SAMBA’s Term Life Insurance plan for active and retired federal employees
Issued by The Prudential Insurance Company of America
Accidental Death and Dismemberment (AD&D) benefit included at no additional cost.
Add coverage for your spouse and unmarried children up to age 26.
Available Coverage Amounts:
Select the coverage amount that is right for you.
Choose from $25,000 to $750,000.
Includes (AD&D):
Double indemnity if you die before age 65 as a result of an accidental injury.
Add Family Coverage:
Your spouse can be covered up to $750,000. Unmarried children, up to age 26, can be covered for $20,000 each.
Terminal Illness:
If your life expectancy is 12 months or less, you can receive up to 75% of your coverage amount. Your beneficiary will receive the remainder following your death.
Permanent Coverage:
You can retain this plan for life even if you change agencies, retire, or resign.
- Paper Enrollment and Change Coverage Forms
- Beneficiary Designation Form
- FAQs
- Summary Plan Description (under development)
- Termination Policy
- Payroll Allotment Form
- Direct Debit Application Form
- Authorized Representative Form (HIPAA)
This coverage is not health insurance coverage (often referred to as “Major Medical Coverage”).
Group Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, Newark, NJ. The Booklet-Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. Contract Series: 83500
This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York State Department of Financial Services.
IMPORTANT NOTICE – THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS.
THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.
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