New Jersey Life & Health Insurance Guaranty Association
Proxy Ballot for Election of Board Members at the 2026 Annual Meeting of Members
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Please email us at Operations@njlifega.org if you encounter problems completing this form.
Email Address *
Company's NAIC # *
Provided Security Code *
In accordance with the Plan of Operations, the Nomination Committee of the Board of Directors has selected the slate of three nominees below for a term of three years to succeed Board members whose terms expire at the end of this year. You are requested to designate three candidates.

Please select up to three.
 *
Required
Enter your write-in candidate(s) here
Attestation
The company named below, being a member of the New Jersey Life & Health Insurance Guaranty Association, casts its ballot as indicated above for the election of member insurers to the Board of Directors.
Company Name *
Your Name *
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