Eligible Employees have the opportunity to take advantage of accidental death & dismemberment (AD&D) insurance, which provides additional financial protection for covered injuries that are the result of a covered serious accident. It also covers the accidental loss of life.
AD&D can help to pay for unexpected costs, such as:
Keep in mind, this coverage shouldn’t be a replacement for life insurance or major medical insurance as it provides accident-only coverage.
The content in this portal is for informational purposes only and contains words and phrases that have special meanings. These words and phrases appear in the General Definitions section. The Certificate of Insurance (Certificate), provided to you once coverage has been issued, will contain the specific information on each benefit, and additional information (including the eligibility rules for participation) can be found in the Insperity Welfare Benefits Plan Summary Plan Description (SPD).
Note: The information provided is for voluntary (employee-paid) AD&D insurance. If you want information for basic (employer-paid) AD&D insurance, access Insperity PremierTM, or call the Insperity Contact Center at 866.715.3552.
*Formerly known as Personal Accident Insurance.
Complete, sign and date the enrollment application and return to Cigna at the address shown on the form or via email at DSM_CignaCustomerSupport@infymccservices.com.
If you have questions, please call 800.231.1193 to speak to a Cigna representative (Monday through Friday, 8 AM to 5 PM CST or 9 AM to 6 PM EST).
Who is Eligible for Coverage?
If you are an Eligible Employee, coverage is available for you and your Spouse/Domestic Partner (if he or she is under age 70).
Your dependent children are also eligible from live birth to 26 years of age (or dependent children 26 years of age or older who are primarily supported by you and incapable of self-sustaining employment because of a mental or physical disability).
No one can be covered more than once under this plan. If you are covered as an Eligible Employee, you cannot also be covered as a dependent.
How Much Coverage Can You Buy?
Coverage for you
If you are an Eligible Employee, you may purchase coverage in the following amounts:
Coverage for your family
Each family member’s coverage is a percentage of the benefit amount you select. It will depend on who your insured family members are at the time of a covered accidental loss.
When the covered employee reaches age 70, benefits will be reduced to 70% of the benefit amount selected; at age 75, 45%, at age 80, 30% and at age 85, 15%.
Coverage for your Spouse/Domestic Partner ends when they attain age 70.
Monthly Cost of Insurance
Use this chart to help you figure out the cost of monthly AD&D insurance coverage. You pay your premiums through payroll deduction unless you are on an unpaid leave of absence, in which case you will be required to pay via check. The total depends on how much coverage you select.
|Monthly Cost of Insurance|
|Employee only||$0.016 per $1,000 of coverage|
|Employee and Family||$0.026 per $1,000 of coverage|
AD&D is paid for with after-tax dollars. Rates are subject to change.
A Valuable Combination of Benefits
We will pay benefits if you, or an insured family member, are seriously injured in a covered accident that results in dismemberment, loss of eyesight, speech and hearing, and paralysis.
If you suffer multiple covered losses in one covered accident, you’ll receive only one benefit—the largest benefit to which you’re entitled. See your plan’s Schedule of Covered Losses below for details.
Schedule for Covered Losses
|If, within 365 days of covered accident,
bodily injures result in:
|Cigna will pay this % of benefit amount:|
You and Your Spouse/
|Loss of life||100%||100%|
|Loss of two or more hands or feet||100%||200%|
|Loss of one hand or one foot and sight in one eye||100%||200%|
|Loss of one hand or foot||50%||100%|
|Loss of thumb or index finger of the same hand||25%||50%|
|Loss of four fingers of the same hand||25%||50%|
|Loss of sight of both eyes||100%||200%|
|Loss of speech and hearing (in both ears)||100%||200%|
|Loss of sight in one eye||50%||100%|
|Loss of speech||50%||100%|
|Loss of hearing (in both ears)||50%||100%|
|Note: Only one benefit (the largest) will be paid for losses from the same accident.|
Other Benefit Features
Some accidents could seriously affect your finances—especially if extensive rehabilitation is needed. That’s why AD&D insurance gives you these additional benefits to help meet special needs.
Child-care center benefit
We will pay a benefit to help pay for each of your children’s daycare expenses if you, or your insured Spouse/Domestic Partner, dies because of an accident. We’ll pay up to 3% of your total coverage each year but not more than $3,000 a year, until the child turns 13. We’ll send the payments to the dependent child’s surviving custodial parent or legal guardian.
There are certain limitations:
Increase accidental injury benefit for children
We will pay double the dependent child’s coverage amount if your insured dependent child suffers an accidental injury. The maximum payment amount is $100,000. Restrictions apply. If the dependent child dies within 90 days of the accident, you will receive the death benefit only.
Seat belt and air bag benefits
We will automatically increase the benefit amount by 10% if you, or an insured family member, die in a motor vehicle accident while wearing a seat belt. Maximum benefit is $25,000.
We will automatically increase the benefit amount by 5% if you, or an insured family member, die in an accident while positioned in a seat protected by an air bag that properly inflated on impact. Maximum benefit is $12,500.
We will pay $1,000 if it isn’t clear whether the Insured had been wearing a seat belt, and/or if the air bag inflated properly upon impact.
Restrictions, limitations and exclusions apply as outlined in the Certificate.
If you die in a covered accident, we will provide benefits for training or education, as follows:
For your children. If you die in a covered accident, we will pay an extra benefit for each insured dependent child who is enrolled in college or is in the 12th grade and enrolls in college within one year of the accident. To help pay college expenses, we will increase your benefit amount by actual charges up to 5% or $5,000 (whichever is less), for each qualifying child. This benefit is payable each year for four consecutive years, as long as your dependent children continue their college education.
For your Spouse/Domestic Partner. If, within one year of your death in a covered accident, your Spouse/Domestic Partner enrolls in an accredited school to gain skills needed for employment, we will pay the actual cost of this education or training program for up to one year after enrollment begins, up to $5,000. If your Spouse/Domestic Partner doesn’t elect this education program and you have no dependent children, we will pay an additional $1,000 to your beneficiary.
Exposure and disappearance benefit Benefits are payable if you suffer a covered loss due to unavoidable exposure to the elements as a result of a covered accident. If your body is not found within one year of the disappearance, wrecking or sinking of the conveyance in which you were riding, on a trip otherwise covered, it will be presumed that you sustained loss of life as a result of a covered accident.
If you, your Spouse/Domestic Partner, or your children are in a coma as a result of a covered accident, we will pay a Coma benefit as long as the insured person entered the coma within 31 days of the accident. We will make 11 monthly payments, provided the person remains in a coma during this period. If the person recovers, the payments will stop.
If the insured person dies while the monthly Coma benefit payments are being made, or if the insured person remains in a coma after the 11 monthly payments have been made, he or she will be entitled to a lump-sum payment equal to the full benefit amount.
When Your Coverage Begins and Ends
Coverage for You (and your Dependents, if applicable,) will start on the date we receive your completed and signed application form.
If you are not actively at work on the date coverage would become effective, coverage will become effective on the first day the employee returns to Active Service.
Your coverage will end on whichever comes first:
Spouse/Domestic Partner or dependent children coverage will end on whichever comes first:
Changing from the Group Plan to Individual Coverage
If your coverage ends before you reach age 70, for any reason except nonpayment of premium, you can convert to an individual policy. Proof of good health is not required.
To continue your coverage, you must apply for the conversion policy and pay the first premium within 31 days after your group coverage ends. Family members may convert their coverage as long as they have not reached the maximum age limitation.
Converted policies are subject to certain benefits and limits, as outlined in your policy. Contact Cigna directly for additional information at 800.231.1193
Plan benefits are not payable if:
Designating Your Beneficiary
You can designate your beneficiaries during the enrollment process and maintain your beneficiaries online once your coverage is issued by clicking on My Account.
If the listed beneficiary is a trustee or a trust, you will need to enter the trustee's name, the name of the trust and the date of the trust agreement. The trust document must be presented in order for the claim to be processed.
Need To Access Or Designate Your Beneficiaries?
Below are steps to access your beneficiary designations online:
You can also designate and/or change beneficiaries using the Beneficiary Designation form.
Understanding these words and phrases may be helpful as you read through the information about AD&D insurance.
An employee is in active service on a day which is one of the employer’s scheduled work days if either of the following conditions are met.
An employee is in active service on a day which is not one of the employer’s scheduled work days only if he or she was in active service on the preceding scheduled work day.
Affordable Care Act (ACA)
The federal health care reform legislation that was enacted in 2010, as amended.
Applicable Large Employer (ALE)
An employer that employed, on average, at least 50 full-time employees (including full-time equivalent employees), as defined by the ACA, on business days during the preceding calendar year. Contact Insperity if you have questions concerning ALE determinations and whether you are an employee subject to these rules.
Benefits Eligibility Date
The first date you are eligible to become covered following satisfaction of any required waiting period (as provided in your enrollment materials).
For Full-Time employees, Covered Earnings is your base annual salary, plus actual earnings for the previous 12 months. For part-time employees, this is actual earnings for the previous 12 months. If the employee has been employed for less than 12 months, actual earnings will be annualized.
Covered Earnings includes commissions, piece-work and fee based work. It does not include bonuses, overtime pay, special pay or another form of extra compensation.
A person (of the same or opposite sex as the eligible employee) engaged in a spouse-like relationship with the eligible employee characterized by mutual caring and dependency. In addition, the eligible employee and domestic partner have to (a) be registered as domestic partners under any governmental law or ordinance or civil union law creating legal rights and obligations similar to marriage; or (b) satisfy all of the following requirements:
Important Note: In order to file a claim for benefits, proof of the domestic partnership as indicated above must be furnished the same as proof of a marriage. If you are applying for domestic partner coverage, it is recommended that you retain a notarized affidavit along with the documentation set forth above, or proof of your domestic partner registration, in case required for a claim submission. Claim payment may be delayed if this information is not on file with the insurer at the time the claim is made. An Affidavit of Domestic Partnership form may be found on the Insperity PremierTM Platform, or by contacting Insperity toll-free at 866.715.3552
The Plan administers two sets of eligibility rules – one for employees of a non-ALE company and one for employees of an ALE company, as described below and in the SPD.
Employees of a Non-ALE Company
You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and you are:
Employees of an ALE Client Company
You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and if you are:
Eligibility for employees of an ALE Client Company will be determined based on hours worked during the employee’s Measurement Period. Once the employee is determined by Insperity to be eligible for benefits, eligibility will be retained during the Stability Period associated with that Measurement Period (regardless of any changes in hours worked during the Stability Period).
Certain exclusions may apply. Please see the Certificate for more information.
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