FEGLI’s Accidental Death and Dismemberment Coverage

Key Takeaways:

  1. FEGLI‘s Accidental Death and Dismemberment (AD&D) coverage provides additional benefits for specific accidents resulting in death or dismemberment.
  2. Understanding eligibility, enrollment, benefits, and the claims process is essential for maximizing the protection offered by AD&D coverage.

FEGLI’s Accidental Death and Dismemberment Coverage

The Federal Employees Group Life Insurance (FEGLI) program offers a range of benefits to federal employees, including Accidental Death and Dismemberment (AD&D) coverage. This coverage provides additional financial protection in the event of an accident resulting in death or dismemberment. This article explores FEGLI’s AD&D coverage, including an overview, eligibility and enrollment, benefits and payouts, and the claims process.

Overview of FEGLI’s Accidental Death and Dismemberment (AD&D) Coverage

FEGLI’s AD&D coverage is designed to provide extra financial support to federal employees and their families in the event of a severe accident. This coverage is included as part of Basic FEGLI coverage and is also available with Optional coverage under certain conditions.

Purpose of AD&D Coverage

  1. Additional Protection: AD&D coverage provides extra financial protection beyond the standard life insurance benefits. It is specifically designed to cover accidents that result in death or serious injury.
  2. Financial Support: The benefits from AD&D coverage can help cover immediate expenses, medical costs, and long-term financial needs arising from an accidental death or dismemberment.

Key Features

  1. Included with Basic Coverage: AD&D coverage is automatically included with Basic FEGLI coverage at no additional cost to the employee. This ensures that all employees with Basic coverage have some level of protection against accidents.
  2. Optional Coverage: Employees who elect Optional coverage (Options A, B, or C) may also receive AD&D benefits under specific conditions, further enhancing their financial protection.

Eligibility and Enrollment for AD&D Coverage

Understanding eligibility and the enrollment process for AD&D coverage is crucial for federal employees seeking this additional protection.

Automatic Inclusion with Basic Coverage

  1. Automatic Enrollment: All federal employees who are enrolled in Basic FEGLI coverage automatically receive AD&D coverage. There is no need to take additional steps to enroll.
  2. No Additional Cost: AD&D coverage is included in the Basic coverage at no extra cost, making it an affordable way to gain additional protection.

Optional Coverage and AD&D

  1. Eligibility for Optional Coverage: Employees who elect Optional FEGLI coverage (Option A, B, or C) may also receive AD&D benefits under certain conditions. However, the specific terms and conditions of AD&D coverage may vary based on the elected options.
  2. Enrollment Process: To receive AD&D benefits through Optional coverage, employees must elect the desired level of Optional coverage during their initial enrollment period, during open seasons, or following a qualifying life event.

Benefits and Payouts Under AD&D Coverage

The benefits and payouts provided by FEGLI’s AD&D coverage depend on the nature and extent of the accident. Here is a detailed look at what beneficiaries can expect.

Accidental Death Benefits

  1. Full Benefit Payout: In the event of accidental death, the AD&D coverage provides a full benefit payout equal to the amount of the employee’s Basic coverage. This is in addition to the standard death benefit from the Basic coverage.
  2. Enhanced Financial Protection: The combined payout from the standard death benefit and the AD&D benefit provides substantial financial protection to the employee’s beneficiaries, helping to cover immediate expenses and long-term financial needs.

Dismemberment Benefits

  1. Partial Benefit Payouts: AD&D coverage also provides benefits for dismemberment resulting from an accident. The amount of the payout depends on the severity and type of dismemberment.
    • Loss of Limb: The loss of one limb (hand, foot, or eye) typically results in a payout of 50% of the AD&D coverage amount.
    • Loss of Multiple Limbs: The loss of two or more limbs or a combination of a limb and an eye results in a full payout equal to the AD&D coverage amount.
  2. Coverage for Various Injuries: The AD&D benefits cover a range of injuries, including the loss of hands, feet, and sight. Each type of injury has a specified payout percentage, ensuring that employees receive appropriate compensation for their injuries.

Combined Benefits

  1. Double Indemnity: In cases where the employee’s death is accidental, the beneficiaries receive both the standard death benefit and the AD&D benefit. This double indemnity provides significant financial support, doubling the payout amount.
  2. Multiple Payouts: If an accident results in both dismemberment and subsequent death, the beneficiaries may receive multiple payouts, including partial benefits for dismemberment followed by the full benefit for accidental death.

How to File a Claim for AD&D Benefits

Filing a claim for AD&D benefits involves several steps. Understanding the process ensures that beneficiaries can access the benefits quickly and efficiently.

Initial Steps

  1. Notification: In the event of an accidental death or dismemberment, the designated beneficiaries or the injured employee should notify the employing agency or the Office of Personnel Management (OPM) if the employee is retired.
  2. Required Information: Provide necessary information, including the employee’s name, date of birth, Social Security number, date of the accident, and a detailed account of the incident. For accidental death, a copy of the death certificate is required.

Completing the Claim Form

  1. Claim Form: Complete the appropriate FEGLI claim form. For accidental death, use form FE-6; for dismemberment, use form FE-7. These forms can be obtained from the employing agency or OPM.
  2. Supporting Documentation: Attach any required supporting documentation, such as medical reports, police reports, and a death certificate. Detailed documentation helps expedite the review process.

Submission and Review

  1. Submission: Submit the completed claim form and supporting documentation to the appropriate office. For active employees, this is typically the agency’s human resources office. For retirees, it is OPM.
  2. Review Process: The agency or OPM will review the claim, verify the information, and determine eligibility for the AD&D benefits. The review process includes verifying the nature of the accident and the extent of the injuries.

Receiving the Payout

  1. Lump Sum Payment: AD&D benefits are paid out in a lump sum to the designated beneficiaries. The payment can be made via check or electronic funds transfer (EFT) to a bank account.
  2. Timeline: The timeline for receiving the payout can vary but typically takes a few weeks after the claim is approved. Beneficiaries should follow up with the agency or OPM to ensure timely processing.

Appeals Process

  1. Denied Claims: If a claim is denied, beneficiaries have the right to appeal the decision. The denial letter will provide information on how to file an appeal, including the required forms and supporting documentation.
  2. Reconsideration: The appeals process involves a thorough review of the claim and any additional evidence provided. The reconsideration process can take several weeks to months, depending on the complexity of the case.

Conclusion

FEGLI’s Accidental Death and Dismemberment (AD&D) coverage provides valuable additional financial protection for federal employees and their families in the event of a severe accident. Understanding the scope of AD&D benefits, eligibility and enrollment requirements, and the claims process is crucial for maximizing the protection offered by this coverage. By being informed and prepared, employees and their families can ensure they receive the financial support they need during challenging times.

Contact Information:
Email: [email protected]
Phone: 8132032515

Disclosure:
Investment advisory services are offered through BWM Advisory, LLC (BWM). BWM is registered as an Investment Advisor located in Scottsdale, Arizona, and only conducts business in states where it is properly licensed, notice has been filed, or is excluded from notice filing requirements. This information is not a complete analysis of the topic(s) discussed, is general in nature, and is not personalized investment advice. Nothing in this article is intended to be investment advice. There are risks involved with investing which may include (but are not limited to) market fluctuations and possible loss of principal value. Carefully consider the risks and possible consequences involved prior to making any investment decision. You should consult a professional tax or investment advisor regarding tax and investment implications before taking any investment actions or implementing any investment strategies.

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