Life

If you are eligible for Full or Mid-level benefits, you can add supplemental life, dependent life and expanded dependent life insurance for an additional premium. Your costs depend on your age and the coverage amount you choose. Estimate your monthly premiums here.

UC pays the full premium cost for eligible individuals. The value of this additional coverage is considered imputed income and is subject to income taxes (see Section 79 of the Internal Revenue Code for details); taxes are withheld monthly as part of the UC payroll process.

You have a 31-day period of initial eligibility (PIE) to enroll yourself and your eligible family members in the supplemental and/or dependent life plans. Your PIE starts on the first day of eligibility (for example, the day you begin work in a position that makes you eligible for life insurance coverage). The PIE ends 31 days later for online transactions.

You may request to enroll yourself in supplemental life insurance (and/or dependent life for your spouse/domestic partner) at any time during the year by submitting a request through your UCPath account. The insurance company will reach out by email with a statement of health for you to complete. If it is approved, UCPath will finalize your enrollment and send you a confirmation statement.

• Basic Life – Benefit equal to employee’s annual salary up to a maximum of $50,000
• Core Life – $5,000 benefit
• Supplemental Life – Five coverage levels from $20,000 to four times annual salary up to $1 million.
• Basic Dependent Life – $5,000 coverage each for spouse or domestic partner and/or eligible children
• Expanded Dependent Life – 50% of employee supplemental life benefit up to a maximum of $200,000 for a spouse or domestic partner; $10,000 each for eligible children
• Senior Management Life – Two times senior manager’s annual salary to a maximum of $800,000. This benefit is in addition to Basic Life.

Benefits are paid to your beneficiaries if you die while employed, on paid leave, or during the first four months of approved leave without pay or temporary layoff. Your beneficiaries receive these benefits in addition to any other death benefits for which you may qualify.

You should designate a beneficiary immediately upon enrolling in Life and/or AD&D insurance. You may name the same or different beneficiary for your UC Retirement Plan and/or Senior Management Life, if any.

You may name more than one beneficiary and specify the percentage that each beneficiary will receive on UC Retirement At Your Service (UCRAYS) or by submitting form UBEN 116 PDF. A beneficiary may be a person, trustee, or organization.

You can change your beneficiaries at any time. If no beneficiary is named or if your beneficiary is no longer living, any benefits will be paid to your survivors in the following order:

• Surviving legal spouse or surviving domestic partner; or, if none,
• Surviving children, on an equal-share basis; or, if none,
• Surviving parents on an equal-share basis; or, if none,
• Surviving siblings; or, if none,
• The member’s estate.

If you need assistance completing the claim form, call UCPath at (855) 982-7284 to work with a beneficiary care coordinator. For reference, UC’s policy number is 97000.

When you leave UC employment or retire, you may be able to continue life insurance benefits. You have different options depending upon the plan.

Download the form corresponding to your location below:

• ASUCLA PDF
• Berkeley PDF
• Davis PDF
• Davis Medical Center PDF
• Hastings PDF
• Irvine PDF
• Irvine Medical Center PDF
• Lawrence Berkeley National Laboratory PDF
• Los Angeles PDF
• Los Angeles Medical Center PDF
• Merced PDF
• Office of the President PDF
• Riverside PDF
• San Diego PDF
• San Diego Medical Center PDF
• San Francisco PDF
• San Francisco Medical Center PDF
• Santa Barbara PDF
• Santa Cruz PDF