Skip to main content
Oregon.gov Homepage

Accidental Death and Dismemberment

Summary Information Only

This Web page presents summary information only. Any error or omission here is unintentional and will be resolved in favor of plan documents or applicable federal or state law or rule.

Plan Documents

 

Eligibility & Effective Dates 
 
All PEBB-eligible employees may enroll in this benefit. If you enroll during Open Enrollment, your coverage becomes effective January 1 of the new plan year. If you enroll outside of Open Enrollment, your coverage becomes effective the first of the following month.

Description of Benefits
 
The AD&D plan provides 24-hour coverage for accidental loss of life, limb, hand, foot, hearing, speech, sight or thumb and index finger (of the same hand). You may select a coverage amount from $50,000 to $500,000, in increments of $50,000. 

Employee Coverage
With Optional AD&D insurance, benefits are payable in the event of an employee’s or insured dependent’s death or covered loss resulting from an accident. The amount payable is a percentage of the AD&D insurance amount in effect for the person who suffers the loss on the date of the accident, as shown below:

Life 100%
One hand or one foot  50%
Sight in one eye, speech or hearing in both ears 50%
Two or more of the losses listed above  100%
Thumb and index finger on the same hand 25%
Quadriplegia 100%
Hemiplegia 50%
Paraplegia 50%

Spouse or Domestic Partner and Children Coverage
If you elect employee and dependent coverage, the AD&D insurance amounts for each of your dependents is equal to a percentage of your AD&D insurance amount, determined as follows:

  • If on the date your spouse or domestic partner dies or suffers a loss you do not have any eligible children, your spouse’s or domestic partner's AD&D insurance amount is 50 percent of your AD&D insurance amount.
  • If on the date your spouse or domestic partner dies or suffers a loss and you have both a spouse or domestic partner and eligible children, your spouse’ or domestic partner's AD&D insurance amount is 40 percent of your AD&D insurance amount.
  • If your eligible child dies or suffers a loss, the child’s AD&D insurance amount is 15 percent of your AD&D insurance amount.

The loss must occur due to an accident (or accidental exposure to the natural elements), independently of all other causes, and within 365 days after the accident.

If you or your dependent disappears in an accident that could have caused loss of life and is not located within one year despite reasonable search efforts, death will be presumed.
  
paid for accidental loss of thumb and index finger of either hand. 
 
When a claim is filed on a dependent, the payable benefit is equal to a percentage of your employee AD&D insurance as follows:

  • Spouse or domestic partner only — 50 percent 
  • Children only — 15 percent for each child
  • Spouse or domestic partner and children — 40 percent for spouse or partner, 15 percent for each child.

The maximum benefit payable for all losses caused by the same accident will not be more than the principal sum. 

Premium Rates

Accidental Death and Dismemberment Premium Rates 
Amount
Employee
Employee & Dependents
$50,000
$1.00
$1.70
$100,000
$2.00
$3.40
$150,000
$3.00
$5.10
$200,000
$4.00
$6.80
$250,000
$5.00
$8.50
$300,000
$6.00
$10.20
$350,000
$7.00
$11.90
$400,000
$8.00
$13.60
$450,000
$9.00
$15.30
$500,000
$10.00
$17.00

 


Tax Treatment
 
For the AD&D insurance program, payroll deducts the monthly premium after taxes. However, any benefit dollars you receive through this benefit are not taxed.

Contact the Standard

Your browser is out-of-date! It has known security flaws and may not display all features of this and other websites. Learn how

×