AFFILIATED 

BENEFIT REPRESENTATIVES

[ Home ] INSURE YOUR MOST VALUABLE ASSET! . . . . . . . . .YOUR ABILITY TO EARN AN INCOME. BUY DISABILITY INCOME!

 

 

[ Want Colonial? ] [ **Call Center Support Materials** ] [ Voluntary Benefits ] [ Got Life (insurance)? ] [ Career Opportunities ] [ Employee Benefits ] [ KAISER EMPLOYEES ] [ About Us ] [ Training Videos ] [ IRA Distribution Planning ] [ BENEFIT STATEMENT EXAMPLES ] [ Open Enrollment ] [ Postal Home Page ] [ STATE OF CALIFORNIA EMPLOYEES ] [ Links ] [ Spanish Benefit Communication ] [ Corporate Benefits ] [ Individual  Needs ] [ Personnel ] [ Prepaid Legal and Identity Theft Protection ]

If you are interested in obtaining Colonial Coverage or you need service, please complete the form below. A representative will contact you within 24 hours.

YOU CAN ALSO CALL (213) 261 5088 24 HOURS A DAY

Who is your employer? Pick one below.

 

What kind of Colonial Coverage are you looking for?

Disability Income Life Insurance Cancer Insurance 

 Accident Insurance   Medical Supplement Insurance. 

 More than 1 product    Other

 Other Comments :

If you are not looking for coverage but are in fact looking for "service" on your existing policy please indicate check here.

Policy Number (For exsiting policy holders who need service only)

Description of Service you need on your policy:

If you are either self employed or working for a company not listed above, please state the name of your employer or the name of your business and give a brief description of they type of work you do below

Tell us how to get in touch with you:

Name: 
E-mail: 
Tel: 
FAX: 
STATE YOU WORK IN: 
Please contact me as soon as possible regarding this matter.

    If you'd like to see what the experience of meeting with a Colonial Representative would be like click here.