You may purchase Voluntary Life Insurance for yourself up to a maximum of $500,000 in $10,000 increments. You must provide Evidence of Insurability (EOI) if you apply for Supplemental Life Insurance greater than $120,000.
You may purchase Voluntary Life Insurance for your spouse or domestic partner up to a maximum of $250,000, in $5,000 increments. You must provide evidence of good health if you apply for Life Insurance for your spouse or domestic partner greater than $50,000.
You may purchase Voluntary Life Insurance for your child or children up to a maximum of $10,000, in $2,500 increments.
After your New Hire event closes, any other requests to increase Voluntary Life Insurance will require you provide evidence of insurability.
The Prudential EOI Form -Personal Health Statement is the process of providing health information to qualify for certain types of insurance coverage. If you elect voluntary Life and AD&D coverage above the guaranteed issue limit or outside of the guaranteed issue period, you will be required to submit a health questionnaire (in some cases, a physical exam may be required). Your questionnaire will be reviewed by Prudential and you will be notified of their decision directly.
To complete this process, please complete the Prudential EOI Form -Personal Health Statement yourself and spouse (if applicable).
Your employee number is your Associate ID that starts with RS in ADP/WFN.
The completed form should be sent to [email protected] or faxed in 877-605-6671 or mailed to Prudential Group Medical Underwriting (P.O. Box 8796, Philadelphia, PA 19176).
You will have 30 days to complete the Prudential EOI Form -Personal Health Statement from your election date.