Evidence of Insurability
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First Published :Mon Nov 02 21:12:45 GMT 2015
Last Modified :Fri Dec 15 17:40:42 GMT 2017
Last Published :Fri Dec 15 17:40:42 GMT 2017
Cases where employees may need to complete an Evidence of Insurability document
There may be instances where an employee must complete an Evidence of Insurability (EOI) document. These instances include enrollment in these benefits:
* Supplemental Employee Life Insurance – Amounts in excess of the lesser of 3 times your annual base salary or $750,000 require Evidence of Insurability as a New Hire (note for the remainder of 2017 New Hires will complete paper EOI forms- see Related Information- but starting in 2018, New Hires will follow the online process described below under Open Enrollment.
* Supplemental Employee and Dependent Life Insurance and/or Long Term Disability - All applications to become newly enrolled or change to increase the amount of Supplemental Employee, Dependent Life or LTD insurance will require an online EOI process to be completed and approval from the insurance company. After Open Enrollment, Prudential will contact employees directly to initiate the EOI process. Click here for a sample of the email that Prudential will send. On the email you will find the website (www.prudential.com/eoi), Tufts control number (0046943) and more information. The employee will log into the website, register, and complete a Short Form. If additional information is required, a Long Form will appear on the screen. Once the screens are completed, the information is sent directly to Prudential. You do not need to take any further action, as Prudential will advise you whether or not coverage is approved and will also update the Benefits group so that payroll deductions can begin. *Note if you apply for additional Supplemental Life of either 4x or 5x salary during Open Enrollment, but it is not approved, you will NOT get a lower Supplemental Life. Only NEW HIRES who have enrolled in 3x Supplemental Life and also apply for higher Supplemental life during the New Hire period will be enrolled with the minimum of 3X if their application for 4x or 5x is denied. The below applies only to NEW HIRES and NOT during Open Enrollment:
| Note: As a new hire or newly Benefit Eligible Employee, you can elect up to 3 times your base annual salary (to a maximum of $750,000) without EOI. If applying for coverage for 4 or 5 times your salary, it is required that you elect coverage equal to 3 times your salary on eServe in conjunction with submitting this request. This will insure that regardless of the decision by Prudential, you will be enrolled for at least 3 times your salary. |
For those who enroll during 2017 Open Enrollment for 2018, there is an online process and the below forms are not needed.
Evidence of Insurability/Short Form Health Statement form- to be used by New Hires starting after the OE process is complete in 2017 (starting in 2018, there will be an online process for New Hires)
EOI Long Form - to be completed by employee and returned to Prudential- no longer needed in 2016 for 2017.
Prudential Phone: 888-257-0412
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