The Accidental Death and Dismemberment (AD&D) Insurance plan offers accidental death and dismemberment insurance for employees and their spouse or domestic partner and eligible children. You may select coverage levels that range from $25,000 to $500,000.
In addition to benefits payable in the event of accidental death or dismemberment, this plan provides the following benefits:
– travel assistant program that provides benefits when you travel at least 100 miles from your home.
- Print your for your next trip. Policy number is GTU8364005.
- Benefits to care for surviving family members including benefits to pay for daycare expenses, higher education benefits, and retraining benefits.
- Benefits for covered injuries including home alteration and vehicle modification benefits, hearing aid benefit, and therapeutic counseling benefits.
- Additional benefits paid in certain situations such as carjacking, coma, and natural disaster benefits.
- If an accidental death claim is paid due to the death of a covered employee, family coverage continues premium-free for one year after death.
- Continuation of group policy coverage at retirement.
- of coverage to an individual policy at the end of employment.
See thefor an explanation of all benefits under this plan.
Popular Forms & Publications
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.
An eligible dependent includes:
- 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 for coverage until the earliest of:
- The end of the month in which he/she marries, or
- The end of the year in which the child is no longer dependent upon you for at least 50% of their financial support, or
- The end of the year in which the child turns 19, except
- If child is a full-time student, he/she is eligible until the end of the year in which the child turns 25 or ceases to be full-time student, whichever is earlier.
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 children who are also eligible for this plan as an employee.
- You may enroll, change, or cancel your coverage at any time.
- Coverage is effective on the first of the month on or following receipt of your application. You may enroll within your first 30 days via eBenefits or with a paper application and you may submit a paper at any time after your first 30 days to enroll.
You are strongly encouraged to submit a
- 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 covered employee.
Forms & Publications
- – Complete and submit to your institution’s benefits office to enroll in the plan.
- – Complete and submit to UW System Administration to name who you would like to receive benefits payable upon your death.
- – Follow the instructions on the conversion bulletin to learn how to convert your group policy to an individual policy. Must be under age 70 to convert.
- Continuation Form – Contact your benefits office if you need a continuation form.
The Accidental Death and Dismemberment Insurance plan (group policy #GTU 8364005) is administered by University of Wisconsin System Administration and Hausmann-Johnson Insurance and underwritten by Zurich American Insurance Company.