Skip to main content

Life Policy Form Numbers

Guaranteed policies2

ICC15 FGCLT01-01 Form

Standard

Arizona

Arkansas

 

FGCLT03-01 Form

California

Connecticut

Delaware

District of Columbia

Florida

Montana

North Dakota

South Dakota

 

FGCLT10-04 NY Form

New York 10 Year Plan

 

FGCLT15-04 NY Form

New York 15 Year Plan

 

FGCLT20-04 NY Form

New York 20 Year Plan

 

FGCLT25-04 NY Form

New York 25 Year Plan

 

FGCLT30-04 NY Form

New York 30 Year Plan

ICC11 SIWL01-01 Form

Standard

 

SIWL01-02 Form

Arizona

Arkansas

District of Columbia

Florida

South Dakota

WL2006-01 Form

Standard

 

WL2006-01 NY Form

New York

 

WL2006-01 OK Form

Oklahoma

FPDA-IRA01-01 Form

Standard IRA

 

FPDA-RothIRA01-01 Form

Standard Roth IRA

 

FPDA-NQA01-01 Form

Standard Non-Qualified

SPDA-IRA01-01 Form

Standard IRA

 

SPDA-ROTHIRA01-01 Form

Standard Roth IRA

 

SPDA-NQA01-01 Form

Standard Non-Qualified

“A.M. Best has awarded Amica Life its second highest rating, A+ (Superior).”

Policy name may vary by state
2 Guaranteed Period: The period of time during which premiums are guaranteed to remain level