Life Insurance

The Guardian Life Insurance Company of America

Below is a summary of benefits for your group plan:


  • Basic Life: $50,000
  • Life Cutbacks: 35% at age 65, 50% at age 70
  • Accidental Death and Dismemberment: Additional $50,000
  • Accidental Death and Dismemberment Cutbacks: 35% at age 65, 50% at age 70

Waiting Period: 1st of the month following date of hire

Premium: $22/month (Church as employer must pay full amount / no contribution from pastor)
For those 65 years and above, the premium will increase to $14/month.

Use the links below to access the necessary forms, fill them out and mail them to Cathy Kelley, 7282 State Route 305, Belfast, New York 14711 (Ph# 585-365-2889):

GG42NY Group Life Claim Form
GG013374L-D-DI-2 Enrollment Form (Please note: this form does not ask for spouse’s Social Security number or birthdate, but Cathy Kelley will need this information as well.)
GG-17 Request For Change Of Beneficiary and/or Name