AFSCME AFSCME Local 2076
HEALTH & WELFARE TRUST FUND
Administered by Design Benefits Administrators

Voluntary AD&D Insurance

As a Union Member, you may purchase $100,000 of voluntary AD&D insurance for yourself. You may also purchase $50,000 of voluntary AD&D insurance for your spouse. Your children may be covered by $10,000 of voluntary AD&D insurance. The rate table shows the per pay period cost. No other insurance amounts are available.

Employee

Amount of Coverage


$100,000

Cost Per Pay Period


$1.62
Spouse $50,000 $0.81
Child $10,000 $0.21

Benefits issued when first eligible are guarantee issue to $100,000 thereafter members wishing to increase their AD&D insurance benefits other than when first eligible are subject to filling out an evidence of insurability form and subsequent approval by Aetna Life Insurance Company.


All rates are on a per pay period basis. An application must be submitted for all supplemental and voluntary plans. Eligibility requirements may be waived if enrolling within thirty (30) days of employment.