Enrollment Forms





Agent Forms



Cancellation Forms



You can mail or fax forms to:
Professional Benefit Administrators
1000 Hurricane Shoals Road
Suite C 370
Lawrenceville, GA 30043
Phone: (770) 963-3939
Tollfree: (800) 578-2082
Fax: (770) 963-6126
Tollfree Fax: (888) 264-6975
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Professional Benefit
Administrators has over 20 years experience assisting in the
administration of health related supplemental benefits including Dental Insurance,
Life Insurance, Vision Insurance, Short and Long Term Disability and Critical care.
The uniqueness of our
administrative system gives us the ability to not only specialize in the
administration of payroll deduction for federal employees nationwide, but
allows us to offer a variety of payment options to all of our benefit
subscribers.
To be competitive in
service and product availability we represent the following companies:
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5 STAR LIFE
AFLAC
AIG AMERICAN GENERAL
ALL STATE
AMERICAN FIDELITY
AMERICAN HERITAGE
AMERICAN NATIONAL
AMERICO
APL
ASSURITY
LIFE
BROKERS NATIONAL
DENTAL
CAREINGTON DENTAL
CENTRAL UNITED LIFE
CITIZENS SECURITY
COLONIAL LIFE
COLORADO BANKERS
COMPBENEFITS
DELTA DENTAL
DENTAL SOURCE
DINA DENTAL
DOMINION DENTAL
FIDELITY & GUARANTEE
FORESTERS
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GLOBE LIFE
GREAT AMERICAN LIFE
HUMANA
INDUSTRIAL ALLIANCE PACIFIC
ITT LIFE
KANAWHA
LIFE OF ALABAMA
LIFE OF THE SOUTHWEST
MADISON NATIONAL LIFE
MIDLAND NATIONAL
MUTUAL TRUST LIFE
NATIONAL LIFE GROUP
NORTH AMERICAN LIFE
PIC SUNLIFE
PREPAID LEGAL
PRINCIPAL
SOUTHWESTERN LIFE
OHIO STATE LIFE
SURETY LIFE
TEXAS LIFE
TRANSAMERICA
UNION CENTRAL
WEST COAST LIFE
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