Special Open Enrollment ended at midnight on March 31, 2012. This page is for reference only. Benefits-eligible UW employees may apply for additional life insurance at any time by following the normal enrollment/application process.

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The Public Employees' Benefits Board (PEBB) authorized a one-time Special Open Enrollment to allow some state employees to increase their supplemental life insurance coverage up to the allowable limits without providing “Evidence of Insurability” (EOI) or medical review. Additionally, these employees may increase supplemental life insurance coverage (up to the allowable limits) on their spouse/qualified domestic partner without a medical review.

Whether or not you qualify for the Open Enrollment, you should verify your life insurance amounts in Employee Self Service (ESS) at www.uw.edu/ess since the Health Care Authority has stated that the amounts listed in state records on April 1, 2012 will be considered final.

Special Open Enrollment Eligibility

As a UW employee, you qualify for up to $50,000 additional Employee Supplemental life insurance without medical review (EOI) if:

• You currently have PEBB Employee Supplemental Life Insurance, and
• You have not been declined for PEBB life insurance in the past, and
• Your total desired Employee Supplemental coverage does not exceed $250,000, if you are under age 60 (as of February 2, 2012); or
• Your total desired Employee Supplemental coverage does not exceed $100,000, if you are age 60 or greater (as of February 2, 2012).

Your spouse/qualified domestic partner qualifies for up to $25,000 additional Supplemental Life insurance without medical review (EOI) if:

• Your spouse/QDP currently has both Basic Life and Supplemental Life Insurance; and
• Your spouse/QDP's total desired Supplemental coverage does not exceed half of your approved Employee Supplemental coverage; and
• Your spouse/QDP's total desired Supplemental coverage does not exceed $50,000 coverage; and
• Your spouse/QDP has not been declined for life insurance in the past.

If you meet the Open Enrollment eligibility requirements, proceed to the next section. If you do not, you can apply for additional life insurance at any time by following the normal enrollment/application process.

ACT

1. Find your current life insurance coverage amounts by logging into Employee Self Service (ESS) and selecting the "Insurance" tab.
2. Determine how much additional life insurance coverage you will need to reach your goals. See the PEBB's Life Insurance Guide (page 1-3), Rates (page 4) and Calculator (page 5).
3. View the 2012 premium rates for supplemental life insurance.
4. Complete the Life and AD&D Insurance Special Reenrollment Form.
5. Be sure to indicate your (or your spouse/QDPs) total desired supplemental coverage, not just the incremental amount. Since this form replaces your previous form, if you indicate a lower amount, we will assume you are reducing your coverage.
6. Make a copy of the form for your records.*
7. The enrollment form and any related documents must be signed and dated no later than March 31, 2012. These can be delivered to the Benefits Office:
   • Before the Office closes at 5:00 p.m. on Friday, March 30, 2012,
   • Dropped in the UW Tower lobby's campus mail box (open 24/7) by midnight on Saturday, March 31, 2012,
   • Or sent via U.S. mail by Saturday, March 31, 2012 to:
     Benefits Office, University of Washington, Box 359556, Seattle, WA 98195-9556

Note: The effective date of your new coverage is March 1, 2012 for forms signed in February and April 1 for forms signed in March. The premiums for these amounts will appear on your March 26, 2012 paycheck for forms signed in February and April 25 for forms signed in March.

* Benefits does not have sufficient staffing to search for and confirm receipt of forms. You can review your life insurance in ESS after 5:00 p.m. on Friday, March 16 to confirm your application has been processed for the March 1 effective date. If there is a discrepancy, please contact us between March 16 and March 31 and we will make any necessary corrections.

EXPLORE

In addition to the rates, forms, and publication links shown at the right sidebar, here are more resources to help you understand your life insurance choices:

Open Enrollment Letter from PEBB to UW Employees

Life and Accidental Death & Dismemberment (AD&D) Booklet

PEBB's Life Insurance Guide (page 1-3), Rates (page 4) and Calculator (page 5)

Disclaimer: The information on this page does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority.

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