Effective 7/1/17 the City of Manchester, NH is changing from The Hartford to UNUM as our Life and Disability carrier.
Life Insurance Overview
Long Term Disability Overview
Other Forms, Information and Rate Charts
Converting or Porting Life Insurance when no longer an employee of City
You are eligible for Basic Life Insurance and Supplemental Life insurance if you are an active part-time or full time employee who works at least 20 hours per week on a regularly scheduled basis.
Your employer provides, at no cost to you, Basic Life and AD&D (Accidental Death and Dismemberment) insurance in an amount equal to 1 times your annual Earnings, rounded to the next higher $1,000, to a maximum of $50,000.
You can, at your own cost, also purchase additional life insurance. This is called Supplemental Life Insurance.
Supplemental Life Insurance is coverage above the basic life insurance amount that the City provides. It is insurance that is paid by you, the employee. You must have Supplemental Life insurance on yourself in order to purchase Supplemental Life insurance on your spouse or children.
Supplemental Life Insurance amounts can be purchased as follows:
For yourself - $25,000 to a maximum of $300,000
For your spouse - 1/2 of the Supplemental amount you chose for yourself to a maximum of $150,000
For your child(ren) - $10,000 for each child
Life Insurance pays your beneficiary a benefit if you die while you are covered.
You are eligible for Long Term Disability if you are an active part-time or full time employee who works at least 30 hours per week on a regularly scheduled basis.
The City provides Basic Long Term Disability which will cover you for 24 months (2 years).
At your own cost, you can purchase Optional Long Term Disability which will cover you past the 24 month period covered by the City, up to your normal Social Security Retirement Age.
The Social Security web site http://www.ssa.gov/OACT/ProgData/nra.html shows the chart to display what is considered your "normal social security retirement age".
Basic and Optional Long Term Disability provides coverage that pays you a benefit of 60% of your earnings to a maximum monthly benefit of $5,000 per month.
City of Manchester Life & Disability Enrollment Form
Complete this form to request Supplemental Life Insurance and/or Optional Long Term Disability
Evidence of Insurability Form
Current Employees - Complete this form if you are requesting either Optional Long Term Disability or Supplemental Insurance if you had a qualifying event.
New Employees - Complete this form ONLY if requesting Supplemental Life Insurance over $150,000 for yourself or $20,000 for your spouse. As a new employee, you have 31 days after your date of hire to enroll in Optional Long Term Disability and Supplemental Life insurance. If not done within those 31 days, you will have to wait until the next open enrollment period.
Change of Status Form
If you have a qualifying event such as marriage, new child, etc, you have 31 days from that qualifying event to enroll in the Optional Long Term Disability or to add or increase Supplemental life for yourself, your spouse or your child. You will need to complete the Evidence of Insurability form when enrolling in Optional Long Term Disability or if you wish to add or increase your Supplemental life insurance. If the qualifying event is a marriage, you can purchase Supplemental life of $20,000 on your new spouse without having to fill out the Evidence of Insurability form. Any amount requested over $20,000 will require the Evidence of Insurability form.
This form is to update your Life Insurance beneficiaries for both the Basic Life insurance that the City pays for and Supplemental Life insurance that you pay for
Term Life Insurance and AD&D Flex Coverage Highlights
This is a description of your UNUM Term Life and AD&D Insurance Plan
Long Term Disability Income Protection Insurance Plan Highlights
This is a description of your UNUM Long Term Disability Income Protection Insurance Plan
Supplemental Life Insurance Rate Chart
If you choose to purchase Supplemental Life Insurance above the basic amount provided by the City, this rate chart will show you the weekly cost of the insurance amount you are electing.
**Important: Please know that when you purchase Supplemental Life Insurance, the weekly rate you pay will change when you reach a birthday ending in "5" or "0".
Optional Long Term Disability Rate Chart
If you choose to purchase Optional Long Term Disability (Buy-up) above the core benefit provided to you by the City, this rate chart will show you your estimated weekly cost.
Supplemental Life Insurance Cancelation Form
Use this form if you want to cancel your current Supplemental Life insurance
Supplemental Life Insurance Decrease Form
Use this form if you want to decrease your current level of Supplemental Life insurance
Optional Long Term Disability Cancelation Form
Use this form if you want to cancel your current Optional Long Term Disability insurance
Additional Services Offered by UNUM
Below are flyers on how to convert or port your life insurance once you are no longer an employee of the City of Manchester
Brochure - What do I need to do to convert or port my coverage?
Life Insurance Notification of Conversion Privilege
Term Life Insurance Election of Portability Coverage