Life and AD&D Insurance Plans
Leidos offers several types of financial protection for participants and their families if they were to die or be injured in an accident. For more information, download the Life and Accidental Death and Dismemberment (AD&D) Insurance document.
Naming a Beneficiary
An employee can name any person or persons* as beneficiary(ies) for his or her Basic Term Life Insurance, Group Universal Life (GUL) Insurance, Basic AD&D Insurance, Voluntary AD&D Insurance and Business Travel Accident Insurance by accessing the Leidos Human Resources System, Workday. If the employee wishes to name a minor (under age 18 in most states) or a trust as beneficiary, the employee should obtain legal advice, since special rules may apply.
The beneficiary the employee designates for these coverages may be different for each plan Leidos offers. The employee may change his or her beneficiary(ies) at any time by accessing the Leidos Human Resources System, Workday.
If you fail to designate a beneficiary(ies) with Leidos, your benefits will be paid based on the preferential beneficiary designation clause at the time of a claim. This means that any amount of insurance for which there is no beneficiary at your death will be payable to the first of the following:
- Your surviving spouse, or if none
- Your surviving child(ren), in equal shares, or if none
- Your surviving parents, in equal shares, or if none
- Your surviving siblings, in equal shares, or if none
- Your estate
*Community Property Laws — If you are married and reside in a community property state (Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington or Wisconsin) and name someone other than your spouse as beneficiary, it is possible that payment of benefits may be delayed or disputed unless your spouse also signs the beneficiary designation.
NOTE - The employee is automatically the beneficiary for any covered dependents.
Filing Claims
If an employee or a covered dependent dies or is seriously injured, the appropriate insurance company should be notified immediately.
Life Insurance and Group Universal Life (GUL) Insurance claims should be submitted to:
The Prudential Insurance Company of America
P.O. Box 8517
Philadelphia, PA 19176
1-888-257-0412 (phone)
1-888-227-6764 (fax)
Accidental Death & Dismemberment claims should be submitted to:
New York Life Group Benefit Solutions
Life and AD&D Claims Services
P.O. Box 22328
Pittsburgh, PA 15222-0328
1-800-362-4462 (phone)
1-877-300-6770 (fax)
After receiving notification, the insurer will process the claim for payment of benefits. All claims for benefits must be made by filing a properly completed form. If the claim is for a death benefit, a death certificate must be furnished along with the claim form.
If a covered person has concerns about how a claim has been administered or wishes to appeal a claims decision, information on relevant procedures is available in Claims Appeal and Review Procedures Under ERISA section.
Claim Forms
Prudential Group Term Life Claim Form
new York Life Accidental Death & Dismemberment Claim Form
Continuing Insurance After Coverage Ends
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Basic Term Life Insurance
An employee may port or convert his or her Basic Term Life Insurance coverage to an individual life insurance policy issued by The Prudential Insurance Company of America. The employee must make this election within 31 days of losing coverage under the Leidos group plan. No medical examination or other evidence of insurability (EOI) will be required for conversion. However, EOI is required for portability. The employee pays the cost of coverage directly to the insurer.
Portability is not available for Basic Life coverage that ends due to retirement or disability or for Basic Dependent Life coverage.
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Group Universal Life (GUL) Insurance
An employee may continue his or her Group Universal Life (GUL) Insurance coverage by making an election within 31 days of leaving employment with Leidos. No medical examination or EOI will be required for continuation of GUL.
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Optional Dependent Life Insurance
An employee may port or convert his or her spouse's or registered domestic partner's Dependent Life Insurance as well as any child life coverage, to individual policies. An employee must port his or her life insurance in order for a spouse or domestic partner and any dependents to be eligible to continue coverage. The exceptions to this rule are death of employee or divorce. In the event of the employee's death, both the spouse life and child life can be ported. In the event of divorce, the spouse life can be ported.
Spouses or Registered domestic partners may continue Spouse Life coverage up to the amount he or she was eligible for prior to losing coverage.
In addition, a dependent age 26 years or older who loses eligibility for Child Life may continue all or a portion of his or her coverage. He or she must submit an application within 31 days of losing coverage under the Leidos group plan.
To continue Dependent Life Insurance, you must complete an application and apply within 31 days of your coverage termination. To obtain an application, please contact Prudential at 1-800-778-3827 and provide the contract number 52844 when calling. If you are using a telecommunications device for the hearing impaired (TDD), please call 1-800-496-1214. Representatives are available to assist you Monday through Friday between 8:00 a.m. and 8:00 p.m.
An employee must elect to port life insurance coverage in order to port coverage for his or her spouse or registered domestic partner and/or dependent child(ren), except in the event of divorce or the death of the Leidos employee. In the event of divorce, the Spouse Life coverage can be ported. In the event of the employee's death, both the Spouse Life coverage and Child Life coverage can be ported.
Separate certificates of insurance will be issued for an employee's spouse or registered domestic partner and/or dependents. The employee and/ or dependent pay the full cost of any continued coverage directly to The Prudential Insurance Company of America. -
Basic AD&D Insurance and VAD&D Insurance
If an employee is age 69 or younger, his or her Basic AD&D Insurance and VAD&D Insurance, as well as the policies covering the employee's dependents, can be converted to an individual policy through New York Life Group Benefit Solutions. The employee pays the full cost of coverage directly to New York Life Group Benefit Solutions.
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Life and Accident Insurance Continuation (Portability/Conversion) Matrix
The information in the Matrix will help you determine which life insurance plans you can continue (port) and which ones are eligible for conversion only.
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Important Information for Basic and Dependent Life Insurance Portability
- The cost to convert/continue the life insurance products is based on the insurance company's standard group rates and will differ from the rate employees currently pay
- An insured will remit premiums directly to The Prudential Insurance Company of America
- Ported insurance is a group term policy issued by The Prudential Insurance Company of America
- Age Restrictions - Ported life insurance terminates at the age of 80
- Portability application must be submitted in writing within 31 days of the date coverage ends
- Employee portion of application should be completed and submitted to the address indicated on the form by the individual seeking coverage.
- The insurance company will contact Leidos for the employer data.
- The insurance company will issue new policy(ies), which becomes effective 31 days after active coverage ends.
- EOI is not required if life insurance is continued within the specified time period.
Important Information for Group Universal Life Insurance Continuation
- The cost to continue the GUL insurance for retirees and employees on a leave of absence is the same as active employee rates. For terminated employees, the cost is based on the insurance company's standard group rates and will differ from the rate employees currently pay.
- An insured will remit premiums directly to Mercer Health & Benefits Administration, LLC.
- Continued insurance is a whole life policy issued by The Prudential Insurance Company of America.
- Continued GUL insurance terminates at the age of 100.
- An application for Continuation must be submitted in writing within 31 days of the date coverage ends
- The Continuation portion of application should be completed and submitted to the address indicated on the form by the individual seeking coverage.
- Mercer Health & Benefits Administration LLC will obtain the employer data from Leidos.
- The insurance company will issue new policy(ies), which becomes effective 31 days after active coverage ends.
- EOI is not required if life insurance is continued within the specified time period.
Important Information for Accident Insurance Conversion
An employee can convert group accident insurance to an individual policy without medical certification for themselves and their eligible family members. To convert a policy, an employee must be under age 70 and apply for conversion within that later of 62 days of the group insurance coverage end date or 31 days of the date of the conversion notification. In no event will an application be accepted beyond 105 days of the group insurance coverage end date. The converted policy will be effective on the day following the date coverage ended under the group insurance policy or the date of the application, if later. The converted policy terminates at age 70.
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Conversion/Continuation Forms
- Group Term Life Conversion Form
This form should be completed if employee would like to convert all or a portion of the terminating coverage to an individual policy (subject to conversion amount limitations). - Group Term Life Portability Form
This form should be completed if employee would like to convert all or a portion of the terminating coverage to an individual policy (subject to conversion amount limitations). - Accidental Death and Dismemberment (AD&D) Conversion Form
This form should be completed if employee would like to convert all or a portion of the terminating coverage to an individual policy (subject to conversion amount limitations).
- Group Term Life Conversion Form