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Accidental Death and Dismemberment

The Group Accidental Death and Dismemberment (AD&D) Insurance Plan helps provide broad accident coverage

Forms

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

Please note that some states have state-specific certificates of insurance. If you currently reside in a state that is listed, please click on that state’s certificate. If you reside in a state not listed, please click on the “All Other States” certificate.

MSBA – Voluntary AD&D – Members Certificate – MN
MSBA – Voluntary AD&D – Employees Certificate – MN
MSBA – Voluntary AD&D – Members Certificate – ND
MSBA – Voluntary AD&D – Members Certificate – All Other States
MSBA – Voluntary AD&D – Employees Certificate – All Other States

Contact Information

We’re here to help! Please contact us in whatever manner is most convenient for you.

Address

AMBA
PO BOX 14533
DES MOINES, IA 50306

Underwriting Company

Metropolitan Life Insurance Company
200 Park Avenue
New York, NY 10166

MSBA
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