Apply for the SAF Comprehensive Accident Plan today
	Just three easy steps to get the protection you need
	Choose either the $50,000 Plan or the $100,000 Plan and download the Application Form. Complete, sign, and date the form. For coverage up to $100,000 click here* *Applications are provided in pdf format.  To view the application, you must have Acrobat® Reader® installed. You can download Acrobat® Reader® from the Adobe® Web site: http://www.adobe.com/products/acrobat/readstep2.html Find your semiannual premium using the rate chart. Mail your completed application along with your check for the first semiannual premium payment, made payable to SAF Insurance, to:         JZA Affinity         7735 Old Georgetown Road, Suite 800         Bethesda, MD 20814 Underwritten By Hartford Life and Accident Insurance Company, Simsbury, CT. Form 7582 A2 (HLA) (11039) Questions? Call your SAF Customer Service Representative toll-free at 1-800-865-2727 x1792. Return toSAF Comprehensive Accident Plan Information Page