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I want to enroll or change voluntary dependent life insurance:

 

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  • Ensure you have elected life insurance for yourself, as this is required before electing life insurance for your dependent(s).
  • Complete the Life Insurance Enrollment Form.
  • Send the form to Human Resources by e-mail, fax, or intercampus mail.
  • If electing spouse or domestic partner coverage, request theĀ Life Insurance Medical History StatementĀ from Human Resources.
  • Complete and submit the Medical History Statement to Cigna.
  • If approved, Human Resources will set up payroll deduction.

 

 

If you also want to enroll or change voluntary life insurance and/or voluntary accidental death and dismemberment (AD&D) insurance, you may complete additional sections on the Life Insurance Enrollment Form. You will not need to complete the Life Insurance Medical History Statement for AD&D insurance.