Enrollment Steps:

Please complete the following easy steps to enroll in this great new benefit:

STEP 1
Complete, Sign and Date Enrollment Form. Be sure to include information on all individuals to be covered.

STEP 2
Complete, Sign and Date the Payment Options Form (included with the Enrollment Form).

STEP 3
Write a Check made payable to Greater Insurance Service for the first month’s premium.

STEP 4
Return the above items to:

Greater Insurance Service Corp.
PO Box 8633
Madison, WI 53708-8633