ATTENTION: If applying for Life or Disability as a California or New York resident please contact HBI at 877-285-4445 or see the bottom of this page for a state-specific application.
This insurance program is not available to residents in all states.
Make Sure Your Life Insurance Helps Fit Your Growing Needs
Nothing can replace the loss of a loved one, but carefully chosen life insurance coverage can help to ease the financial stress that death brings to a family. As your financial responsibilities increase, you should ensure that your life insurance will help to meet the added expenses.
All active members of ACEP who are under age 60, reside in the United States and can provide acceptable evidence of insurability are eligible to apply for coverage. Your legal spouse, can also apply as long as they meet the same eligibility requirements. Your unmarried, dependent children, from age 15 days up to age 25 are eligible for coverage as well. All full-time employees of members (working at least 30 hours per week) under age 60 are also eligible to apply.
When both spouses are eligible members, each may apply for coverage as "members"; however, coverage may not be duplicated by applying as dependents of each other. Coverage for eligible children may only be requested by one member.
Planning ahead often spells the difference between success and failure. When it comes to your family's security, that means adequate life insurance protection. Now is a good time to review your life protection and make sure it has kept pace with inflation and your changing needs.
*The maximum benefit amount will be reduced to $300,000 on the premium due date on or next following the date you attain age 65, with an appropriate reduction in premium.
Benefits Amounts under $100,000 - (per $25,000 in coverage)
|Under Age 30||$1.60||$2.00|
|30 - 34||$1.68||$2.18|
|35 - 39||$2.32||$3.22|
|40 - 44||$3.52||$5.27|
|45 - 49||$5.84||$9.32|
|50 - 54||$8.97||$14.59|
|55 - 59||$13.80||$22.12|
|60 - 64*||$21.97||$33.75|
|65 - 69*||$35.24||$51.00|
Benefits Amounts $100,000 and Higher - (per $25,000 in coverage)
|Under Age 30||$1.44||$1.83|
|30 - 34||$1.49||$1.97|
|35 - 39||$1.98||$2.80|
|40 - 44||$2.88||$4.43|
|45 - 49||$4.73||$7.78|
|50 - 54||$7.27||$12.27|
|55 - 59||$11.25||$18.79|
|60 - 64*||$19.26||$30.35|
|65 - 69*||$33.09||$48.50|
*Premium rates for persons age 60 or older are renewal only.
Rates are based on the attained age of the insured person and increase as you enter each new age category.
Rates and/or benefits may be changed on a class basis
Coverage for children is $16.50 annually.
Smoker means you or your Eligible Dependent who has smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine chewing gum or snuff during the 12 months prior to the date application for coverage was made.
Facing a Terminal Illness is a critical time for anyone, both emotionally and financially. Most people have friends or family for emotional support, but where do they turn for financial assistance?
The Hartford's Living Benefits Option may relieve some of the financial burdens associated with a Terminal Illness. This benefit allows you (and your spouse if covered) a one time option to receive up to 50% of the Term Life insurance proceeds, from $12,500 to a maximum of $100,000, upon being diagnosed by a physician as having twelve months or less to live as long as you are under age 70. Life proceeds can be distributed after a request and due proof have been received.
For example, if you're covered for $100,000 under the Term Life Plan and you become Terminally Ill, you may request an amount between $10,000 and $50,000. However, if you select $20,000 now, you may not request the remaining $30,000 in the future.
The funds are received in a lump sum payment without restriction on how you can use them. The face amount of your term life policy is then reduced by the Accelerated Death Benefit amount paid out.
Individuals should consult their personal tax advisor since the proceeds under this benefit may be taxable.
This information is written in connection with the promotion or marketing of the matter(s) addressed in this material. The information cannot be used or relied upon for the purpose of avoiding IRS penalties. These materials are not intended to provide tax, accounting or legal advice. As with all matters of a tax or legal nature, you should consult your own tax or legal counsel for advice.
Your and your dependent's insurance will become effective on the first day of the month following the your application is approved and you pay your premium.
If on the date that you are to become covered, you, your covered spouse or your employee are not Actively-at-Work at least 30 hours per week, or if not employed, unable to carry on the normal activities of a person of like age and sex in good health, coverage will not become effective until the first day of the month on or next following the date you complete such activities for 90 consecutive days.
Your coverage will remain in force as long as you pay your premiums when due, remain an active member of the American College of Emergency Physicians, you are under age 70, and the program remains in force. Dependents' coverage terminates if your coverage terminates, premiums are not paid when due or such person ceases to be an eligible dependent.
If you become Totally Disabled before age 60 while you're covered under this program and the disability continues for six consecutive months, your life insurance will be continued in force without further premium payment while you remain disabled. Please note this provision does not apply to dependents' benefits. A Total Disability is one which prevents you from engaging in any occupation for wage or profit and must result from an injury or sickness.
If your coverage ends for any reason (except for policy cancellation, coverage for a class of persons ends, or because of non-payment), you have the right to request an individual policy without having to provide evidence of insurability. To convert to an individual policy you must complete a notice of conversion privilege form for the conversion policy and send in the required premium within 31 days from the time your term life plan ends. Complete details may be found in your term life certificate of insurance.
You have 30 days from your effective date of coverage to look over the program and discuss it with your family and advisors. If you are not satisfied, you may return your certificate within 30 days for a full premium refund.
You may name anyone as the beneficiary of this insurance. You can change your beneficiary at any time by giving written notice to the Plan Administrator.
The life benefit will not be paid for death occurring as a result of suicide while sane or insane (in Missouri while sane) during the first two years (we will refund the entire premium paid to date if suicide is committed during the first two years). Life benefits are paid to the beneficiary you designate.
Print a PDF and complete application and fax to 605-444-7017
Acceptance into this plan is subject to medical evidence of insurability as determined by The Hartford1. Depending on your age, the amount of coverage you request and your answers on the application, a medical examination, medical test(s) or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience and at no expense to you.
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
Hartford Life and Accident Insurance Company
Hartford, CT 06155
Life Form Series includes GBD-1000, GBD-1100, or state equivalent.
1The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.