GBA - Individual Long Term Disability Coverage

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Home > Individual Coverage > Long Term Disability

Long term income replacement if you are sick or injured.

Income replacement for up to 66% of your monthly income.
Options lasting for 5 years in duration up to age 65.

Please Contact Us for information and pricing.

Three Simple Steps..

1. Open and print the Individual Application

2. Fill everything out and remember to sign and date the form.

3. Fax it back to GBA at 614-410-0999

Start NOW!

Note: You will need Adobe Acrobat Reader, free software that lets you view and print PDFs. Click the image to download.

©2002 Group Benefits Agency, Inc.
1105 Schrock Road, Suite 236 Columbus, Ohio 43229
(614) 785-1991 1 (800) 282-3934 Fax (614) 785-0266