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Enrollment Instructions for Life/AD&D Insurance

Enrollment Time Frame

New employees must complete the enrollment form within 60 days of their date of hire to avoid medical underwriting for Life/ Accidental Death & Dismemberment (AD&D) insurance.

Email the insurance_plans @ if you were hired more than 60 days ago and would like coverage.

Enrollment Procedures

  • Congregational-Employers provide the Term Life / AD&D Insurance Enrollment Form (PDF) to eligible employees to complete during their on-boarding process.
  • Keep a copy in the employee's permanent personnel file.
  • Email is not a secure method for transmitting personal information, social security numbers and the like.
  • Fax or mail the form to the Unitarian Universalist Association (UUA)—see bottom of page one of the form.
  • Do not send enrollment forms to Guardian; this is a group plan.

Effective Date

The effective date of your coverage is the day after we receive the properly completed enrollment form (via fax or mail), as per the terms of our contract with the insurance company.

For more information contact insurance_plans @

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Last updated on Monday, June 16, 2014.

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