Application Information for Member

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Insurance coverage is provided under the terms of a group life insurance policy, Group Policy #70696-5-6, issued and delivered in the state of Illinois to Midwest Coalition of Labor – Chicago Laborers District Council as the policyholder. The group life insurance policy is issued by ReliaStar Life Insurance Company, Minneapolis, Minnesota. The policy is administered on behalf of ReliaStar Life Insurance Company by Selman & Company, LLC, an insurance administrator licensed in the state of Illinois. Coverage may not be available in all states. Contact Selman & Company, LLC for further details. Policy form ICC LP14GP or LP00GP (may vary by state).