Evidence of Insurability

HartfordIf your bargaining unit participates in BSSP's group term life insurance program through The Hartford,  may elect supplemental  life insurance coverage for you, your spouse/registered domestic partner, and/or dependent children. 

 

Employee
$2.60 per $10,000
per month
Spouse/RDP
$1.30 per $5,000
per month

Minimum supplemental covereage

 $10,000

$5,000

Maximum supplemental coverage without Evidence of Insurability

$100,000

$30,000

Maximum optional coverage

$300,000

$100,000

Total optional coverage cannot exceed

5 times basic annual earnings  Sum of employee's group term plus optional coverage

Coverage in the amount of $5,000 is available for dependent children at a cost of $0.70 per employee per month. 

If you are electing supplemental coverage exceeding $100,000 (employee) or $30,000 (spouse), you must complete the online Evidence of Insurability form.


 

Employee
$2.30 per $10,000 
per month
Spouse/RDP
$1.15 per $5,000 
per month

Additional amount available during open enrollment without Evidence of Insurability (You must already have a minimum $20,000 employee or $10,000 spouse optional coverage to purchase this amount without Evidence of Insurability.)

 $10,000

$5,000

Maximum optional coverage without Evidence of Insurability

$100,000

$30,000

Maximum optional coverage

$300,000

$100,000

Total optional coverage cannot exceed

5 times basic annual earnings  Sum of employee's group term plus optional coverage

Coverage in the amount of $5,000 is available for dependent children at a cost of $0.70 per employee per month.  

You must first complete the Additional Life Insurance Election worksheet before making your open elections in VBAS.  Once you have completed the Additional Life Insurance Election worksheet, enter your elections in VBAS.  

If you are electing additional coverage in excess of $10,000 (employee) or $5,000 (spouse) or exceeding $100,000 (employee) or $30,000 (spouse), you must complete the online Evidence of Insurability form (policy number 201700).  

 

Employee
$2.30 per $10,000 
per month
Spouse/RDP
$1.15 per $5,000 
per month

Additional amount available during open enrollment without Evidence of Insurability (You must already have a minimum $20,000 employee or $10,000 spouse optional coverage to purchase this amount without Evidence of Insurability.)

 $10,000

$5,000

Maximum optional coverage without Evidence of Insurability

$100,000

$30,000

Maximum optional coverage

$300,000

$100,000

Total optional coverage cannot exceed

5 times basic annual earnings  Sum of employee's group term plus optional coverage

Coverage in the amount of $5,000 is available for dependent children at a cost of $0.70 per employee per month.  

You must first complete the Additional Life Insurance Election worksheet before making your open elections in VBAS.  Once you have completed the Additional Life Insurance Election worksheet, enter your elections in VBAS.  

If you are electing additional coverage in excess of $10,000 (employee) or $5,000 (spouse) or exceeding $100,000 (employee) or $30,000 (spouse), you must complete the online Evidence of Insurability form (policy number 201700).