UW Hospital and Clinics Benefits: Supplemental Life Insurance, UW Health, University of Wisconsin Hospital, Madison , UW Health, University of Wisconsin Hospital, Madison

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Regular and Part-time Employees

Supplemental Life Insurance

There is no open enrollment for Supplemental Life.
You may apply for Supplemental Life at anytime throughout the year (your application will be subject to medical underwriting) by submitting an evidence of insurability application directly to Minnesota Life. Please contact Human Resources to obtain an underwriting application.
Beneficiaries:

UWHC and Minnesota Life have implemented a new service to assist in managing beneficiary designations for the Supplemental Life Insurance plan through LifeBenefits. Minnesota Life will be mailing participants a letter with user information and instructions to access the new system during the week of October 1, 2012.
Participants are encouraged to make beneficiary designations by January 1, 2013. After January 1, 2013 beneficiary information will default as stated by the policy.
For questions or if having problems accessing the LifeBenefits website please contact Minnesota Life at 1-877-494-1754.

Forms to increase your life insurance will be emailed to participants the week of October 1, 2012.
The Annual Option to Increase period will be October 8 through November 2, 2012 for a coverage effective date of January 1, 2013.

Premiums

Employee Age	Employee Premium	Spouse/Domestic Partner Premium
27 or less	0.34	0.40
28 – 30	0.37	0.44
31 – 33	0.48	0.56
34 – 36	0.56	0.66
37 – 39	0.68	0.80
40 – 42	1.02	1.20
43 – 45	1.62	1.90
46 – 48	1.96	2.30
49 – 51	2.72	3.20
52 – 54	3.49	4.10
55 – 57	4.85	5.70
58 – 60	6.04	6.90
61 – 63	8.33	8.60
64 – 66	11.99	12.00
67 – 69	16.75	16.70
70 - 72	25.84	25.90
73 - 75	36.98	37.00

Dependent Premiums

Amount of Insurance	Monthly Rate (insures all eligible children)
$2,500	$0.30
$5,000	$0.60
$7,500	$0.90
$10,000	$1.20