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 Insurance.

Supplemental 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 $50,000
For your child(ren) - $10,000 for each child

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.

Life Insurance pays your beneficiary a benefit if you die while you are covered.

INFORMATION

FORMS

Basic Life and AD&D Summary This sheet explains your basic life and Accidental Death and Dismemberment insurance with the City of Manchester.   Supplemental Life Insurance Summary This summary sheet explains your Supplemental Life Insurance plan available with The City of Manchester.   Supplemental Life Insurance Rate Chart This chart will show you your weekly rate for Supplemental Life and gives you a brief explanation of how much Supplemental Life you can purchase.   Beneficiary Assist Counseling Services Brochure on beneficiary assitance services available to employees covered by The Hartford Group policy. That is part time and full time employees who work at least 20 hours per week.   Estate Guidance Will Services Brochure of will service available to employees covered by The Hartford group policy. If you are part time or full time regular employee working 20 hours; you have this Will preparation service available to you.

Enrollment Form Complete this form if you are a new part-time or full time employee working at least 20 hrs/wk; or if you are a current employee & need to change your Life or Disability insurance due to a qualifying event such as marriage; divorce; new child, etc.   Health Application Form If you are applying for Life Insurance above the guarenteed amount of $150,000 for yourself; or $20,000 for your spouse, this form, along with the Enrollment Form must be completed.   Beneficiary Designation Form Use this form if you want to change your beneficiaries for your basic life and/or supplemental life insurance.   Request To Decrease Supplemental Life Insurance If you want to decrease the Supplemental Life Insurance you currently have on yourself or your spouse, complete this form.   Cancellation Form If you want to cancel the Supplemental Life insurance you currently have on yourself, your spouse or child, complete this form.