Southern Insurance Group
NATCA

NATCA Benefits Partner Since 2002

1-800-467-8571

Contact Us

Contact
Lance Liberty

Email:
liberty733@gmail.com

Phone:
440-309-6498

Address:
548 N. Willow
Cookeville, TN 38501

air traffic control tower

NATCA BENEFITS LIFE INSURANCE QUESTIONNAIRE

The following questions will help provide you with an accurate life insurance quote as well as cost-savings comparison to your current FEGLI insurance plan (if you are enrolled in FEGLI).

Your responses are confidential and will only be shared with your NATCA Benefits Partner Lance Liberty at Southern Insurance Group (SIG).

 

Name
Date of Birth
Email Address
Cell Phone
Married
How many children and what are their ages?
Facility
What does your leave and earnings statement show for your annual salary?
Do you have FEGLI life insurance?
If so, what amount is shown on your leave and earnings statement for FEGLI Regular (Option A)
If so, what amount is shown on your leave and earnings statement for FEGLI Additional (Option B)
If so, what amount is shown on your leave and earnings statement for FEGLI Family(Option C)
If you are not on FEGLI or have VGLI, or SGLI but would like to just see a quote, give us an amount, and we will run it for you.
Height
Weight
Have you used ANY tobacco products in the last 5 years. If so, what and when?
Are you currently taking any medications? If so, what and what for?
Have you gotten any moving violations or DUI in the past 5 years?
If so, when?
Are you a pilot?
How many hours have you flown in the last year?
How many hours do you anticipate in the next 12 months?
What are you licensed in and what are your ratings?
Prior to age 60 has your father passed away due to cancer or coronary related illness?
What illness?
Prior to age 60 has your mother passed away due to cancer or coronary related illness?
What illness?
Lastly, is there anything you want to comment on so that we can give you an accurate quote? This way we will show you how we can save you thousands on your insurance.

Remember, SIG (Southern insurance Group) has been a NATCA Benefits Partner since 2002 and we have saved over 6000 members of NATCA thousands of dollars on their insurance. We appreciate you giving us the opportunity to show you how we will be able to do you the same!