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Chittenden Central Supervisory Union
Serving the Essex Junction, Essex Union #46, and Westford Schools

Life and AD&D Insurance

Table of Contents

Coverage Amounts

Chittenden Central Supervisory Union provides term Life Insurance and Accidental Death and Dismemberment (AD&D) benefits to eligible employees through UNUM.  The cost of the coverage is paid for by the corresponding school district.  Below is a chart that outlines the coverage amount based on the employee's group.  Employees should refer to their master agreement or individual employment contract for eligibility and coverage information:

Employee Group Basic Coverage Amount
Full-time School-Year Support Staff $15,000
Full-time 12-month Support Staff, Essex Junction and Union #46 Teachers $25,000
Westford Teachers $30,000
Administrators and Directors 2.5 x Annual Salary*

*Maximum basic coverage amount available is $250,000.

Membership and Coverage Information

Initial Enrollment

New hires/rehires are eligible to enroll on our group life insurance plan the first of the month following his/her first day of employment as an eligible employee.  In order to enroll, a Life Insurance Enrollment Form needs to be completed within 30 days of the employee's date of hire.  If the enrollment form is received after 30 days, coverage will begin on the next open enrollment date.

Additional Coverage

In addition to the coverage amounts outlined above, employees have the option for purchasing additional coverage amounts.  The cost of the additional coverage is paid for by the employee through payroll deductions.  The cost of the coverage is dependent on the employee's age per the chart below.  Said rates are subject to change at the carrier’s discretion:

Age of Employee Rate/$1000 of Coverage
00-34 0.11
35-39 0.15
40-44 0.21
45-49 0.32
50-54 0.48
55-59 0.81
60-64 1.04
65-69 1.88
70-99 4.90
  • A 30 year old employee who elects an additional $75,000 in supplement coverage would pay $8.25/month ($75,000 / $1,000 x $0.11 = $8.25) or $99.00/year.  
  • A 55 year old employee who elects an additional $50,000 in supplemental coverage would pay $40.50/month ($50,000 / $1,000 x $0.81 = $40.50) or $486.00/year.

Additional coverage amounts available vary depending on the basic coverage amount provided by the district.  Below is an outline of the additional (supplemental) coverage amounts available based on basic coverage:

Standard Coverage Option A Option B Option C
$15,000 $10,000 $20,000 $30,000
$25,000 $25,000 $50,000 $75,000
$30,000 $30,000 $60,000 $90,000
2.5 x Salary* 1 x Salary 2 x Salary 2.5 x Salary

*The overall maximum (basic and additional) coverage available is $500,000.

At initial enrollment, employees can choose Option A or Option B without submitting evidence of insurability (see below). 

Open Enrollment

The life insurance open enrollment date is July 1st each year.  During an open enrollment, eligible employees can:

  • Increase additional coverage option (if not already at option C)
  • Enroll, if not already enrolled

Evidence of Insurability

Evidence of Insurability must be completed and submitted with the Life Insurance Enrollment Form in the following events.  When evidence of insurability is required, coverage shall be subject to carrier approval. Coverage will begin on the date it is approved:

  • Additional coverage Option C is chosen at initial enrollment
  • Employee refused coverage at initial enrollment and elects to enroll during open enrollment (regardless of the coverage level)
  • Participating employee elects to increase coverage during open enrollment (regardless of the option chosen)
  • Participating employee elects to increase coverage as a result of a change in family status.

Imputed Income

Premiums paid for basic coverage amounts in excess of $50,000 is treated as taxable income and subject to federal, state and FICA taxes. 

Change of Status

Participating employees may elect to increase or decrease coverage between open enrollment dates in the following circumstances: 

  • Marriage/Civil Union
  • Divorce/Dissolution
  • Birth/Adoption of a Child
  • Death of a Spouse/Child

A completed Life Insurance Change Form and Evidence of Insurability (if increasing coverage) must be completed and submitted within 30 days of the event.  The new coverage amount will take effect the later of the following:

  • First of the month following the date of the event; or,
  • Date the new coverage amount is approved (if increasing coverage).

Termination of Coverage and Conversion Privileges

Coverage for a participating employee will automatically be cancelled the first of the month following one of the following events:

  • Termination of employment
  • Employee retires
  • Employee takes an unpaid Leave of Absence in excess of 2 weeks
  • Employee no longer meets the carrier eligibility requirements (minimum of 30 hours/week)
  • Employee changes positions and is no longer eligible for coverage

As a result of one of the events outlined above, an employee is eligible to convert his/her policy to an individual policy, without evidence of insurability, provided s/he has been continuous insured by the plan for at least five (5) consecutive years.  The employee would be responsible for paying the premiums associated with the plan.  Please refer to the Life Insurance Conversion Rates for information about plan costs.

Plan Documents

Participating employees should refer to corresponding plan document for more details about coverage and limitations.  Links to the plan documents are provided below based on district and basic coverage amount:

District Basic Coverage Amount
Essex Junction School District 15K
25K
2.5 x Salary
Essex Union #46 School District 15K
25K
2.5 x Salary
Westford School District 15K
25K
30K
2.5 x Salary
Chittenden Central S.U. 25K
2.5 x Salary

Related Forms

Click here for the following forms:

  • Evidence of Insurability
  • Beneficiary Change Form
  • Life Waiver of Premium Form
  • Enrollment Forms
  • Enrollment Change Forms

Additional Resources