Supplemental Life is a voluntary insurance program that allows eligible employees to add to the Basic Life protection provided by the Northern California Conference. Active part-time or more, regular employees (working a minimum of 19 hours per week) may elect to provide coverage for themselves, their spouse, and dependent children. Only dependent unmarried children under age 26 are eligible. New enrollees may elect up to $250,000 without medical evidence. Coverage for spouses is available for new enrollees up to $30,000 without medical evidence. Child coverage may be elected up to $25,000 in $1,000 increments. The premium cost will be deducted from your payroll.

If you would like to request employee or spousal coverage amounts greater than the limits stated above, please call the Human Resources Department to request a personal health statement form.

For employees who change employers or retire, their Supplemental Life Benefits may be transferred to their new employer or converted to a personal insurance policy. For more information, download and read the Term Life Coverage Continuation Request Form(Submit to Human Resources)

Forms

Life and Disability Income Insurance Enrollment

Term Life Coverage Continuation Request

(Submit to Human Resources)