Stars and Stripes Loyalty Accident Insurance Enrollment Form

Yes, by all means, I want to start enjoying the Hartford Life Stars and Stripes Group Accident Insurance coverage. Please send me my Certificate of Insurance reflecting the coverage available to me as a loyal Member. I understand that my coverage will take effect the 1st of the month following receipt of this completed Enrollment Form along with my first premium payment. The VFW Auxiliary Insurance program will bill me once this form has been received. 

Optional: Download this enrollment form and submit with your premium payment for faster service. 

View all terms, descriptions, exclusions and limitations.

Accident Form Series includes GBD-1000, GBD-1300, or state equivalent.

Hartford Life and Accident Insurance Company
One Hartford Plaza
Hartford, CT 06155

If you have any questions about this plan call the VFW Auxiliary Insurance Program, toll-free at 1.800.550.5287, weekdays from 8:00 a.m. to 8:00 p.m., Eastern Time.