To review the Student Security Plan, use the button below to download the form for the appropriate year. Please note that the student must be attending a school that has endorsed this plan in order to obtain coverage.
EJ Smith & Associates currently offers coverage in the following states: Arizona, Arkansas, Colorado, Delaware, District of Columbia, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin.
If you intend to pay your premium with a credit card, click the button below to download an authorization form that you will need to fax to our office to complete your order.
If you need an Enrollment Form, click the button below to download an Enrollment Form that you will need to fax to our office to complete your order.