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 (2018), Basic AD&D Insurance, VAD&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.
The employee is automatically the beneficiary for any covered dependents.
*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.
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:
Life Insurance Company of North America
Life Claims
P.O. Box 22326
Pittsburgh, PA 15222-0326
1-800-238-2125 (phone)
1-412-402-3506 (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 participant 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
Cigna Accidental Death & Dismemberment Claim Form
Continuing Insurance After Coverage Ends
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Basic Term Life Insurance
An employee may convert his or her Basic Term Life Insurance coverage, as well as the policies covering his or her dependents, to an individual life insurance policy issued by The Prudential Insurance Company of America (2018 plan year). 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 (2018)
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 evidence of insurability will be required for continuation of GUL.
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Dependent Life Insurance
An employee may continue or convert his or her spouse's or registered domestic partner's Dependent Life Insurance as well as any dependents' coverage, to individual policies. A special application is available for the employee to complete for all dependents whose coverage is to be continued.
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 of 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 (2018 plan year). -
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 Life Insurance Company of North America. The employee pays the full cost of coverage directly to Life Insurance Company of North America.
Please refer to the life insurance continuation (portability) conversion matrix to determine which plans can be converted or continued and under what circumstances
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Life Insurance Continuation (Portability)/Conversion Matrix
The information in the 2018 Maxtrix will help you determine which life insurance plans you can continue (port) and which ones are eligible for conversion only.
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- 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 insurer
- An insured cannot port and convert the same group policy
- Ported insurance is a group term policy
- Converted insurance is an individual whole life policy and is used to continue coverage for individuals who lose a portion or all coverage under the active group policy
- Age Restrictions
- Ported life insurance terminates at age of 80
- Converted AD&D insurance terminates at age 70
- Conversion and/or 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 or one of its service providers will contact Leidos for the employer data
- The insurance company will issue new policy(ies), which becomes effective 31 days after active coverage ends
- Evidence of Insurability (EOI) is not required if life insurance is converted/continued within the specified time period
- In 2018, Evidence of Insurability (EOI) is required to port Employee Basic Life
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Conversion/Continuation Forms
- Group Term Life Conversion Form (2018)
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 (2018)
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 (2018)