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Life and AD&D Insurance

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How to Enroll

Booklets Additional Life and AD&D Short Term Disability Long Term Disability MEDEX® Travel Assist Beneficiary Financial Counseling Certificates Life and AD&D Short Term Disability Long Term Disability Forms - To apply for Coverage - - To submit Evidence of Insurability - Medical History Statement - To apply for Benefits - Life Claim Packet Accelerated Benefit Claim Packet Accidental & Dismemberment Claim Packet Short Term Disability Claim Packet Long Term Disability Claim Packet - To update your Beneficiary Designation - Contact Us




Instructions for Submitting Evidence of Insurability

Please follow these instructions when Evidence of Insurability (EOI) is required.

Within 31 days of first being eligible for benefits

Basic Life, Accidental Death & Dismemberment insurance - All eligible employees qualify for benefits after serving a waiting period. No EOI is required.

Additional Life and Dependents Life Insurance for your Spouse/Domestic Partner and for your Child(ren) - You can automatically purchase up to $100,000 of Additional Life insurance and choose any one of the three Dependents Life options for your spouse/domestic partner and/or child(ren). The amount of your Dependents Life coverage (spouse/domestic partner and child separately) may not exceed 100 percent of your employee paid Additional Life coverage. No EOI is required. However, any amount of Additional Life insurance over $100,000 will require EOI.

Note: If both you and your spouse/domestic partner work for Hennepin County, only one employee can insure the dependent child(ren). Additionally, no Dependents Life coverage will be provided if the dependent spouse/domestic partner works for Hennepin County or the dependent spouse/domestic partner is a member of the armed forces (military) for any country.

Due to qualifying events (within 31 days of the event)

Dependents Life Insurance - A spouse/domestic partner may be added without EOI, if added within 31 days of becoming an eligible dependent. Children may be added without EOI.

Any period after the first 31 days of being eligible

Additional Life Insurance - For elective increases to your Additional Life coverage, EOI will be required. For example, if you are insured for $70,000 and want to increase your coverage to $80,000, you would need to provide EOI. If you are declined for the increased coverage, both the Basic Life and the prior Additional Life amounts ($70,000 in this example) will continue to be in force.

Short Term Disability - If you drop STD coverage and want to enroll again EOI will be required. EOI is not required if this is your first time enrolling in STD coverage.

Dependents Life Insurance - If you would like to increase your optional Dependents Spouse/Domestic Partner Life insurance or purchase the coverage for the first time (outside of a change in family status) medical evidence will need to be provided for the spouse/domestic partner electing coverage. The new or increased amount of optional Dependents Life insurance will not become effective until the date EOI is approved.

Note: If you are required to submit EOI, please complete a Medical History Statement.