Commonly Used Forms
These following insurance forms are available for the use of the GBA members who participate in the GBA Insurance Trust insurance programs.
- GBAIT Request for Change
- GBAIT Group Insurance Enrollment Card
- GBAIT Group Insurance Enrollment Card - Regular Part-Time Employees
- GBAIT HMO/POS Application
- GBAIT HMO/POS Change Form
- GBAIT Death Beneficiary Claim Form
-
GBAIT Medical
Questionnaire
(Late Enrollee for Dependent Life Insurance) -
GBAIT Evidence of
Insurability
(Late Enrollee for Long Term Disability Insurance)
Please mail all completed forms to the attention of Susan Kelley at:
GBA Insurance Trust
50 Hurt Plaza, Suite 1050
Atlanta, Georgia 30303
Insurance Trust
Staff
Dan Thomason
Susan Kelley
Lee Belaus
Courtney Rowland
Marketing &
Service
Holmes/Shaw Agency
Bruce Shaw
David Holmes
Rad Downey
Skip Hill
Guy Whidby
Noel Williams