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SafeGuard® New Business Submission

Obtain a USHL SafeGuard Quote:

To submit USHL SafeGuard New Business:

  • Required documents:  
    • Employer Disclosure  Found here
    • Employee Submissions*
    • Group Setup Form Found here
    • First month’s premium check
    • ACH Payment Processing Form Found here
    • Administrative Service Agreement
    • Writing Agent Transmittal Form Found here
    • Quarterly Wage and Tax Statement (indicating part-time or full-time status)
    • Current Carrier Billing Statement and Prior Year Rates

* Employee submissions vary by group size. Contact USHL Sales Support for assistance.

US Health and Life Insurance
Sales Support
8220 Irving Road
Sterling Heights, MI, 48312

Please allow two weeks from the time of receipt of all new business documentation to final enrollment.

For calendar-year deductible credits, prior carrier EOBs indicating deductible amounts paid for the year must be submitted to USHL account management within 90 days of implementation.

Final rates will be based upon information submitted. Do not cancel current coverage until receipt of welcome letters.