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Human Resources - WA 615
(510) 885-3634 FAX (510) 885-2951
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PROGRAM An employer-paid life insurance and accidental death/dismemberment program administered by Standard Insurance Company. Group Policy #603267-C. The Standard's CSU basic term life and AD&D Insurance Plan contains a number of enhanced coverage features including:
MEDEX TRAVEL ASSIST ELIGIBILITY Employees must be appointed half-time or more for a duration exceeding six months. In addition, lecturers with a time base of .40 or greater who are appointed for an academic year or two quarter appointment are eligible. Please download the Lecturer Benefit Eligibility Criteria for additional information. There is no coverage for family members under this plan. ENROLLMENT All eligible employees are automatically enrolled. Coverage will be effective the first of the next pay period following eligibility PREMIUMS The full cost of this coverage for eligible employees is paid by the CSU except during unpaid leaves of absence. COVERAGE
**Life Insurance coverage in excess of $50,000 will have an imputed income tax liability computed and reported in accordance with IRS regulations and State Controller's Office procedures. Employees who do not want the additional tax liability may waive the excess coverage at any time, on a prospective basis only. Contact Human Resources for the appropriate form. CERTIFICATE Each new participant will be provided with a certificate of insurance detailing the program. Please refer to the Certificate of Coverage for complete details. CONVERSION OPTION Upon termination of employment or if you become ineligible for coverage, you may elect to convert the life insurance then in force to any form of individual policy of life insurance issued by Standard Insurance Company. No evidence of insurability is required if application is made within 31 days following termination of employment or ineligibility. BENEFICIARY PROVISIONS If you wish to designate a beneficiary other than a spouse, child or parent that are considered automatic (statutory) beneficiaries, you must complete a beneficiary designation form, which can be obtained from Human Resources. DIRECT PAY If you go on a leave without pay or are otherwise on approved non-pay status, you may elect to pay the full premium for continuous coverage. For further information, contact Human Resources. This summary of Group Life and Accidental Death and Dismemberment Insurance benefits is not to be construed as a substitute for the master contract. Individual insurance booklets detailing the benefit are provided to each covered employee.
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