American Enterprise Association

Who We Are About AEA Join AEA On-line

Enroll Here

NOTE: You must submit both the health/dental plan enrollment form and the AEA membership application to obtain coverage. Whether paying by check or credit card, coverage will be effective the first of the month following receipt of both the enrollment form and the premium

Complete the form online
and print it to Fax or Mail

To print this form you will need the Adobe Acrobat Reader (version 4.0 or later). Click on the Adobe icon to get this free software.

Mail your completed form to:	Towers Affinity Benefit Services 4510 Cox Road, Suite 111 Glen Allen, VA 23060

IMPORTANT: If paying by check (with check payable to "TABS"), you should include the 1st month's premium and the 1st month's AEA $6.00 Membership dues.