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GP_Registration

Personal Information

(required field)

User Type(s)

Name Type

First Name

Last Name

Date of Birth(mm/dd/yyyy):

Company Name

Government Identifier

Member Identifier/Policy Number

User Type(s)

First/Last Name or Institution Name is required.

First Name

Last Name

Provider Group / Institution Name

National Provider ID or Provider Government ID is required.

National Provider ID

Provider Government ID

Payee Address

Provider Registration Instructions:

Providers may register multiple users under the same provider credentials.

For Individual Providers, enter a valid NPI or Government ID (or both).
For Group/Institution Providers, enter Name and a valid NPI or Government ID (or both).

User Type(s)

First Name

Last Name

Email Address (example: jsmith@abc.com)

Phone Number

Job Title

Company Authorization

User Type(s)

First Name

Last Name

Date of Birth(mm/dd/yyyy):

Government Identifier

Agent Number

User Type(s)

Agency Name

Government Identifier

Agency Number

User Type(s)

First Name

Last Name

Email Address (example: jsmith@abc.com)

Phone Number

Job Title

Company Authorization

Your Inquiry

First Name

Last Name

Phone

Email Address

Question Characters remaining: 100

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GIAS Portal Version

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Build Timestamp

Welcome to the secure policyholder services portal for the Air & Space Forces Association’s Member Insurance Program.

The portal provides an array of services for members, their spouses and dependents who have life insurance or supplemental health coverage through AFA’s insurance program. Members can view coverage details, make premium payments, monitor claims, update their personal information, or download forms for various policy coverage adjustments.

The portal is provided by Forrest T. Jones & Company, the broker/administrator for AFA’s Member Insurance Program.

Afa.SeeMyInsurance.com®

1-800-291-8480

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