Application to convert coverage must be made within 31 days of the loss or benefit reduction of group term coverage. Note: Converting to an individual policy does not extend coverage under the life insurance coverage provided by the State.
Benefits and provisions under the converted policy may not be the same as this group term life insurance. Aetna should be contacted for full details on the coverage available under conversion and how to apply for it.
Applying for Benefits – During the Conversion Period If a person dies during the 31 days when he could have applied to convert to an individual policy, a claim may be made under this group term life insurance coverage by the beneficiary for the maximum amount for which an individual conversion policy could have been issued. This right exists regardless of whether application for an individual policy had actually been made. If application for an individual policy had been made, the beneficiary designation on that application will be followed in the event the person dies during the conversion period.
Filing a Claim Claims should be filed as soon as possible after a loss.
Employees: The beneficiary or other interested party must submit a certified copy of the insured’s death certificate to the employee’s personnel office. The employee’s personnel office is responsible for completing a Proof of Death form and submitting it, along with the certified copy of the death certificate and a copy of the employee’s most recently completed Enrollment/Change Request Form to the Department of Finance and Administration, Office of Insurance. The Office of Insurance will verify coverage and the completeness of the claim, and forward the appropriate documents to Aetna for benefit processing.
Retirees and/or totally disabled employees: The beneficiary or other interested party must submit a certified copy of the death certificate directly to the Office of Insurance. The Office of Insurance will verify coverage, complete a Proof of Death form, and forward the appropriate documents to Aetna for benefit processing.
Additional information may be requested by the Office of Insurance or Aetna in order to process a claim.
Note: All claims should be filed through the employer’s personnel office or, if a retiree, directly with the Department of Finance and Administration, Office of Insurance. Claims should not be filed directly with Aetna, as this will only delay the process.
Other State-Sponsored (Alternative) Life Insurance Policy If an employer (school or community college) was approved by the State and School Employees Health Insurance Management Board to insure with a private group term life insurance policy instead of participating in the State and School Employees’ Life Insurance Plan, several of the policies and procedures described above will not apply. Although the basic benefit structure and