GROUP INSURANCE PLAN FOR ELIGIBLE EMPLOYEES OF THE UNITED STATES GOVERNMENT THE WAR AGENCIES EMPLOYEES PROTECTIVE ASSOCIATION
Document Type:
Collection:
Document Number (FOIA) /ESDN (CREST):
CIA-RDP57-00384R001200020004-5
Release Decision:
RIFPUB
Original Classification:
K
Document Page Count:
21
Document Creation Date:
December 9, 2016
Document Release Date:
August 6, 2000
Sequence Number:
4
Case Number:
Content Type:
MISC
File:
Attachment | Size |
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CIA-RDP57-00384R001200020004-5.pdf | 914.18 KB |
Body:
or R4lease 2001/08/17 : CIA-RDP57-00384R001200020004-5
00,000* Maximum
Payable as the result of death from any cause.
$20,000* Maximum
If death results from an accident.
:j'Or such amount of insurance as your salary classi-
fication entitles you.
GROUP INSURANCE PLAN
FOR ELIGIBLE EMPLOYEES
OP THE
UNITED STATES GOVERNMENT
THE WAR AGENCIES
EMPLOYEES PROTECTIVE
ASSOCIATION
Officers of the Association
FREDERICK J. LAWTON, President
EDWARD E. HUNT, Vice President
MARVIN W. WILL, Secretary-Treasurer
STACEY K. BEEBE, General Manager
NATHAN OSTROFF, Counsel
Board- of Directors
FREDERICK J. LAWTON ..................Bureau of Budget
EDWARD E. HUNT ....................Department of State
MARVIN W. WILL ....................Department of State
BERNARD F. BURDICK ..................The Panama Canal
WILLIAM G. THARP.... Central Intelligency Agency
GORDON D. TAFT ..............Department of the Army
THE WAR AGENCIES EMPLOYEES
PROTECTIVE ASSOCIATION
1040-43 WASHINGTON BLDG.
15th & NEW YORK AVENUES
WASHINGTON, D. C.
Telephone-Republic 7500-Ext. 16254
6254
COOPERATION PAYS OFF AGAIN!
Will every member please read the blue insert and
page 12 carefully. Will you try to procure another
member?
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UNDERWRITTEN BY
THE EQUITABLE LIFE ASSURANCE SOCIETY
OF THE UNITED STATES
NEW YORK, N. Y.
ONE OF THE LARGEST FINANCIAL
INSTITUTIONS IN THE U. S.
OLD LINE LEGAL RESERVE
LIFE INSURANCE COMPANY
EIGHTY EIGHT YEARS OLD
MORE THAN
41/2 BILLION DOLLARS ASSETS
100% MUTUAL
OVER 3,000,000 POLICY HOLDERS
LICENSED IN EVERY STATE IN THE UNION
ORIGINATOR OF GROUP LIFE INSURANCE
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A NON-PROFIT SERVICE
ORGANIZATION
Now Offers to
Civilian U. S. Government
Employees
Serving Overseas
$10,000.00 Low Cost
Group Life Insurance
Membership and Insurance May Be
Continued During Your Entire
Active Government Service
Whether Abroad or in the United States
No Travel Restrictions
No Restrictions Placed on
Payments of Benefits
INSURANCE BECOMES EFFECTIVE
AND IN FORCE AS OF THE DATE
OF APPLICATION
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EXECUTIVE OFFICE OF THE PRESIDENT
BUREAU OF THE BUDGET
WASHINGTON 25. 0. C.
- FOREWORD --
During the War, when unrestricted Life Insur-
ance coverage was unavailable to many Civilian
U. S. Government employees who were to serve
overseas, this association was founded on a mutual
non-profit basis to provide such protection. The
Equitable Life Assurance Society of the United
States entered a contract with your Association at
very low rates and with no restrictions as to medical
examination, travel, or occupational hazards.
. Many thousands of Government employees have
availed themselves of this liberal and low cost
coverage.
During the first four and one-half years of its
existence War Agencies Employees Protective Asso-
ciation has authorized distribution of $1,208,314.35
in benefits to its beneficiaries and members. The
continued demand from its old members, plus the
desire on the part of new applicants to obtain sim-
ilar protection has caused your officers and directors
to arrange with the Equitable for the continuance
of this protection for the indefinite future. You
may continue to enjoy this protection after your
return to the United States, and as long as you
remain actively employed in Government service,
during the lifetime of the Association. Thus a
service conceived as a war measure emergency will
continue to offer its unusual benefits and low cost
coverage in peacetime.
Qualified Government employees will, I feel sure,
choose to avail themselves of this most liberal offer.
Sincerely yours,
FREDERICK J. LAWTON
Administrative Assistant
President of the War Agencies
Employees Protective Association
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Approved
WAR DEPARTMENT
WASHINGTON
To OUR MEMBERS:
I feel so strongly about the need for inexpensive
life insurance for government employees assuming
overseas assignments that I have accepted the Presi-
dency of the War Agencies Employees Protective
Association. If you feel the need for greater life
insurance ' security for your families, I believe it
will be to your personal interest to familiarize your-
selves with the relatively large amount of life in-
surance obtainable through this Association for a
small premium.
The War Agencies Employees Protective Asso-
ciation was organized early in the war to provide,
on a mutual non-profit basis, life insurance for
civilian government employees serving outside the
continental limits of the United States. It is some-
what comparable to the National Service Life In-
surance Program provided for members of the
armed forces. The Association, the officers of which
serve without compensation, has made an arrange-
ment with The Equitable Life Assurance Society of
the United States, one of the country's oldest and
largest mutual companies and the originator of
group life insurance protection. Many thousands of
members already enjoy this low cost protection. I
am sure you will want to give this matter your earn-
est consideration.
Sincerely yours,
ROBERT P. PATTERSON
Secretary of War,
Ex-President of the War Agencies
Employees Protective Association,
1945-6.
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TO ELIGIBLE EMPL QYEES OF- THL
UNITED STATES GOVERNMENT
You may apply for membership and the amount
of Group Life Insurance for which you are eligible
to be effective as of the date you sign your appli-
cation.
On May 21, 1943 a plan of Group Life In-
surance was made available to members of the
Association under a Master policy issued by The
Equitable Life Assurance Society of the United
States, one of America's largest mutual com-
panies and the originator of Group Protection.
The primary purpose was to provide member-
ship and insurance to Civilian U. S. Government
Employees serving overseas.
This plan is a low cost private arrangement
between the Association and the Equitable, rather
than a Government financed and operated
program.
The background and advantages of membership
in the Association are as follows:
peal to Eligible Employees for many reasons:
It provides sound liberal protection.
The rate is low because of the Association's
Group purchasing power.
This rate may be reduced by dividends or other
benefits paid as determined by the Association,
a mutual non-profit organization.
No restrictions have been placed on the pay-
ment of benefits. The principal sum will be paid
in a lump sum or in instalments over a period
of years in the event of death from any cause.
Protection may be continued so long as you
continue your premium payments and are a mem-
ber of. the Association in good standing and the
member continues actively employed in Govern-
ment Service whether abroad or in the United
States.
The Association believes the protection will ap-
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PLAN OF INSURANCE FOR
ELIGIBLE EMPLOYEES OF THE
UNITED STATES GOVERNMENT
THE WAR AGENCIES
EMPLOYEES PROTECTIVE ASSOCIATION
ELIGIBILITY: Membership and Group Life
Insurance is offered to:
outside the continental limits of the United!
States, wherever domiciled.
2. All employees located in the United States
now in training for duties abroad or await-
ing transportation.
3. All supervisory or administrative employees
located in the United States who in the normal
course of their duties are required to make
trips abroad.
4. Directors of training programs for such em-;
ployees and Home Office Staff of WAEPA
Membership is limited to individuals in the above
classes who are actively engaged as employees of
the U. S. Government.
1. All employees of American citizenship nowJ
You become insured as of the date you apply
and no medical examination is required if you sub-
scribe for the insurance within 60 days following
the date you are first eligible for membership in
the Association. After that time, you can enter the
plan only by submitting a medical examination satis-
factory to the Equitable.
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Basic
Amount of
*Monthly
Annual Salary
Life Insurance
Cost
Less than $3,200
$5,000
$6.25
$3,200 and Over
10,000
12.50
within sixty days of the time your basic annual
salary is changed to qualify you for increased in-
surance, provided you are then actively at work
on the date you apply; if you are not actively at
work, the increase will be made effective upon your
return to active service. If you do not apply for
the increased insurance within sixty days of the
time you become eligible for such increased amount
and later wish to have the higher amount of insur-
ance it will be necessary that you submit to a medical
examination. satisfactory to The Equitable Life As-
surance Society at your own expense.
METHOD OF PREMIUM PAYMENT: If the
applicant elects to pay by allotment he must make
in advance an initial quarterly payment together
with a $2.00 membership fee. This remittance
(check, draft or money order) should be attached
to the application and forwarded tothe Association.
This payment is required because the insurance be
comes effective as of the date the application is
signed and is to carry the insurance in force up
until the time the payment of insurance premium
by allotment, as authorized by the applicant, be-*
comes operative.
Appropriate allotment forms may be executed by
applicants to provide for the payment of the group
premium by allotment subsequent to the first quar-
terly cash payment.
*In addition an initial $2 membership fee is required.
Present monthly cost-subject to adjustment.
For the two fiscal years 1943 to 1945 a dividend
return of 35?fo of total premium contribution was
made to members. In the fiscal year 1945-1946 a
dividend return of 30% of the total premium con-
tribution has been declared.
YOU MAY SUBSCRIBE ONLY FOR THE
EXACT AMOUNT FOR WHICH YOU ARE
ELIGIBLE. Increases in the amount of insurance,
due to change in salary classification, will be made
if you apply in writing for such increased amount
PLAN OF INSURANCE
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ail
"HE WAR AGENCIES EMP O EES
A
L~l PROTECTIVE ASSOCI
4'iAj the fa rab e experience ? en
beaus
ast five yens it has become
joyed over the p
possible for the Association to provide this
tional Group Accidental ve Death Benefit to be
' befod~ I
in effect frori May 2I, 1948 to May 20, 1949
and at no additional cost to its insured mem-
bers.. It is hoped and expected that this cov,
era eand practice will be continued through
,,
subsequent Yeats' Only catastrophic losses,
"seeds' deterioration in the interna-
or very continuance
tional situation, shohld affect the
of this additional benefit. In any event, every
inured member will
211 19481 to May 20,
protection from May
'Mir
J
a will be issued to
An lncividual certificate
barb irisirred me nbe'r? In every case the
riouh"t cif insurance' u' 'der the Group Acci-
dent Policy will coincide with that of the
Ike Groins Accidental Death Benefit
ceases oh the last day of the Insured's active
service, and there is no grace period.
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Appro
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ACCIDENTAL Pt. s LT BENEFIT
$10,000
M4 UMUM
.ACCIDENTAL DEATH BENEFIT
The _Accident ltd Casualty Insurance
Company of Winterthur, Switzerland, is a
stock,company organized in 1875 and is
one of the oldest companies engaged in
underwriting accidtent, health, fidelity,
surety and casualty insurance. It operates
in many, countries ,pf the world and has
built an exceedingly fine reputation from
the beginning. Since its organization it
has paid losses in excess of $300,000,000,
It entered the United States through the
State of New York and is presently ti-
ceased to transact business in every state
of the,tInioxt, inclu Sing the District of
Columbia.
The United States Branch is located at
Ill John Street, New York City, New
'York.
Insurance has been obtained for our Members
against loss of life resulting directly and indepen-
dently of all other causes from bodily injuries ef-
fected solely through accidental means.
If the bodily injuries sustained by any insured
Member results in loss of life within ninety days
frozx date of accident, the amount of Principal Sum
iti force on the life of the Insured Member will
be paid to the named beneficiary, if surviving the
Insured Member, and otherwise to his estate.
NOT COVERED: This accidental death bene-
fit does not cover death caused directly or indirectly,
wholly or partly (1) by bacterial infections (ex-
cept pyogenic infections which shall occur with
and through an accidental cut or wound), or (2)
by any kind of disease, or (3) by medical or sur-
gical treatment (except such as may result directly
from such treatment made necessary by injuries
covered by this policy), nor shall it cover (4)
suicide or any attempt thereat, sane or insane, nor
(5) any injury sustained while in or on any vehicle
or device for aerial navigation, except as a passenger
in an aircraft operated by an established concern
organized to operate an airplane service and licensed
for the carriage of passengers by the recognized
governmental authority of the country whose reg-
istry it bears, including aircraft operated by military
ry.
MEMBERS ELIGIBLE: All Members of the
Association in the classes shown below who are in
good standing and are actively engaged as employees
of the United States Government are eligible for
this insurance:
All employees of American citizenship now
outside the continental limits of the United
States wherever domiciled.
now in training for duties abroad or awaiting
transportation.
All supervisory or administrative employees
located in the United States who in the normal
cps se of their duties are required to make
trips ak ad.
4. Dirgctors of training programs for such ern.
ployees and members of the home office staff
of The Association.
MEMBERS INSURED: All Members of the
Association in good standing and in the classes
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upon the effective date of this Policy. New Members
in these classes will become insured upon becoming
a Member of the Association. Members transferred
to other Departments of the United States Govern-
ment, except the Armed Forces, may continue this
insurance by continuing Membership in the Asso-
ciation.
AMOUNT OF INSURANCE: The amount of
insurance for accidental death provided for each
Member shall be determined in accordance with
the following Plan of Insurance; except with re-
spect to Members in good standing on the effective
date of this Policy who are insured for less than
$5,000.00 Principal Sum, the amount of insurance
shown on the records of the Association for such
Members shall determine the amount of principal
sum provided hereunder:
Basic Annual Salary Amount of Principal Sum
Less than $3,200.00 $ 5,000.00
$3,200.00 or over $10,000.00
Increase in the amount of insurance due to change
in salary classification, will be made if the Member
applies in writing for such increased amount with-
in sixty days of the time the Member's basic annual
salary is changed to qualify Member for increased
insurance, provided the Member is then actively
at work on the date of application ; if Member is
not actively at work, the increase will be made
effective upon the Member's return to active service.
TERMINATION OF INSURANCE: This ac-
cidental death benefit with respect to an individual
Member will automatically terminate at the earliest
applicable time indicated below, namely;
(a) the termination of the master contract with
the Accident and Casualty Insurance Company of
Winterthur, Switzerland,
cessation
count of theMember'sf insurance thereunder, on ac-
(c) the termination of membership or of active
employment by the United States Government,
(d) the entry of such Member into the Armed
Forces of any Country at war, whether declared
or undeclared.
BENEFICIARY: The beneficiary named by
you for your group life insurance will be the bene-
ficiary under the accidental death benefit. How-
ever, any Member may name another beneficiary
by completing the form provided for that purpose,
such change to become effective only upon receipt
of the completed form at the Association's Office.
Consent of the beneficiary is not requisite to the
change.
Printed in U.S.A. 48 4 20M
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Approved For ReleAgl'CAOIaIWFOR9A-8957001200020004-5
For Eligible Employees of the United States Government
To The War Agencies Employees Protective Association
1040-43 Washington Bldg.,
15th & New York Avenues, Washington 25, D. C.
I . ...........................................................................................................................................................................
hereby make application for membership in The War Agencies Employees Protective Association.
I understand that if admitted to membership I shall be eligible to apply for Group Life Insurance under the Group Contract issued
to the Association by The Equitable Life Assurance Society of the United States and I hereby apply for the amount of insurance for which-
I shall become eligible under the Group Insurance Plan. For purposes of becoming insured I certify that I am actively at work and in
good health on the date of this application and eligible for membership under the rules of the Association.
Primary ........................................................................................................Relationship ...............................................................................................
(Mary Smith Jones - NOT Mrs. John E. Jones)
NOTE: If more than one beneficiary is named, the death benefit, unless otherwise provided herein, will be paid in equal shares to the designated beneficiaries
who survive the member; if no such beneficiary survives, payment will be made in accordance with the terms of the policy.
METHOD OF PREMIUM PAYMENT: In every case the applicant is required to make an initial quarterly payment together with
a $2.00 membership fee. See reverse side for instructions regarding method of premium payment, schedule of payment and allotment
procedure. A.
I hereby elect to have the proceeds of my Group Life Insurance becoming due under the Group Insurance certificate delivered to
me as a member of The War Agencies Employees Protective Association payable, in lieu of a single sum, in accordance with the election
as indicated below.
............Part single sum of $ ..............................and balance in monthly instalments of $............................... Each instalment shall not be less
than 1/2 of 1% of the amount of insurance applied under the instalment settlement.
............Monthly instalments of $ ....................'........... Each instalment shall not be less than 1/2 of 1% of the amount of insurance applied
under the instalment settlement.
PLAN OF INSURANCE
Basic Annual Salary Amount of Insurance
Less than $3,200 $5,000
$3,200 & over - 10,000
NOTE: The monthly cost of the insurance is now $1.25 per $1,000. See schedule regarding methods of payment. For the two fiscal years 1943 to 1945 a dividend
return of 35% of total premium contribution was made to members. In the fiscal year 1945-1946 a dividend return of 30% of the total premium con-
tribution has been declared.
It is understood that the instalments stated above will include a rate of interest then currently announced by the Society and such
excess interest dividends as may be determined and apportioned. The final payment shall be the balance then remaining with the Society.
In the event of the death of my beneficiary subsequent to my death, any balance remaining with the Society shall be paid in a single sum to
the executors or administrators of the aforesaid beneficiary.
(Print Full Name Here)
Date Signed ........................................................................................
Name and address of person to whom certificate is to be sent:
(Permanent reference point within United States unless otherwise indicated)
Eligibility of applic nt certified by
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Title ............................................Agency............................................
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? TO THE EQUITABLE LIFE ASSURANCE
? SOCIETY OF THE UNITED STATES
o I HEREBY CERTIFY THAT
g y ? a4 8 I am in good health and actively at work; except
c o 4 as stated below. I have had no illness, have not
c b 0 v consulted any physician or practitioner, have not
? o been a patient in any hospital or sanitarium nor ID 'd [ .N ? have I ever been rejected for insurance by any
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(u lu
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(Noteeow any exceptions, incuingates
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(Signature of
Applicant) .......................................................
Secretary
Dated at Washington, D. C ............................19......
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Approved Frer cr asen200ls08/ v7fo Ctl - P57e0p 3> 48001200020004-5
ing. The allotment method is recommended to
prevent possible termination for non-payment of
premium.
Should you pay your premium in advance and
terminate your service with the United States Gov-
ernment any unearned premiums will be refunded,
terly, semi-annually, or annually in advance by
direct remittance to the Association, but at no sav-
SCHEDULE OF PAYMENT
THREE MONTHS' CONTRIBUTION
$10,000 of Insurance ..................................$ 37.50
Plus Initiation Fee ................................ 2.00
Total Cost ..............................$ 39.50
$ 5,000 of Insurance ..................................$ 18.75
Plus Initiation Fee ................................ 2.00
SIX MONTHS' CONTRIBUTION
$10,000 of Insurance ..................................$ 75.00
Plus Initiation Fee ................................ 2.00
Total Cost ..............................$ 77.00
$ 5,000 of Insurance ...................................$ 37.50
Plus Initiation Fee ................................. 2.00
Total Cost ..............................$ 39.50
ONE YEAR'S CONTRIBUTION
$10,000 of Insurance ...................................$150.00
Plus Initiation Fee ................................ 2.00
Total Cost ..............................$152.00
$ 5,000 of Insurance ..................................$ 75.00
Plus Initiation Pee ................................ 2.00
Total Cost ..............................$ 77.00
If Standard Allotment Form 1122 is available in
your Agency, it is required that the first quarterly
premium contribution and the initiation fee be paid
in cash and monthly allotment executed to begin
three months from date of application. ,
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INDIVIDUAL CERTIFICATES: In accordance
with the terms of the policy between the Associa-
tion and the Society, an individual certificate evi-
dencing the insurance will be issued to members
insured under the plan. The certificate will show
the name of the insured, the beneficiary and the
amount of insurance. It will be sent by registered
mail, as directed by the member.
DEATH BENEFIT: In the event of your death
FROM ANY CAUSE WHATSOEVER, while
you are insured, under this policy, the full amount
of life insurance is payable to the person you have
named as your beneficiary. You may change your
beneficiary at any time by filling out a request form
and sending it to the Association. You may have
more than one beneficiary, if you wish.
You should indicate on your application whether
your insurance shall be payable to your beneficiary
in a lump sum, or partly in a lump sum and the
remainder in instalments, or all of it in instalments.
The fund held by the Equitable from which instal-
ments arc paid will be credited with interest an-
nually.
CONVERSION: Your Life Insurance auto-
matically terminates thirty-one days after termina-
tion of membership WHICH COINCIDES WITH
THE LAST DAY OF YOUR ACTIVE EMPLOY-
MENT WITH THE U. S. GOVERNMENT NOT
INCLUDING TERMINAL LEAVE. You will be
entitled to have issued to you, without medical ex-
amination, provided you make application to the
Equitable in writing within thirty-one days after
the termination of your active employment, a policy
of Life Insurance in any one of the forms cus-
tomarily issued by the Equitable (except Term In-
surance, or a policy providing benefits in the event
of total and permanent disability or additional
benefits in event of accidental death), in an amount
equal to-or, at your discretion, less than - the
amount of your protection under the Group Life
Policy, but not less than $500, upon the payment
of the premium by you applicable to the class of
risk to which you belong and to your age at the
time of conversion, such policy to become effective
at the end of thirty-one days after termination of
membership.
10
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INSURANCE: A member may discontinue mem-
bership and insurance by resignation. Membership
and insurance will also terminate upon retirement,
separation from U. S. Government service, or non-
payment of premiums.
Pensioners on retirement pay are ineligible from
date of retirement from active service.
Approved
HOW TO APPLY
1. Tear out center spread and complete the ap-
plication form.
2. Have your application certified by your
supervisor. Your insurance is in force from the
day you sign Lip and arrange for transmission of
the application to the Association with your first
payment.
3. Make certain that the application is com-
plete in all details, that, you are applying for the
correct amount of insurance and that the payroll
allotment form has been properly filled out if you
are using the allotment method. There is no op-
tion with respect to the amount of insurance. You
must apply for the full amount to which your salary
class entitles you.
The rules of the Association may be amended
from time to time by action of the Board of
Directors.
Once having been a member of the War Agencies
Employees Protective Association, and having exer-
cised the conversion option in the Group Certificate,
the applicant will be ineligible to rejoin the Asso-
ciation or procure any further benefits as issued by
them.
On, and after, September 24, 1947, applications
for membership and life insurance benefits as is-
sued by the War Agencies Employees Protective
Association will be limited to applicants who have
not attained the age of sixty years.
As of March 17, 1948 membership in the War
Agencies Employees Protective Association, and
insurance benefits as issued by them, shall cease
upon all members who have attained the age of
sixty-five years with the exception of those mem-
bers currently insured who. have already attained
the age of sixty-five.
or Release 2001/08/17 : q A-RDP57-00384R001200020004-5
Approved For Release ?~0fRI/08/17 : $IA-P5t7-003,84130(1200020004-5
pecia essage o em efs-
These are times when the increasing cost of liv-
ing have caused many of us to realize that our de-
pendents might be faced with a serious financial
problem. By making your monthly payment of only
$12.50 you have immediately created a fund of
$10,000., which might go far in meeting certain
of the fixed charges for rent, food, clothing, recrea-
tional, educational and medical expenses of your
family.
We frequently receive inquiries from Govern-
ment employees stationed abroad who tell us they
were not informed about our Association before
proceeding overseas and have learned about our of-
fer through associate workers. We have made every
endeavor to obtain complete distribution through
the various personnel departments of every branch
of the U. S. Government, but because of the con-
stant shifting it is sometimes difficult to obtain one
of our descriptive pamphlets. We would consider
it a great favor if you could ascertain whether the
personnel officer at your post is familiar with our
plan, and has a supply of pamphlets available.
In every group insurance plan it is both desirable
and profitable to all the members to procure the
highest percentage of participation which spreads
the risk and reduces the cost. The Association,
therefore, solicits your cooperation, and would
greatly appreciate your active aid in carrying our
message and information to your associate workers
of the benefits you are enjoying.
Approved For Release 2001/08/172: CIA-RDP57-00384R001200020004-5
Approved For Release 20,01/08/17 : tIA-RDP57-00384R001200020004-5
NOTICE TO PERSONNEL OFFICERS
ALL DEPARTMENTS U. S. GOVERNMENT
A copy of this booklet should be given to each
United States Government Employee entering
foreign service.
After application has been detached and for-
warded, booklet may be retained for reference by
member.
for information concerning a somewhat similar plant
available to Officers of the Army, Air Corps, Navy,
Marine Corps and Coast Guard consult your finance or
personnel officer or write to The Armed Forces MnEual
Benefit Association, Pentagon Bldg., Washington, D. C.
Approved Fc}t Rellase`2001/08/17: CIA-RDP57-00384R001200020004-5
``{ 48 4 20M
Approved F,pr Release 2001/08/17 : CIA-RDP57-00384R001200020004-5
POLICY RECORD REGISTER
Initial Premium Paid ........................................................................
(Date)
........................................................................
(Name)
...............................................
(Address)
DATE- AMOUNT
- -o0384R001200020004-5
ApprovedForFelease 2001/084--.C
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