Supplemental Accidental Death & Dismemberment (AD&D) Insurance
Overview
Supplemental AD&D coverage provides an insurance benefit in the event of death or dismemberment resulting from a covered accident. This coverage is in addition to AD&D benefit automatically included with your IU-sponsored Basic Life Insurance.
Eligibility
Full-time (75% FTE or greater) Academic and Staff employees (including IU Residents) actively employed by IU are eligible to enroll in the plan.
Employees can also insure their spouse and dependent children (through age 25) under the family coverage option. Coverage for disabled dependents may be kept in force beyond age 25 if proof of total disability is provided within 31 days of the date when coverage would have ended due to the age limit. To be eligible for coverage, dependents cannot be full-time members of the armed forces of any country, cannot be insured by more than one employee, and cannot be insured as both an employee and a dependent.
Coverage Options
Eligible employees can purchase coverage from $30,000 to $500,000. If family coverage is purchased, each family member’s coverage is a percentage of the benefit amount selected. See the Plan Booklet for details.
Cost
The premiums for Supplemental AD&D coverage are paid by the employee through pre-tax payroll deductions.
Monthly Premium Rates
| Benefit Amount | Monthly Cost
for Employee Only Coverage |
Monthly Cost
for Employee and Family Coverage* |
|---|---|---|
| $30,000 | $0.42 | $0.72 |
| $60,000 | $0.84 | $1.44 |
| $90,000 | $1.26 | $2.16 |
| $120,000 | $1.68 | $2.88 |
| $180,000 | $2.52 | $4.32 |
| $240,000 | $3.36 | $5.76 |
| $300,000 | $4.20 | $7.20 |
| $350,000 | $4.90 | $8.40 |
| $400,000 | $5.60 | $9.60 |
| $450,000 | $6.30 | $10.80 |
| $500,000 | $7.00 | $12.00 |
| *For Employee and Family Coverage, benefits for family members will be a percentage of the Benefit Amount selected. | ||
Enrollment
Employee may enroll in Supplemental AD&D within 30 days of becoming eligible (typically your date of hire or date of transfer into an eligible position). After 30 days, enrollment in the plan may only occur during the annual Open Enrollment period. Outside of these enrollment periods, changes may only be made within 30 days of an IRS-qualifying life event.
Enrollment continues as long as the employee remains eligible and pays the premium. Coverage for dependents ends when they no longer qualify as dependents.
When Coverage Ends
Participants may voluntarily terminate coverage only during the annual Open Enrollment period, or within 30 days of certain IRS-qualifying life events. Coverage otherwise ends when benefit eligibility ends, usually due to separation from IU employment or transferring to an ineligible position. A covered employee may port their coverage to an individual policy by submitting a completed portability application and the first premium payment to the policy underwriter, The Standard, within 31 days after the date group coverage ends. Please contact IU Human Resources to request completion of the employer portion of the application at or (812) 856-1234.
Supplemental AD&D Portability Application
How to File an AD&D Claim
To file a claim, complete the Supplemental AD&D Claim Packet (English | Spanish) and submit it to The Standard at their mailing address listed on the form. Contact IU Human Resources at to request completion of the Employer’s Statement (Section 2).
Plan Documents
- Supplemental AD&D Claim Packet: English | Spanish
- Supplemental AD&D Plan Booklet
- Supplemental AD&D Certificate
- Supplemental AD&D Portability Application