Life Insurance and Long and Short Term Disability Coverage

Basic Life Insurance (click here to view plan summary)

Northshore School District covers the cost of Group Basic Life Insurance for benefit-eligible employees, it is a mandatory benefit. This provides a death benefit to the employee's beneficiary up to the amount of their annual base salary. This coverage also provides group Accidental Death & Dismemberment Insurance at one times the employee's base salary.  

Eligible employees must complete an enrollment form within 30 days of eligibility. Benefits are reduced to 50% at age 70. Claims are only processed after an enrollment and beneficiary form has been completed. Beneficiary designations continue in effect from year to year unless a subsequent beneficiary form is completed. Beneficiary changes can be made at any time.

Click here to view and print the Life Insurance Enrollment Form (for newly benefit eligible employees)

Click here to complete the Life Insurance Beneficiary Change Form (for all benefit eligible employees, already enrolled)

Optional Life Insurance (click to view plan summary)

In addition to the Basic Life/Accidental Death & Dismemberment Insurance provided by the District, eligible employees can purchase additional group insurance by enrolling in the Optional Life/Accidental Death and Dismemberment insurance. The insurance provides an additional death benefit to the beneficiary that the employee has designated, in the event of the employee's death.

You may enroll for an amount equal to one times your base annual salary (as defined by the carrier) or two times your annual base salary. At age 70 the amount of paid benefit is reduced to 50%. The monthly premium is 14.5 cents per thousand dollars of annual base earnings (as defined by the carrier). If your earnings vary monthly, the premium will vary monthly as well. However, the insurance benefits are paid on your annual base rate (as defined by the carrier) of earnings

To guarantee eligibility, enrollment needs to be completed within the first 30 days of eligibility (usually your hire date). If you wish to enroll after your initial 30 days of eligibility, a health statement and enrollment form must be completed and accepted by the insurance company. Coverage is not guaranteed after the first 30 days of eligibility.

Dependent Life Insurance (click to view plan summary)

Eligible employees can purchase Group Life Insurance for their dependents. This coverage provides a flat benefit amount in the event of the death of your spouse or dependent children. The Plan offers a single monthly rate that covers your spouse and children combined. The rate is the same regardless of the number of family members.

There are four levels of coverage available. The level you can purchase is determined by your base salary. Enrollment is guaranteed if purchased within 30 days of eligibility or at Open Enrollment. For further information on rates and eligibility, please contact the Benefits Department.

Options Plan 1 Plan 1A Plan 2A Plan 2
Spouse $10,000 $15,000 $20,000 $25,000
Children-Birth to 6 months $1,000 $1,000 $1,000 $1,000
Children-6 Months to 26 years $5,000 $5,000 $10,000 $10,000
Rate Per Month $3.95 $5.84 $7.73 $9.62

 

Long Term Disability Insurance (click to view plan summary)

Long Term Disability Insurance is intended to provide you with income if you're unable to work, long term, due to an illness or disability. Long Term Disability Insurance is a mandatory benefit, paid for by the district.

Plan Options

Long Term Disability Insurance has two different plan options. One begins income after 90 calendar days, which pays 55% of your salary to age 65, or one that begins after 180 calendar days, which pays 66-2/3% of salary to age 65. Employees who do not elect a level of coverage within their first 30 days of eligibility will be automatically placed in the 180 day plan. Changes can only be made during Open Enrollment. 

Income received from Social security, retirement, workers compensation payments, etc. decrease the amount of the benefit received. Claim forms are available in the Benefit Department. Coverage is not available to dependents.

Short Term Disability Insurance (click here to view brochure for plan)

Employees may purchase short term disability insurance (salary insurance) to provide them with income during the long-term disability waiting period (90 or 180 days). Coverage is available to benefit-eligible employees.

To enroll, call 1-866-576-0201 or go to the American Fidelity Website to schedule an appointment.

If you are already enrolled and need to file a claim for short term disability, see below for claim forms:

Click here for the American Fidelity Medical Disability Claim Form

Click here for the American Fidelity Pregnancy Claim Form