Accidental Death & Dismemberment

Complementary to your basic term life coverage, our CSEA Accidental Death & Dismemberment (AD&D) provides enhanced coverage for unexpected events.

This low-cost coverage pays for a covered accident that results in a loss of life, speech, hearing or sight, paralysis and other losses offering Members more ways to protect themselves and their loved ones.

We hope you won’t find yourself in any of these situations. If you do, you can be confident in knowing that UIP has you covered!

For more specific plan information, including eligibility, benefits, coverage, and disclosures, please click here to download our CSEA Plan Summary and Cost of Coverage Sheet.

*For disclosures and detailed plan information, please download the sheet above.

FILLABLE ENROLLMENT FORMS

For Working Members
For Members within 120 Days of Retirement
For Members Retired More Than 120 Days

Make paying easier with online payments.
Click here to download our ETF Authorization Form and include it with your application to sign up.

FILLABLE FORM SUBMISSION
After completion, please sign and date the form, make a copy for your records, and return to:
Forrest T. Jones & Company
ATTN: Admin-FP
3130 Broadway Blvd.
Kansas City, MO 64111
OR Fax to (816) 751-6092

IMPORTANT DOCUMENTS & DISCLOSURES

Our Accidental Death & Dismemberment program is underwritten by MetLIfe, a leading global provider of insurance programs.