Life Insurance - Group Term and Supplemental Life

Group Term and Supplemental Life Insurance

Group Term Life Insurance — totally County paid, this coverage is equal to one times salary rounded to the next highest thousand for a full-time employee. This plan provides a benefit in the event of death of an employee. Coverage can be converted or ported to an individual policy upon separation from employment.

Supplemental Group Term Life Insurance — employees may purchase additional group term coverage equal to one, two or three times salary, upon employment or during open enrollment periods. Enrollment at other times or increases in amounts requires Evidence of Insurability. Payment is made through convenient payroll deduction, at reasonable group rates, based on age.  Coverage can be converted or ported to an individual policy upon separation from employment.

VENDOR INFORMATION:

Minnesota Life

A Securian Company

Basic Life Policy #34440

Supplemental Life Policy #34448

For beneficiary designations, supplemental coverage or claims/follow up: Customer Service 877-491-5269

www.lifebenefits.com

Forms

Supplemental Life Enrollment Form

Beneficiary Designation Form

Evidence of Insurability Application Form

Portability Application Form

Continuation of Group Life Insurance (Conversion) Form

Documents

Life Insurance Plan Summary