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Affordable Term Life Coverage for Your Company

It's important to provide your employees with affordable, high-quality benefits. Mutual of Omaha can help you meet that objective. When you provide employees with our Term Life insurance with optional AD&D coverage, you'll be helping them protect their families with financial security during life's most difficult transitions. And, you'll be taking advantage of AIM's buying power to obtain the coverage at a low cost.

To get started, select the amount of life insurance you want to provide your employees and enter the total number of employees your company has in each age group.

Once you have completed these steps, you'll be asked to provide additional information which will be sent to Mutual of Omaha for consideration.

Volume per Person:

Age Range Number of Lives Volume
0-39
40-49
50-59
60+
Totals

Rate Calculations for Term Life and AD&D coverage

Life AD&D (optional) Total
Rate/1000
Monthly Premium
Annual Premium

Employer Group Contact Form

Based on the information you supplied us, you can provide your employees with Term Life coverage from Mutual of Omaha at the low rate below. For more information about how Mutual of Omaha can build a customized Term Life with AD&D plan to fit your specific company needs, please enter your information below and a Mutual of Omaha representative will contact you within two business days.

Volume:
Total Lives:
Total Volume:
Monthly Premium:
Annual Premium:

Group Insurance Application Request
Completion of this form is for consideration of group life insurance coverage through Mutual of Omaha.

Group Name:
Contact Name:
Address:
City:
State:
Zip:
Phone:
E-mail:
Requested Effective Date:
I am also interested in:
Employee Assistance Program (EAP)
Travel Assistance

Actively Working requirement
An employee must meet an Actively Working requirement to become insured. Are all proposed insureds actively working full-time?  
Yes   No

Certain states have enacted legislation requiring insurers to provide specific coverage for people residing in their states. Do you have employees residing in or working in other states? 
Yes  No

Financial Risk
If “Yes” to either of the following questions, please explain below
1. ) Has your company ever filed for bankruptcy? 
Yes No
2. ) Do you anticipate ceasing or materially reducing your company’s active business operations? 
Yes No

Explanation:

Application is made on the basis of the proposal, any available experience data and the information contained in this application request.

Fraud Warning – Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

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Life and AD&D insurance underwritten by United of Omaha Life Insurance Company, Mutual of Omaha Plaza, Omaha, NE 68175. Policy 7000GM-U-EZ 2001 or state equivalent.

AFN41033-1