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Coverage options allow employees to design their own plan. For questions about enrollment and administration, contact your personnel, payroll, or benefits office. For additional information, you may contact the plan.
Basic Life and Accidental Death and Dismemberment (AD&D) Insurance for Employees
This benefit provides $25,000 Basic Life insurance for death from any cause and $5,000 Basic Accidental Death and Dismemberment insurance.
If your employer offers the PEBB full benefits package, Basic Life and AD&D Insurance is provided at no cost to you.Supplemental Life Insurance for Employees
You may apply for additional amounts of life insurance in $10,000 increments from $10,000 up to $750,000. If you apply within 60 days of becoming eligible for benefits, you may obtain up to $250,000 of coverage without evidence of insurability (if under age 60) or $100,000 of coverage without evidence of insurability (if age 60 or older). If you apply after 60 days, or for coverage exceeding these amounts, you must provide evidence of insurability by completing a Life Insurance Evidence of Insurability Form. Supplemental Employee Life Insurance covers death from any cause.
Review the 2012 premiums for monthly costs.
Basic Dependent Life Insurance
This benefit provides $2,500 Basic Dependent Life Insurance for a spouse or qualified/Washington State-registered domestic partner and $2,500 for each eligible unmarried dependent child. If you apply no later than 60 days after becoming eligible for benefits or no later than 60 days after your marriage or the effective date of your Washington State-registered domestic partnership, your spouse or qualified/Washington State-registered domestic partner may obtain coverage without providing evidence of insurability. (Dependent children do not need to provide evidence of insurability.) If you apply after 60 days, your spouse or qualified/Washington State-registered domestic partner must provide evidence of insurability. Basic Dependent Life Insurance covers death from any cause.
Review the 2012 premiums for monthly costs.
Supplemental Spouse Life Insurance
If you enrolled your spouse or qualified/Washington State-registered domestic partner in Basic Dependent Life Insurance, you may apply for additional amounts of life insurance for your spouse or qualified/Washington State-registered domestic partner in $5,000 increments up to one-half of the amount of Supplemental Life Insurance you obtain for yourself. If you apply no later than 60 days of becoming eligible for benefits or no later than 60 days after your marriage or the effective date of your Washington State-registered domestic partnership, your spouse or qualified/Washington State-registered domestic partner may have up to $50,000 of coverage without providing evidence of insurability. If you apply after 60 days, or for coverage in excess of $50,000, you must provide evidence of your spouse's or qualified/Washington State-registered domestic partner's insurability by completing a Life Insurance Evidence of Insurability Form. Supplemental Spouse Life Insurance covers death from any cause.
Review the 2012 premiums for monthly costs.
Supplemental Accidental Death and Dismemberment (AD&D) Insurance for Employees
You may enroll in Supplemental AD&D coverage in $25,000 increments from $25,000 up to $250,000. Deaths and dismemberments from other causes are not covered.
Review the 2012 premiums for monthly costs.
Supplemental Accidental Death and Dismemberment (AD&D) Insurance for Dependents
If you select Supplemental AD&D Insurance for Dependents in addition to your own, your spouse or qualified/Washington State-registered domestic partner will be insured for 50 percent of your benefit if you have no dependent children. If you have children, your spouse or qualified/Washington State-registered domestic partner will be insured for 40 percent and each dependent child for 5 percent of your benefit. If there is no spouse or qualified/Washington State-registered domestic partner, each dependent child will be insured for 10 percent of your benefit. This dependent coverage will not reduce your Supplemental AD&D Insurance coverage.
