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Enrolling in Life Insurance An eligible employee must either enroll in life insurance coverage or waive coverage when he begins covered employment. If the employee enrolls in the life insurance coverage, the effective date of coverage is his date of employment; however, a life insurance Enrollment/Change Request Form must be completed, signed, and sent to the employer within the first 31 days of employment. The employer is responsible for forwarding the completed form to Blue Cross & Blue Shield for final processing.

Late Enrollees If an employee applies for life insurance after the first 31 days of employment or initially waives coverage when first eligible and subsequently elects to participate, he will be considered a “late enrollee” applicant. As a late enrollee, he will be required to complete an Evidence of Insurability Statement in addition to the life insurance Enrollment/Change Request Form. Forms are available from the employees’ personnel office, or can be downloaded from the Know Your Benefits website. The employee must return the Enrollment/Change Request Form to his employer. The employee may submit the completed Evidence of Insurability Statement confidentially directly to Aetna or return the form to his employer for submission. Aetna will be responsible for evaluating the late enrollment request, along with any follow-up documentation they may request from the applicant, to determine if coverage will be approved. Upon completion of their review and determination process, Aetna will notify the employee and the employer of their decision. Aetna is the sole authority for evaluating late enrollment applications.

If a late enrollee application is approved, the effective date of coverage will be the first of the month following or coincident with the date of Aetna’s approval.

How Much Is An Employee Insured For? An employee’s life insurance amount is calculated by doubling his annual salary and rounding the result up to the next higher thousand.

The minimum amount of life insurance under the Plan for employees is $30,000, and the maximum amount is $100,000, regardless of annual salary.

If an employee’s salary changes (increases or decreases), the amount of life insurance coverage may also change. Any change in the amount of the employee’s life insurance will be effective on the first day of the month following or coincident with the change in salary.

Cost of Coverage for Employees The employee shares with his employer in the cost of his life insurance premiums. The employee pays half of the monthly premium cost through payroll deduction, and his employer pays the other half.


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