Individual and Family Group Life Insurance

If you are currently enrolled in Individual and Family Life Insurance on or before 10/1/14, you are eligible to increase your coverage during the Annual Benefit Enrollment period from October 6 to October 31, 2014. Visit the Annual Benefit Enrollment (ABE) website for more information on your increase options for 2015.

Plan Summary

The Individual and Family Group Life Insurance (I&F) plan offers term life insurance for employees and their spouse or domestic partner and eligible children. An employee may initially select up to $20,000 of employee coverage, $10,000 of spouse or domestic partner coverage, and $5,000 of child coverage. There is an annual opportunity to increase coverage.

In addition to benefits payable in the event of a death, this plan provides the following benefits:

  • An annual opportunity to increase your coverage level.
  • If you are terminally ill with a life expectancy of 12 months or less, you may receive up to the full amount of your coverage prior to your death. This living benefit is also available for an insured spouse/domestic partner or child.
  • Conversion of coverage to an individual policy at the end of employment.
  • Premiums may be waived to age 65 should you become totally disabled prior to turning age 60.

Eligibility

Employee

You must meet the following requirements to be eligible for this plan:

  • Eligible for State Group Health Insurance; and
  • Are not receiving a Wisconsin Retirement System (WRS) annuity.

Dependents

An eligible dependent includes:

  • Spouse
  • Domestic partner
  • Children as defined as your or your spouse’s or domestic partner’s unmarried children, who are:
    • At least 15 days old, and
    • Dependent upon your for at least 50% of their financial support.
  • Children remain eligible until the earliest of the following:
    • The day the child no longer meets the eligibility criteria above, or
    • The end of the calendar year in which the child turns 25 years old.

Note: If you and your spouse/domestic partner are both eligible for this plan as employees, you and your spouse/domestic partner may only be covered as an employee or a dependent – not both. This rule also applies to eligible children who are also eligible for this plan as an employee.

Enrollment

Coverage Effective Date

  • You may enroll within 30 days of the start of your first eligible appointment.
  • Coverage is effective on the first of the month on or following receipt of your application, either through eBenefits or paper application.
  • If you were initially eligible for coverage when you were not covered by the WRS, you have another opportunity to enroll within 30 days of your WRS coverage begin date.
  • If you do not enroll when first eligible, you may apply for coverage at any time through Medical Evidence of Insurability (acceptance not guaranteed). Coverage is effective on the first of the month on or following the approval of your application by the plan’s underwriter.

Note: You may decrease or cancel coverage at any time during the year.

When to Enroll a Dependent in Coverage

  • If you have eligible dependents when you initially enroll in coverage, you may enroll your dependents at the same time you enroll in coverage.
  • You may add spouse/domestic partner coverage within 30 days of marriage or within 30 days of establishing a domestic partnership for benefit purposes.
  • You may add child coverage within 30 days of gaining an eligible child for the first time (e.g. due to birth, adoption, marriage, or domestic partnership). Child coverage covers all eligible children.

Premiums and Coverage Levels

Coverage Level Options
Coverage Type Initial Enrollment
Coverage Levels
Amount Coverage can
Increase During Annual
Increase Option Period
Coverage Maximum
Employee $5,000, $10,000,
$15,000 or $20,000
$5,000, $10,000,
$15,000 or $20,000
$300,000
Spouse / Domestic Partner $5,000 or $10,000 $5,000 or $10,000 $150,000
Child(ren) $2,500 or $5,000 $2,500 $25,000

Note: Spouse/DP and Child(ren) coverage level may not exceed employee coverage level.

You may also apply for coverage levels above the initial amount through Medical Evidence of Insurability.

Use the Premium Calculator or see the rate chart below to determine your monthly premium.

Monthly Premiums and Coverage Levels
Age as of January 1 Employee Spouse / Domestic Partner*
$5,000 $10,000 $15,000 $20,000 $5,000 $10,000
27 or less $0.12 $0.23 $0.35 $0.46 $0.18 $0.36
28-30 0.13 0.25 0.38 0.50 0.20 0.40
31-33 0.16 0.32 0.48 0.64 0.25 0.50
34-36 0.19 0.37 0.56 0.74 0.30 0.59
37-39 0.23 0.45 0.68 0.90 0.36 0.72
40-42 0.34 0.68 1.02 1.36 0.54 1.08
43-45 0.54 1.08 1.62 2.16 0.86 1.71
46-48 0.65 1.30 1.95 2.60 1.04 2.07
49-51 0.91 1.81 2.72 3.62 1.44 2.88
52-54 1.16 2.32 3.48 4.64 1.85 3.69
55-57 1.62 3.23 4.85 6.46 2.57 5.13
58-60 2.02 4.03 6.05 8.06 3.11 6.21
61-63 2.78 5.56 8.34 11.12 3.87 7.74
64-66 4.00 7.99 11.99 15.98 5.40 10.80
67-69 5.59 11.17 16.76 22.34 7.52 15.03
70-72 8.62 17.24 25.86 34.48 11.66 23.31
73+ 12.33 24.66 36.99 49.32 16.65 33.30

*Spouse/domestic partner coverage is determined by the employee’s age.

Child Coverage
Benefit Amount Monthly Premium
$2,500 $0.18
$5,000 $0.35
$7,500 $0.53
$10,000 $0.70
$12,500 $0.88
$15,000 $1.05
$17,500 $1.23
$20,000 $1.40
$22,500 $1.58
$25,000 $1.75

The University does not contribute towards the premium.

Beneficiary Information

You are strongly encouraged to submit a beneficiary designation to ensure benefits are paid according to your wishes. If there is no eligible beneficiary, or you do not name one, benefits will be paid in the following order:

  • Your surviving spouse or domestic partner, otherwise;
  • Your surviving children equally, otherwise;
  • Your surviving grandchildren equally, otherwise;
  • Your surviving parents equally, otherwise;
  • Your surviving siblings equally, otherwise;
  • Your estate.

All claims associated with the death of a covered family member will be paid to the employee.

Forms & Publications

  • Application - Complete and submit to your institution’s benefits office to enroll in the plan.
  • Beneficiary Designation - Complete and submit to UW System Administration to name who you would like to receive benefits payable upon your death.
  • Accelerated Death Benefit Form - Complete and submit to Minnesota Life if you have a terminal illness with a life expectancy of less than 12 months and want to apply for benefits payable during your lifetime. Your benefits office must complete the Employer Section before it is submitted to Minnesota Life.
  • Conversion Form - Complete and submit to Minnesota Life if you want to convert your coverage to an individual policy at end of employment. Your benefits office must complete the Employer Section before it is submitted to Minnesota Life.
  • Medical Evidence of Insurability Form - Complete and submit to Minnesota Life if you want to apply for coverage through Evidence of Insurability. Your benefits office must complete the Employer Section before it is submitted to Minnesota Life.

Plan Administration

The Individual and Family Group Life Insurance plan (group policy #32871-G) is administered by University of Wisconsin System Administration and underwritten by Minnesota Life Insurance.