Contact your human resources office.
Accidental Death and Dismemberment (AD&D) Insurance offers insurance in the case of an accidental death or dismemberment 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.
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.
See thefor an explanation of all benefits under this plan.
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.
You may enroll, change or cancel your coverage at any time. If you enroll during your initial 30-day enrollment period, your coverage will begin on the first of the month following 30 days from your eligibility date. If you enroll outside of your initial enrollment period, coverage will begin on the first of the month on or following receipt of your application.
For detailed information regarding who you can cover on this plan, see the.
Premiums & Coverage Levels
If you enroll in Family coverage, the benefit amount of your family member(s) coverage will be a percentage of the employee benefit amount.
|Coverage Level||Single Coverage
|The UW System does not contribute towards the premium.|
Rates may be different upon retirement for continuation. See thefor more information.
You are strongly encouraged to designate a beneficiary(ies) to ensure benefits are paid according to your wishes. To designate a beneficiary(ies), complete theform and submit it directly to UW System Administration (the address is listed at the bottom of the form).
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; if one of your children dies before you, that child’s share is divided between your deceased child’s children, otherwise;
- Your surviving grandchildren equally; if one of your grandchildren dies before you, that grandchild’s share is divided between your deceased grandchild’s children, otherwise;
- Your surviving parents equally, otherwise;
- Your surviving siblings equally; if one of your siblings dies before you, that sibling’s share is divided between your deceased sibling’s children, otherwise;
- Your estate.
All claims associated with the death of a covered family member will be paid to the employee.
For more information, see Beneficiary.
Forms & Resources
- Continuation Form – Contact your human resources office if you need a continuation form.
last updated: 12/09/2016