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MetLife Life Insurance Group Claims

P.O. Box 6100
Scranton, PA 18505-6100
Fax: 1-570-558-8645

www.metlife.com

1-800-MET-6420 (1-800-638-6420)

Hours of Operation

Monday through Thursday
8:00 AM to 8:00 PM EST

Friday
8:00 AM to 5:00 PM EST

Cigna Business Travel Accident/Commuter Life/Accident Insurance

P.O. Box 22328
Pittsburgh, PA 15222-0328

1-800-362-4462
FAX: 1-877-300-6770
EMAIL:  claimspghlif2@Cigna.com

Important Forms & Documents

Statement of Health Form

Life and AD&D Insurance Portability Form

Life Insurance Conversion Form

Spouse Waiver & Release Form

Plan Document 

Basic & Supplemental Life Certificate (Full-Time)

AD&D Certificate (Full-Time)

Supplemental Life Certificate (Part-Time)

Business Travel Accident Policy Certificate

Life Insurance Plans

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NightDesert

The City of Mesa provides several life insurance policies for employees, including basic life insurance, accidental death & dismemberment (AD&D) coverage, supplemental employee and dependent life insurance, and business travel accident/commuter travel life insurance at no cost to the employee. Employees may also purchase Supplemental (Voluntary) life with included AD&D insurance for additional financial protection.

 

Basic Life Insurance

Basic Life Insurance (insured by MetLife) is provided to full-time employees at no cost. The benefit is equal to the employee's annual salary rounded up to the nearest $1,000. At hire, employees are asked to designate a beneficiary. It is highly recommended that employees review their beneficiaries every few years, but especially when they've experienced a major life event, such as marriage, divorce, birth or death of a family member. This coverage includes conversion or portability rights should you terminate your employment or retire from the City of Mesa.

Accidental Death and Dismemberment (AD&D)

Like the Basic Life Insurance policy, AD&D coverage (insured by MetLife) is provided to full-time employees at no cost and is an additional benefit over and above the Basic Life Insurance benefit. The benefit is equal to an employee's annual salary rounded up to the nearest $1,000. The beneficiary of this policy will match the designation of your Basic Life Insurance.  This coverage includes conversion or portability rights should you terminate your employment or retire from the City of Mesa.

Business Travel Accident/Commuter Life/Accident Insurance

Provided through Cigna (Life Insurance Company of North America), this policy provides a $200,000 death benefit to your beneficiary in the event you are killed as a result of an accident that occurs while you are engaged in City business travel (e.g., attendance at external business seminars/conferences) or commuting to or from work using your normal route. The beneficiary of this policy will match the designation of your Basic Life Insurance.


Supplemental Life Insurance

Supplemental (Voluntary) Life Insurance (insured by MetLife) offers full-time and part-time benefit eligible employees the opportunity to purchase additional life insurance coverage for you, your spouse/committed partner, and/or your dependent children. Coverage for you and your spouse is available in $10,000 increments up to a total of $300,000 each. Premiums for this coverage are your responsibility and will be deducted via payroll deductions. The City does not contribute to the cost of this coverage.

You may add or increase coverage during annual Open Enrollment. If you have a qualifying event (e.g. marriage, newborn, etc.), mid-year applications may be submitted by completing a Benefit Enrollment/Change Form [PDF].

If you have not previously enrolled in Supplemental Life Insurance, or if you want to increase coverage for you or your spouse, please be advised that your application may be subject to underwriting and approval by the carrier administering this plan after you complete and submit a Statement of Health form (ESH).

This coverage may include conversion or portability rights for both you and your dependents. For additional details on conversion and portability rights, see the Conversion and Portability Privileges section below.

Supplemental Life Insurance Monthly Premiums (per $10,000 of coverage)

Age Band (Employee or Spouse)
Cost/$10,000 of Coverage per Month
<29 $0.80
30 - 34
$1.00
35 - 39 $1.20
40 - 44  $1.40 
45 - 49 $2.60
50 - 54 $3.40
55 - 59 $5.40
60 - 64 $7.60
65 - 69   $13.20
70+   $21.00

*Dependent Children coverage is limited to $500 from birth to six months of age.  After six months, coverage will increase to the elected amount.  Coverage will terminate on the last day of the month the child turns 26 years of age.  You are responsible for notifying the Benefits Office to terminate coverage when your child reaches age 26 to prevent premiums from being deducted.  Refunds are not issued for over payment of premiums if you do not notify the Benefits Office in a timely manner.

Age band increases in premium costs for employee and/or spouse occur in January of every year.  Benefit reductions are applied after the employee and/or spouse turn 70 at the beginning of the next calendar year.


Beneficiaries

Beneficiary designations are processed in eBenMesa during Open Enrollment or anytime during the year.  Arizona is a community property state.  If you are designating any portion of the employee Basic or Supplemental life insurance to someone other than an applicable spouse you must have your spouse complete a Spouse Waiver and Release Form [PDF] (this does not apply to committed partnerships). Life insurance for a spouse and/or dependent children are automatically designated to the employee and cannot be changed.

Group Term Life and AD&D Portability and Conversion Privileges 

If you lose eligibility for Life and AD&D insurance coverage with the City of Mesa, you may be eligible to continue your existing Basic and Supplemental Life and AD&D Insurance coverage at individual rates under the Portability and/or Conversion provisions of the respective insurance policies. 

Application for Portability

Portability allows you and your covered dependents to continue your existing Basic and Supplemental term-life and AD&D insurance under a separate group policy.  Unlike conversion, portable coverage does not have a cash value and the rates you pay will increase as you age.  You will not need to answer any medical questions or have a physical exam to port existing coverage unless you choose the Preferred Life Rates option, which may result in lower premium rates, or you choose to increase the amount of your coverage.  If you choose the Preferred Life Rates option or increase your coverage amount, you must complete a Statement of Health Form.

To Port your Basic and Supplemental Term-Life and AD&D Insurance:

  1. Complete and submit the Life Insurance Portability Form to the Employee Benefits Administration office within 31 calendar days from your last day worked
  2. Employee Benefits will complete "Record Keeper" verification section and forward the application to the insurance carrier for processing
  3. Evaluate your premiums using the Portability Rate sheets.  The insurance company will bill you directly for these premiums

Application for Conversion

Conversion allows you and your covered dependents to convert some or all of your existing term life and AD&D policies to individual whole life or accident policies.  You can convert Basic and Supplemental Life and AD&D when you lose this coverage for any reason (e.g. termination or retirement from employment, move to a non-benefit eligible position, spouse or dependent no longer eligible for coverage (divorce, age-out). 


To convert your Basic and/or Supplemental Life and AD&D Insurance:

  1. Submit the Notice of Group Life Insurance Conversion Privilege to the Employee Benefits Administration office within 31 calendar days from your last day worked
  2. The Employee Benefits Administration office will complete and return the Notice to you, which provides the necessary information required for a Conversion Application
  3. Call 877-275-6387 for a local MassMutual financial professional to contact you directly, usually within 48 hours of your request, to complete a Conversion Application and determine your rate.

 

 

FAQs

  • Why should I consider Supplemental Life Insurance?
  • How do I view/update my beneficiary designations?
More FAQs