| The
group term Dependent Life Insurance Plan, also referred
to as the "Dependent Plan," is available for your
spouse or other qualified adult and any eligible children—even
if you do not wish to insure yourself.
Your
Spouse or Other Qualified Adult
Your Dependent Children
Enrollment Form
Dependent Life Insurance Rates
Terminating Coverage
Your
Spouse or Other Qualified Adult
Your
spouse or other qualified adult can enroll in the Dependent
Plan at any time. He or she will need to provide satisfactory
evidence of insurability (health
statement). Coverage will go into effect when (1) the
Dependent Plan application is received in the Benefits Office
and (2) satisfactory evidence of insurability
has been received and approved.
Your
Dependent Children
No
health statement is required to enroll children in the Dependent
Plan. Children may be enrolled in the Dependent Plan when:
-
a faculty or staff member is newly eligible to enroll
in the Dependent Plan,
-
when there is a qualifying change in family status (e.g.,
marriage, birth, etc.),
- during
Open Enrollment, or
- when
the faculty or staff member is approved to participate
in life insurance as a late entrant.
Dependent
Plan coverage for newborns will go into effect at age 15
days or when the Dependent Plan application is received,
whichever is later.
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Enrollment
Form
You can download the Dependent
Life Insurance Plan application form from this site.
Your
Monthly Costs
View Dependent Life Insurance Rates
for the your cost per month for this plan.
Beneficiary
When
you enroll in the Dependent Plan, you do not need to designate
a beneficiary. You are automatically the beneficiary. If both you and your dependent die, life insurance will be payable to the first of the following:
- Your surviving spouse/OQA;
- Surviving children in equal shares;
- Surviving parents in equal shares;
- Surviving siblings in equal shares;
- Estate
Continuation
of Coverage/COBRA
When
your insurance coverage ends, you cannot continue coverage
for dependents. COBRA does not apply to life insurance.
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Terminating
Coverage
You
can terminate dependent coverage at any time. To do so,
complete a Group Life Insurance
Withdrawal Form available for download from this site or
from any Benefits Office.
Dependent
Spouse/Other Qualified Adult Plan coverage terminates
when the faculty or staff member retires, terminates employment
with the University for any reason, or dies.
Dependent
Spouse Plan coverage will terminate the date the faculty
or staff member’s divorce is final.
Coverage
for your eligible dependent child or children ends at the end of the month in which the child turns age 25.
You
must notify the Benefits Office in writing when you no longer
have a child eligible for benefits. There is no continuation
or conversion privilege for this coverage.
For
More Information
View the 2003 University
Group Term Life Insurance Plans (PDF) book for plan
details. If you have questions about the life insurance
plans, call the HR/Payroll Service Center at 734-615-2000
or toll-free at 1-866-647-7657 at 734-763-1214 before electing
this coverage.
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