).
All AFBA products are underwritten by 5Star Life, except in New York. No action is required by the policyholder.