Voluntary employee life insurance is available on a self-pay basis through payroll deduction. This coverage is underwritten by Hartford Life Insurance Company. Employees may purchase up to the lesser of five times annual salary or $400,000. If application is made within 31 days of the date you first became eligible for coverage, a guaranteed minimum amount will be issued without evidence of good health. For more than the guaranteed minimum, evidence of good health acceptable to the company must be submitted. Coverage is effective the first of the month following the first payroll deduction, provided you are actively at work and required application procedures have been followed. If application is not made within 31 days of eligibility, all coverage is subject to insurance company approval.

For employees who purchase the Hartford voluntary employee coverage, spouse and/or children life insurance is also available through payroll deduction. This coverage can be applied for at the same time that application is being made for voluntary employee coverage by completing the applicable section on the enrollment form. A guaranteed minimum issue is available if application is made within 31 days of the later of the following: 1) the date you first became eligible for employee coverage, or 2) the date of your marriage or the birth of your first child (as applicable). Coverage is effective the first of the month following your first payroll deduction, provided you are actively at work and the required application procedures have been followed. If application is not made within 31 days of eligibility, all coverage is subject to insurance company approval. Please note: If your spouse is also an employee, you may have dual coverage for the voluntary life insurance coverage.

Voluntary Accidental Death & Dismemberment Insurance (AD&D) is available on a self-pay basis through payroll deduction. Prudential Insurance Company of America underwrites this insurance. Employees may purchase insurance for themselves only or for themselves and eligible dependents. The dependent benefit is a percent of the employee insurance amount for dependents covered at the time of the covered accident. Eligible employees may choose specified amounts from $50,000 to the lesser of $500,000 or ten times annual salary. A brochure describing the benefit is enclosed.

The cost per month (tenthly) for 2009 is:

To enroll, submit a completed Voluntary Accidental Death and Dismemberment form to the district’s Employee Benefits Operations Office. Coverage is effective the first of the month following your first payroll deduction for the insurance.