Personal Life Insurance Interest Form

Open enrollment for existing participants and churches within Church Benefits Board (CBB) will begin January 2, 2026 and ends February 27, 2026. A participant must be actively employed as a W-2 employee and working an average of 20 hours or more per week to be eligible.* The participant must be age 16 years through 80 years at the time of enrollment.

CBB is working with a dedicated team of enrollment specialists at Hilb Group. After you submit the interest form, you will be redirected to an online calendar to schedule an appointment with a Hilb enrollment specialist. Appointments will take place in January and February 2026 during the initial open enrollment period. At your scheduled appointment time, the Hilb enrollment specialist will call you to review the details of this new life insurance product.

Complete the Personal Life Insurance Interest Form to schedule your appointment with a Hilb enrollment specialist.

*This Personal Life Insurance product is only available to US-based employees who are not serving internationally.

Personal Life Insurance Interest Form

Company

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Enter Email Confirm Email

Phone(Required)

Birth Date(Required)

This data is being collected securely to verify that you are an active CBB participant.

Gender:(Required)

Full Employer Name:(Required)

Please do not use acronyms.

Employer City and State:(Required)

City State

Hire Date: