Basic Life Insurance + AD&D and Supplemental Life Insurance + AD&D through UHC

Your Life Insurance plan provided through UnitedHealth Care is a term life policy that will pay a cash benefit directly to your designated beneficiaries if you should pass away.

During the employer’s scheduled Annual Enrollment Period, whoever is insured for Supplemental Life may increase coverage by one incremental level without providing proof of good health up to the Guaranteed Issue limit as long as Coverage had not been increased in the prior year due to a Family Status Change. *Evidence of Insurability is required for any requested amount for anyone previously denied coverage. 

Eligibility: All Active Full-Time Employees work at least 30 hours per week.

Basic Life 100% Employer Paid + Basic AD&D 100% Employer Paid
Voluntary Life and AD&D Employee Paid, Monthly Rates are age-banded for every $1,000 of Benefit. Employee and Spouse rates are based on Employee’s age.

If you need to file a claim:
· Contact the employer
· Complete, sign, and date the necessary forms.
· Send the completed forms via fax or mail to the contact details listed on the claim form. You may also email the completed forms to our unsecured email address [email protected].

To submit a dismemberment claim
1. You must complete the employer portion of the Statement of Claim for Accidental Dismemberment Benefits form, available online or by calling 1-888-299-2070.
2. Ask the employee to:
• Complete the Employee portion of the claim form
• Have the insured’s physician complete the attending physician statement on the claim form
• Provide a copy of the accident report
• Provide a copy of the toxicology report (if one is performed)
Mail the completed Death or Dismemberment Claim forms to:
UnitedHealthcare Specialty Benefits
PO Box 7149
Portland, ME 04112-7149

The Beneficiary Companion Program is available under your policy. This offers 24/7 guidance on closing an
estate and protecting your loved one’s identity. You may request your Beneficiary Companion Guidebook by
calling toll-free at 1-866-643-4241 or direct 1-240-330-1368.

Send EOI applications to:
UnitedHealthcare Specialty Benefits Group – Medical Underwriting Services
PO Box 17829 Portland, ME 04112-8829