Supplemental Life Coverage

Supplemental Life Coverage is available during the first 31 days of employment.  The employee pays the full premium for this life coverage.  Life coverage in $10,000 increments may be purchased for the employee or spouse.  Coverage is also available for dependent children in the amounts of $2,000; $5,000; or $10,000. Coverage is available within the first 31 days up to the guarantee issue amount of $180,000 for the employee and $50,000 for the  spouse.   If electing coverage for spouse and/or children, the employee must elect the same amount or more of employee coverage.  If you want more than the guarantee issue amounts for the employee or spouse, or if you do not apply for coverage until after the first 31 days of employment, the application will be medically underwritten and can be denied if health problems exist.

SUPPLEMENTAL Life Coverage Rates

ENROLLMENT FORM - NON-EXEMPT EMPLOYEES

ENROLLMENT FORM - EXEMPT EMPLOYEE

EVIDENCE OF INSURABILITY