Upon hire or during any open enrollment period, you may purchase Accidental Death and Dismemberment insurance underwritten by Hartford Life Insurance Company at competitive group rates in increments of $25,000. You have the option to cover yourself, or you and your family. The amount of the benefit for each dependent is determined as a percentage of the principal sum you elect for yourself:

You with* Spouse/Domestic Partner Each Child
Spouse Only 60% 0%
Spouse & Children 50% 15%
Children Only 0% 20%

*As determined on the date of the accident

You are covered 24 hours a day, anywhere in the world. Benefits are payable in the event of accidental death, subject to some exclusions such as suicide, military service and war. Dismemberment benefits are payable according to this table of losses:
  • Full Principal
    Death; Double Dismemberment (both hands, both feet, sight in both eyes or a combination of two, to include speech and hearing); Quadriplegia (movement of upper and lower limbs).
  • 75% of Principal
    Paraplegia (movement of both lower limbs).
  • 50% of Principal
    Hemiplegia (movement of both upper and lower limbs on one side of body) or Single Dismemberment (hand, foot, sight in one eye, speech or hearing).
  • 25% of Principal
    Loss of Thumb and Index finger on either hand.

In addition, this coverage provides these benefit features should an unexpected tragedy occur:
  • Seatbelt Benefit
  • Coma Benefit
  • Travel Assistance Benefit
  • Adaptive Home and Vehicle Benefit
  • Therapeutic Counseling Benefit

Family coverage also includes:
  • Spouse/Partner Education Benefit
  • Student Educational Benefit
  • Dependent Child Dismemberment
  • COBRA Benefit
  • Day Care Benefit
  • Common Disaster Benefit
  • Extended Dependentsí Coverage

See the plan booklet for complete details on all benefits. The booklet is available under Resources in the column at the right, or call the Benefits Office at 206-615-1340 for a copy.

You pay 100% of the premium through payroll deduction. Premiums are deducted the first paycheck of every month for that month's coverage. Please notify your Payroll representative if the deduction fails to appear or is not correct.

You may purchase family coverage within 30 days of a change in family status if you have already been enrolled for employee only. Otherwise, you must wait until an open enrollment period.

Beneficiary Designation
You may designate or change your beneficiaries any time during the year through Employee Self-Service.

AD&D Documents

AD&D Beneficiary Change Form
AD&D Election Form
AD&D Certificate of Insurance
AD&D Certificate of Insurance Modifications
AD&D Claim Form
AD&D Conversion Notice & Form
AD&D Conversion Form Instructions
AD&D Plan Book
Rate Table
Travel Assistance Program Guide
Travel Assist Wallet Card

Printed: 5/26/2020 11:07AM