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NJSFAC/BOLLINGER
NEW JERSEY STATE FIRST AID COUNCIL
ACCIDENT ONLY LONG TERM DISABILITY INSURANCE
Program Eligibility and Structure
2009/2010
 OVERVIEW
To enroll in the NJSFAC’s accident only disability program
requires each participating squad to complete an application.
This document will explain the application form, premiums, and
eligibility. Please read carefully.
ELIGIBILITY and PREMIUMS
- We will have a two month open
enrollment period from May 1st to June 30th.
- The plan effective date will
be July 1, 2010.
- The policy
year is July 1st to June 30th.
- The cost
is $36.00 per member per policy year.
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The cost
is $36.00 per immediate family member per policy year.
Each squad must define their own eligibility according to each
squad’s bylaws. Squad members and their immediate family are
eligible. 100% of eligible squad members must be enrolled.
For open enrollment, the squad must (See Enrollment instruction
Tab):
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Complete
the squad application.
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Complete
and email the covered member roster form.
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Submit a
check payable to Bollinger for the total amount based on
the instruction page of the covered member roster form.
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Enrollment must be received by
June 15, 2010
QUESTIONS
If you have any questions, please refer to our website
NJSFAC.org and click on member benefits. You can also call
Bollinger at 800-952-4050 and reach Irene Walton at extension 4765.
PLEASE NOTE: AIG requires enrollment of 4,000 members
for the continuance of this program.
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