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Please complete the attached forms and mail along with a copy
of your license to:
Avesis Third Party Administrators
3724 North Third Street, Suite 300
Phoenix, Arizona 85012
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Underwritten
by Fidelity Security Life Insurance Company
3130 Broadway, Kansas City, Missouri 64111. Domicile: Missouri NAIC
no. 71870
Authorized to transact insurance in all states except New York. 9004VC(BCBS)
phone: (602)
864-5230 fax: (602) 864-5240
Email:
information@csaaz.com
Mail
Requests: CSA General Insurance Agency, Inc. 8155 N. 24th Avenue,
Suite F Phoenix, AZ 85021 |