University-Paid Life Insurance

Regular full-time faculty and staff are covered by a University-paid group-term life insurance policy in the amount of $5,000. Coverage is effective on the date of appointment. Prudential is responsible for administering this insurance. The group policy number is 35200.

Employee-Paid Age-Graded Life Insurance

As a new employee, you may elect coverage up to three times your salary (rounded to the nearest $1,000) without providing any medical history or proof of good health. The maximum amount available during your first calendar year is $150,000. You may be able to select additional coverage if you provide proof of good health. Please contact the Office of Human Resources for additional information.  

If you would like assistance in determining how much life insurance coverage you need, please try out the Prudential Life Insurance Needs Estimator: http://www.prudential.com/EZLifeNeeds

During the annual open enrollment period, you may increase your age-graded life insurance amount by one times your salary, without providing medical history or evidence of insurability. The maximum amount may be increased each year up to the lesser of eight times salary or $1.5 million.

After age 64, you will not be able to increase the amount of your optional insurance except that it will continue to increase as your salary increases, subject to any amount limitations due to age, as long as you are actively at work. Original amounts of insurance are reduced as follows:

Reduction Rates
Age% Reduced % Maintained
65 35% 65%
70 50% 50%
80 75% 25%

Spousal Age-Graded Life Insurance Coverage

As a new employee, you are able to elect age-graded life insurance for your spouse or same-sex domestic partner up to $20,000, without providing proof of good health.  Any amount selected over $20,000 requires a proof of good health form to be completed.

Dependent Life Insurance Coverage

As a new employee, you are able to elect $5,000 of life insurance coverage for your dependent children, (up to age 26), with no proof of good health required.  The cost is $1.20 per month, regardless of the number of children covered.

How Do I Enroll or Make Changes

As a new employee, and during subsequent open enrollment periods, age-graded life insurance enrollment and changes, as well as spousal, same-sex domestic partner and dependent children enrollment and changes, will be done through ESSIC, the Employee Self Service Information Center.  OTHERWISE:

If you wish to enroll or request increased coverage in the employee age-graded life insurance, you must complete the following forms:

Please Note:  Enrollment/Change forms should be returned to Employee Benefits.  Proof of Good Health forms should be sent directly to Prudential.

If you wish to add coverage or request increased coverage for a spouse or same-sex domestic partner to your age-graded life insurance, you must complete the following forms:

Beneficiary Designation

To be sure that any benefits are paid correctly, you must name your beneficiary. You may change your beneficiary at any time and it is very important that you keep your beneficiary designations up-to-date as your life changes.

To make a beneficiary change you will need to complete the following form:

Premiums

 

Rates
Age RangeBiWeeklyMonthly
Contributions (per $1,000 of coverage)
Less than 25 $.009 $.02
25-29 $.011 $.024
30-34 $.015 $.032
35-39 $.0165 $.036
40-44 $.0205 $.044
45-49 $.0295 $.064
50-54 $.048 $.104
55-59 $.0795 $.172
60-64 $.122 $.264
65-69 $.2345 $.508
70 and above $.3805 $.824

How To Calculate the Cost of Insurance Coverage

Annual Salary X Coverage Amt (1 times your salary up to a max of 8 times) = Insurance Coverage Amt

Insurance Coverage Amount /1000 (per $1000 of coverage) x rate = Monthly Premium Amount

Example: Annual Salary is $51,000

Coverage Amount – 5 times Salary

$51,000 x 5 = Insurance Coverage Amount of $255,000

Age = 44

$255,000/1000 (per $1,000 of coverage) x .044 (2012 Rate Chart) = $11.22

Continuing Coverage After Leaving Penn State

When you end your employment with Penn State, either at retirement or termination, you may be able to convert or port your life insurance coverage. To learn the difference between conversion and portability, click here.

You may be eligible to convert your basic and optional coverage if you are a participant in the Level Premium Plan OR convert your basic coverage and port or convert your optional life coverage if you are a participant in the Age Graded Plan. To be eligible to port coverage, you must have been actively at work on the date employment ended and not retiring.

You must complete an application and apply for these options within 31 days of your coverage termination.

To obtain an application, please contact Prudential at 1-800-778-3827. Please provide the contract number – 35200 when calling. If you are using a telecommunications device for the hearing impaired (TDD), please call 1-800-496-1214. Representatives are available to assist you Monday through Friday between 8:00am and 8:00pm Eastern Time.

Portability of Coverage

To qualify for preferred rates to port your coverage, you must submit proof of good health satisfactory to The Prudential Insurance Company of America. Standard rates do not require proof of good health.

Portability Rates Employee and Dependent Spouse
Age RangePreferredStandard
Contributions (per $1,000 of coverage)
Under 30
$0.099 $0.134
30-34 $0.111 $0.149
35-39 $0.137 $0.185
40-44 $0.200 $0.269
45-49 $0.300 $0.406
50-54 $0.500 $0.675
55-59 $0.852 $1.150
60-64 $1.405 $1.896
65-69 $2.389 $3.226
70-74
$3.869 $5.224
75-79 $6.451 $8.708
Dependent Term Life Monthly rate per thousand for all children covered $0.220

Additional Resources 

Forms