Request for Group Insurance from New York Life Insurance Company New York, NY 10010.  Policyholder AANA Group Insurance Trust.
New York Life Insurance Company (NAIC 66915) is licensed to transact business in all 50 states including the District of Columbia
and is domiciled in the state of New York at 51 Madison Avenue, New York, NY 10010.

Apply in four easy steps

Your Information Your Benefit Your Health FINISH & SUBMIT

We've made applying for coverage simple and quick

Please acknowledge that you have read the Plan’s benefits and features, accept the Terms of Electronic Consent and Disclosure and complete the information below.


Ft In


(show numbers)

Have you been actively engaged in the full-time duties of your occupation (at least 20 hours a week) during the 90 day period immediately before the date of this application?

If no, please explain (max 1000 characters, used: 0)

Electronic Consent and Disclosure   ·   Privacy Policy

Sorry to interrupt

We noticed that it's already 10 minutes since this page was displayed and we have not received your submission yet.

If you wish to have more time to complete entry of this step, please click the green link below, otherwise your application will be discarded in .