Call Center Enrollment Website

This website was created for employees utilizing our call center for enrollment. It contains the outlines of coverage, applications and disclosure forms for the voluntary insurance products from The Paul Revere Life Insurance Company.

Please contact the Call Center, and a Benefits Representative will be able to help you apply for coverage over the phone

** We are pleased to inform you that we have bilingual Benefits Representatives available to help those who require assistance in Spanish. **

** Hablamos Español favor de comunicarse con nosotros al número que le ha facilitado su empleador. **

Important: You Will Need:

If applying for Colonial Voluntary Benefits products:

You must have the correct outline of coverage for the product in front of you before applying by phone. Please print these forms and have them with you when you call. The Benefits Representative will verify that you have the appropriate Outline of Coverage before proceeding with the application via telephone, and will ask you for the form number, located at the bottom-right corner of each page. Please make sure you have reviewed and printed out the Outline of Coverage and application for each of the products you are interested in and one copy each of our HIPPA Disclosure form, Notice of Information, and Tax Deduction Authorization form. (The application is for review only. Do not fill this out. This will be completed by a Benefits Representative during your telephone enrollment.)

***If you are age 65 and older, please print the “Important Notice to Medicare Guide” listed for the appropriate policies.

To find the outline of coverage that you need, click on the forms that you wish to view. Not all policies listed will be available. You should have received materials from your employer with a list of policies being offered to you. If you have not received these materials please contact your benefits coordinator at work. After you have printed and read the materials please call us at the toll free number provided by your employer and we will be happy to help you with your enrollment.

Don't miss this opportunity to make the most of your benefits package!

Policies have exclusions and limitations that may affect benefits payable. See the outline of coverage for complete details.

Accident Insurance

Accident Insurance helps offset the unexpected medical expenses that can result from a covered accident.

  • Accident Care

This policy (ACCPOL-NY) provides accident insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit ratio for this policy is 50%. This ratio is the portion of future premiums which the Company expects to return as benefits, when averaged over all people with this policy.

Specified Disease Insurance for Cancer

Specified Disease for Cancer helps offset the out-of-pocket medical and indirect non-medical expenses related to cancer diagnosis and treatment.

  • Specified Disease Insurance for Cancer (Cancer 1000)
  • Specified Disease Insurance for Cancer (Cancer Security)

The policies (C1000-NY) and (INCANMOD-NY) provides limited benefits health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit for the Specified Disease for Cancer policy is 60%. This ratio is the portion of future premiums which the Company expects to return as benefits when averaged over all the people who have this policy.

Specified Disease Insurance for Critical Illness

Specified Disease Insurance for Critical Illness Insurance helps offset the direct and indirect expenses upon diagnosis of a covered critical illness.

  • Specified Disease Insurance for Critical Illness
  • Group Specified Disease Insurance for Critical Illness 1000 (Group Critical Illness 1000)

This policy (CI(98)-NY) provides limited benefits health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit for the Specified Disease for Critical Illness policy is 60%. This ratio is the portion of future premiums which the Company expects to return as benefits when averaged over all the people who have this policy. The expected benefit ratio for this coverage (GCI-C-NY) is 70%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with the certificate.

Disability Insurance

Disability Insurance replaces a portion of your income to help make ends meet if you are disabled due to a covered accident or covered sickness.

  • Disability 1000

This policy (DIS 1000-NY) provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit ratio for this policy is 50%. This ratio is the portion of future premiums which the Company expects to return as benefits, when averaged over all people with this policy.

Hospital Indemnity Insurance

Hospital Indemnity Insurance is designed to help you with the rising costs associated with healthcare.

  • Medical Bridge
  • Medical Bridge 3000

The policies (HCOS-NY) and (MB3000-NY) provides limited benefits health insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Insurance Department. The expected benefit for the Hospital Indemnity policy is 55%. This ratio is the portion of future premiums which the Company expects to return as benefits when averaged over all the people who have this policy.

Life Insurance

Life Insurance enables you to tailor coverage for your individual needs and helps provide financial security for your family members.

  • Term Life 1000