UW Employees, Inc. Life Insurance

  1. Overview
  2. Publications
  3. Forms

Plan Overview

Description: The plan provides employee-only decreasing term life insurance, with coverage amount based on your age.

Premiums

UW Employees, Inc. Life Insurance Premiums

Learn More

Vendor

Securian Financial Group

Send questions to: benefits@ohr.wisc.edu

Forms

Note: Use Adobe Reader to open and complete PDF forms.
MAC Users: Do not use "Preview," a PDF reader.

Application | Submit to your Payroll & Benefits Office

Application for Enrollment or Cancellation
Coverage is effective on the first of the month after your Payroll & Benefits Office has received your application.

Evidence of Insurability | Submit to Securian Financial Group

Evidence of Insurability
If you do not enroll during your initial enrollment period, you may apply for coverage using this form.

Conversion Application | Submit to Securian Financial Group

Conversion Application

Beneficiary Designation | Submit to Securian Financial Group

Beneficiary Designation

Accelerated Benefit | Submit to Securian Financial Group

Notice of Claim for Accelerated Benefit, F43307-UWEI