As an employee of one of America's federal law enforcement agencies, the Intelligence Community, Homeland Security Agencies and the U.S. Courts, you work hard to protect our laws, communities, and citizens. You extend considerable efforts to build a safe and secure future for you and your family. The Special Agents Mutual Benefit Association (SAMBA) is the non-profit association created expressly to help you achieve this goal.

SAMBA works closely with top-rated insurance providers to create plans at affordable rates that fill the specific needs of our members and their families. The result is a suite of insurance and benefit programs that are among the best offered to any federal government employee. In addition, the SAMBA programs are tailored for today's world and law enforcement environment. That is why SAMBA plans are available only to employees of a few, select agencies.

You become a SAMBA member when your coverage under one of our plans becomes effective.  Enrollees in the SAMBA Health Benefit Plan are full members and pay no separate membership fee.  Members who are not enrolled in the health benefit plan are associate members and pay one dollar biweekly to cover administrative fees.
 

Here’s How to Apply or Update your Coverage

1. Enrollment Form: Complete the SAMBA Enrollment and/or Request for Change Form to apply or update your coverage for any of the SAMBA Plans listed below. Enrollment Forms may be obtained from your agency’s personnel office, by calling SAMBA at (800) 638-6589 or (301) 984-1440, or you can download the forms by clicking on the appropriate plan title:

• Group Term Life Insurance Plan (with AD&D)
• Dependent Group Term Life Insurance Plan
• Supplemental Group Term Life Insurance Plan
• Personal Accident Insurance Plan
• Disability Income Protection Plan
• Dependent Children Health Benefit Plan
• Dental and Vision Care Program
• LegalRx
• Long Term Care Insurance

2. Health Statement Form: Complete a Health Statement Form, if required. Click here to access the appropriate form. Note: A health statement must accompany all new enrollments (unless enrolling only in the Personal Accident Insurance Plan). If you are updating your coverage, no health statement is required if you have kept your benefit amounts current with your job grade and/or salary; refer to plan descriptions.

3. Payroll Allotment Form: Use SAMBA Allotment Form 299. This allows you to have the biweekly premium conveniently deducted from your paycheck. You will find this form attached to the Enrollment Form or you can download one by clicking here. NOTE: Annuitants and active NIS employees do not complete the payroll allotment form; you will be billed quarterly.

4. Mail Your Completed Forms to:

SAMBA
11301 Old Georgetown Road
Rockville, MD 20852-2800