Eligibility Forms and Plan Document New Hire / Newly Eligible Employee: Employees must enroll within 30 days of hire or effective date of when employee became eligible for benefits. Benefits are effective the first of the month following employee's first full calendar month of employment or effective date of when employee became eligibile for benefits. Terminating Employment
Any active employee of LSUS is eligible for life insurance provided the following:
CLICK HERE for Prudential enrollment forms
CLICK HERE for Prudential beneficiary forms
Existing employee/family member- If an employee did not enroll in coverage within 30 days of their eligiblity to obtain benefits, they will have to undergo review of their medical history for coverage.
CLICK HERE for Prudential enrollment forms
CLICK HERE for Prudential medical underwriting forms
If the employee loses coverage or leaves LSUS employment the employee/family member will be able to port their coverage for Prudential. Prudential's rates will change because coverage is being ported. The employees has 30 days from when they lose coverage to port their coverage.
CLICK HERE for Prudential Portability rates
CLICK HERE for Prudential Portability enrollment forms
CLICK HERE for Prudential Life Insurance conversion form
CLICK HERE for the Short Form Health Statement Questionnaire
The LSU System announced that The Hartford has been chosen as the new plan administrator for the LSU System Life Insurance Plan effective July 1, 2009. Employees who were enrolled in the LSU System Life Insurance Plan through ING were automatically converted to The Hartford Plan. Eligibility: Any active employee of LSUS is elgibile for life insurance provided the following: Plan Information: Elect up to 5 X annual salary up to $500,000 if you enroll within 30 days of date of hire. Premiums are age-rated and will increase according to age. Can elect coverage amounts for spouse and children. Note : It is the employees responsibility to notify the Payroll Department to stop deductions when the youngest child is no longer eligible. Employee/family member needs to contact the Human Resources to file a claim New Hire / Newly Eligible Employee: Employees must enroll within 30 days of hire or effective date of when employee became eligible for benefits. Benefits are effective the first of the month following employee's first full calendar month of employment or effective date of when employee became eligibile for benefits.Enrollment Forms, a Plan Summary sheet outlining detailed information regarding this change, and brochures for the extra added benefits with The Hartford Life Insurance Plan are listed below. This information is also available in the Office of Human Resource Management, Administration Building, AD 109. Terminating Employment: If the employee loses coverage or leaves LSUS employment the employee/family member will be able to port their LSU System Life insurance. The employees has 30 days from when they lose coverage to port their coverage. Forms: All Life insurance forms and additional information are located on the www.imala.com/lsu website.
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Accidental Death & Dismemberment (AD&D)
(administered by The Hartford)
This benefit pays in the event of death or dismemberment resulting from an accident. This benefits is offered to eligible employees and eligible family members.
Click here for the plan booklet
Eligibility
Any active employee of LSUS is elgibile for life insurance provided the following:
Enrollment
Click here for more information, rates and the enrollment form
Terminating Employment
If you leave LSU employment, your AD&D policy will end at the last day of the month in which you leave LSU. You will be able to convert your AD&D policy after employment. Please complete the form below and forward it to Hartford directly to convert your policy.
Click here for the enrollment form to convert your policy
Note: Form must be completed by LSU HRM before submission
Retirees: You will be able to continue your AD&D coverage for you and your eligible family members. Retirees must elect to continue coverage.