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Girl Scouts of the USA

Forms

Girl Scouts of the USA

* All forms on this site are in PDF format. In order to view these documents, you will need to have Adobe Acrobat Reader. If you do not have Adobe Acrobat Reader, download it here.

Plan 1-Basic Coverage Brochure

English Version	Spanish Version
Enrollment Forms *	Overseas Enrollment Forms
Select the form that you would like to view:	Select the form that you would like to view:
Online Enrollment Forms Plan 2 Plan 3E Plan 3P Plan 3PI	Plan 2 Plan 3E Plan 3P Plan 3PI
Claim Forms **
NOTE: The address section on the claim form must be the Claimant s Home Address, not the Council or Resident Camp address or the address where the covered event was held.
English Version	Spanish Version
** Claims will not be processed without Council signature
Frequently Asked Questions
Plan 1 Plan 2 Plan 3E Plan 3P Plan 3PI
Other Forms
How to File a Claim How to Enroll Supply Order Form Girls Scouts Activity Accident Insurance (and Optional Insurance Plans) Administrative Guide for Councils Trip Roster Online Users Guide

United of Omaha relies on the Council to validate/authorize both Enrollment Forms and Claim Forms prior to processing. Enrollment Forms and premium must be received prior to the beginning date of any event, United of Omaha cannot back date coverage. Claim Forms and appropriate bills should be filed/submitted as near the date of the accident as reasonably possible.

Mutual of Omaha Insurance Company is licensed in all 50 states; United of Omaha Life Insurance Company is licensed in all states but New York. In New York, Companion Life Insurance Company, Lynbrook, NY, underwrites life insurance and annuities.

AFN 31231