Term Life Insurance
with Member Accidental Death and Dismemberment Benefit
Issued by The Prudential Insurance Company of America
Take care of your family—even if you can’t be there
Plan Benefits:
Life insurance benefits can help your family meet their expenses after your death. The benefit can be used for whatever their needs are—mortgage payments, tuition, credit card bills, or any expenses that affect your family.
Available Coverage Amounts
Coverage up to $750,000
Select the coverage amount that best protects your loved ones. SAMBA Term Life Insurance Plan coverage is available in amounts up to $750,000.
Includes AD&D:
If you are less than age 65, the Accidental Death and Dismemberment Benefit (AD&D) pays your beneficiaries an additional benefit if your death is the result of an accident. The benefit amount matches the amount of life insurance protection you elect.
Terminal Illness:
If you or your covered spouse become terminally ill with a life expectancy of 12 months or less, the Accelerated Life Benefit lets you receive up to 75% of the coverage amount while still living. Use the proceeds as you wish—for travel, medical bills or family expenses. Your beneficiaries will receive the remainder upon your death.
Add family coverage:
If you are approved for coverage, you can request life insurance coverage on your eligible spouse and unmarried dependent children, under age 26.
Your spouse can be covered up to $750,000 not to exceed 100% of your coverage. Children are covered at $20,000 each.
Permanent Coverage:
The SAMBA Term Life Insurance coverage is truly portable—it goes with you even if your employment status changes. That means that once you are approved for coverage, the Term Life Insurance is yours to keep, even if you change agencies, retire or leave federal employment altogether.
You can maintain your Term Life Insurance coverage simply by continuing to make your premium payments.
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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