How You Can Help Make the Application Process Go Smoothly
When you fill out your application, make sure your answers are complete and detailed. Answer all questions, so processing of your application won’t be delayed.
Complete medical information should include the name of physician(s) or hospital(s), street address (and suite or room number), city, state and zip code. Also include a brief description of the nature of an illness or injury, symptoms, treatment and results.
The insurance company underwriting your application relies on your answers and statements. Misstatements or failures to report information on your application may be used as the basis for denying or reducing claim benefits, or even invalidating your insurance.
Applying is Easy
1. Check the Insurance Plans page to locate the Plan of your choice. You’ll find a description of Plan benefits and premium costs. Please refer to this Plan description as you complete your Application, which is located here. Please complete it fully, being sure that it is signed and dated.
2. For the Term Life, First-to-Die Life, 10-Year Level Term Life, Disability, Comprehensive HealthCare, HSA Qualified and Catastrophic Major Medical Plans, send no money now. You will be billed once coverage is approved.
For all other Plans, please make out your premium check for the total amount due. If you are requesting coverage for your spouse or children, you'll need to add their premium to yours. Make your check payable to: SPE Insurance Program.
3. Mail your signed, completed application with your premium check, if needed now, to:
SPE Insurance Program
P.O. Box 189
Santa Barbara, CA 93102-0189
Have a Question or Need Additional Information?
Call Toll-Free or E-Mail
If you have a question, need more information or you need to file a claim, please don’t hesitate to contact your SPE Customer Service Representative.
SPE Insurance Plan Applications
Group Life Insurance
Term Life Insurance Plan
The SPE Term Life Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Residents of New York State: Click here for an application specific to your State.
First-to-Die Term Life Insurance Plan
The SPE First-to-Die Insurance application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Residents of New York State: Click here for an application specific to your State.
10-Year Level Premium Term Life
The 10-Year Level Premium Term Life application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Residents of New York State: Click here for an application specific to your State.
High-Limit Accident Insurance Plan
The SPE High-Limit Accident Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Medical
Comprehensive HealthCare Insurance Plan
The SPE Comprehensive HealthCare Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Health Savings Account Qualified Health Insurance Plan
The SPE HSA Qualified Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Disability
Disability Income Insurance Plan
The SPE Disability Income Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Supplemental
Dental Insurance Plan
The SPE Dental Insurance application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Cancer Expense Insurance Plan
The SPE Cancer Expense Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
In-Hospital Insurance Plan
The SPE In-Hospital Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
Catastrophic Major Medical Insurance Plan
The SPE Catastrophic Major Medical Insurance Plan application is available to view and print here. It may be viewed and printed only with Adobe Acrobat Reader.
SPE Discount Medical Plan
The SPE Discount Medical Plan Enrollment form is available here.
SPE Insurance Claim Forms
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Cancer Expense |
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Dental | |
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In-Hospital | |
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Health/Medical (Comprehensive HealthCare, HSA Qualified Health, Major Medical and MSA Qualified Health) | |
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Additional health/medical state forms (for residents of CA, CO, FL, ME, NJ, NY, VA, and VT) |