Accidental death & dismemberment insurance
Accidental Death and Dismemberment insurance is available to benefit-eligible faculty and staff. You may also purchase coverage for your family at a percentage of your own coverage.
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Accidental Death and Dismemberment insurance is 100% employee-paid. Coverage is available in increments of $25,000 up to a maximum of $150,000.
Accidental Death and Dismemberment- Monthly premiums, 2017
|Coverage amount||Employee cost (per amount listed)|
|Self coverage||Family coverage|
- 2017 Accidental Death and Dismemberment Summary Plan Description (SPD)
- 2017 Benefits Enrollment Form - For active faculty and staff who are newly eligible for benefits (e.g., newly hired or newly promoted to a benefit-eligible job)
- 2017 Benefits Change Form - For active faculty and staff who have a family status change for the 2017 calendar year.
- Beneficiary Designation Form - for active faculty and staff; to be used for Basic Life, Supplementary Life, AD&D, and Pre-Retirement Death beneficiary designations.
- Retiree Beneficiary Designation Information, part of the Retiree Benefits Enrollment/Change Form - for retirees; to be used for Basic Life, Supplemental Life, and AD&D
- Proof of Relationship Requirement form
* In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.
Reviewed January 03, 2017.