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 year is $150,000.

During your initial eligibility as a new employee and during subsequent open enrollment periods, age-graded life insurance enrollment and changes will be done on-line through ESSIC, the Employee Self Service Information Center.

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:

2012/2013 Reduction Rates
Age% Reduced % Maintained
65 35% 65%
70 50% 50%
80 75% 25%

If you are not a new employee and you want to enroll or request increased coverage in the employee age-graded life insurance, you will need to complete the following form:

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 Dependent Enrollment form.

If you wish to add a dependent child(ren) to your age graded life insurance, you must complete the Dependent Enrollment form but no Proof of Good Health is required. The maximum coverage amount for your child(ren) is $5,000, and the cost is $1.20 per month, regardless of the number of children covered.

Once your enrollment change form has been received and processed by Employee Benefits, you will be sent a Proof of Good Health Form.  You will be instructed to submit the Proof of Good Health form directly to Prudential for review.

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 forms:

Premiums

 

2012/2013 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

Calculations

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

Conversion of Coverage

When you end your employment with Penn State, either at retirement or termination, you may convert your life insurance coverage to an individual policy. To do so, visit Prudential's website for more information

Additional Resources

Forms