BASS provide $50,000 of Basic Term Life insurance and $50,000 of Accidental Death & Dismemberment (AD&D) for all full-time, benefit-eligible employees through New York Life.
Life and AD&D
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Claims: 800.362.4462
Plan Documents
Carrier Forms
- Life and/or Accidental Death Claim Form
- How to Submit a Life or AD&D Claim
- Life Insurance Portability Rate Chart
- Application for Portability of Basic and Voluntary Term Life Insurance
- Application for Conversion of Life Insurance to an Individual Policy
- Application for Conversion of AD&D Insurance
- Beneficiary Designation Form
- Evidence of Insurability Form
- Portability vs Conversion Comparison Chart
Additional Benefits
If you would like to purchase additional Term Life and AD&D insurance for you and your dependents, you may do so through New York Life. You can pay for this coverage via convenient payroll deductions.
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Claims: 800.362.4462
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Employee Assistance and Wellness Support Program: 800.344.9752
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Employee Assistance and Wellness Support Program Website Instructions
1. Click on Register and enter our Organization Web ID: NYLGBS
2. For Company Name, enter: Bay A and click submit. Then select Bay Area Surgical Specialists, Inc. dba BASS from the drop down menu.
3. Create your own username and login to access the Employee Assistance and Wellness Support Resources available
Plan Documents
Carrier Forms
- Evidence of Insurability Form
- Life and/or Accidental Death Claim Form
- How to Submit a Life or AD&D Claim
- Life Insurance Portability Rate Chart
- Application for Portability of Basic and Voluntary Term Life Insurance
- Application for Conversion of Life Insurance to an Individual Policy
- Application for Conversion of AD&D Insurance
- Beneficiary Designation Form
- Evidence of Insurability Form
- Portability vs Conversion Comparison Chart
Additional Benefits
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Enroll Now
If you've made your plan selections and are ready to enroll, click the button below to access our online enrollment system.
Enroll Now -
Benefits Service Center
If you have questions or need additional information feel free to contact the Benefit Service Center. Click below to get in touch.
Click Here to Email