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20232024 BENEFITS SUITABLE OF CONTENTS 3ELIGIBILITY19FLEXIBLE SPENDING ACCOUNTS (FSA)4BENEFIT COSTS24DENTAL PLAN5OPEN ENROLLMENT INSTRUCTIONS26VISION PLAN7MEDICAL PLAN27LIFE AND ACCIDENTAL DEATH &

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How to fill out accidental death and dismemberment

01

Obtain the accidental death and dismemberment claim form from your insurance provider.

02

Fill in your personal information including name, address, policy number, and contact information.

03

Provide details of the accident including date, time, and location.

04

Describe the nature and extent of the injuries or dismemberment that occurred.

05

Include any supporting documents such as medical records or police reports.

06

Review the completed form for accuracy and sign it before submitting to the insurance company.

Who needs accidental death and dismemberment?

01

Accidental death and dismemberment insurance is beneficial for individuals who want to ensure financial protection for themselves and their families in case of severe injuries or death resulting from accidents.

02

People with high-risk occupations or hobbies may also benefit from having accidental death and dismemberment insurance.

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What is accidental death and dismemberment?

Accidental death and dismemberment insurance provides financial compensation in the event of death or serious injuries caused by accidents.

Who is required to file accidental death and dismemberment?

The beneficiary or the legal representative of the deceased is typically required to file for accidental death and dismemberment benefits.

How to fill out accidental death and dismemberment?

To fill out accidental death and dismemberment forms, you will need to provide details of the accident, the injuries sustained, and any other relevant information requested by the insurance company.

What is the purpose of accidental death and dismemberment?

The purpose of accidental death and dismemberment insurance is to provide financial protection to the insured and their beneficiaries in the event of a severe accident resulting in death or disability.

What information must be reported on accidental death and dismemberment?

Information that must be reported on accidental death and dismemberment includes details about the accident, the injuries sustained, medical treatment received, and any other relevant information requested by the insurance company.

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