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Mailing Address: U.Va. Human Resources 914 Emmet Street P.O. Box 400127 Charlottesville, VA 22904 Phone: (434) 924-4598 Email: hrdept@virginia.edu

Benefits Summary for Medical Center Salaried Employees Health Insurance Dental Services Discount Vision Plan Prescription Drug Services Claims Inquiries Vision Insurance Core Benefits and Flex Dollars Disability Insurance Matching Contribution Retirement Plan Retirement Programs Accidental Death and Dismemberment Life Insurance Pre-Retirement Guide Flexible Spending Accounts Tax-Deferred Savings Program Miscellaneous Benefits Long-Term Care Insurance Termination Information Benefits While On Leave Without Pay Mental Health and Substance Abuse Services Privacy Notice View All/Print     Effective January 1, 2008 Life Insurance A. Medical Center Retirement Plan Life Insurance: Basic Life Insurance coverage is provided free of charge to all salaried Medical Center salaried employees without a physical examination. The amount of basic life insurance coverage is $25,000. A significant amount of supplemental life insurance may be purchased to meet individual needs. The maximum combined basic and supplemental benefit is $500,000. A benefit equal to two times salary is guaranteed without health questions; all other increases require evidence of insurability. Forms: Prudential Life Insurance Certificate of Coverage Prudential Life Insurance Enrollment Prudential Life Insurance Beneficiary Designation Evidence of Insurability - Long Form Evidence of Insurability - Short Form Active Employees Life Booklet Retiree Life Booklet B. VRS Group Life Insurance The Virginia Retirement System provides two kinds of insurance during active employment: life insurance and accidental death and dismemberment insurance. The University pays the entire premium. The maximum amount of coverage for a natural death is determined by multiplying your annual salary by two. If your compensation is not an even multiple of $1,000, it is considered to be the next higher $1,000. Supplemental Optional Life Insurance With this optional life insurance coverage, a participant has four options from which to choose. You can be insured for one, two, three or four times your annual salary up to $600,000. If you enroll in the optional coverage, you may also insure your spouse, your child(ren), or both. The amount of the coverage corresponds with the selected employee option. Spouse coverage provides half of your optional insurance amount up to a maximum of $300,000. Depending on which option you select, your children can be insured for a maximum of $30,000. Forms Optional Life Change Form Beneficiary Change Form Evidence of Insurability Conversion Form

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