Full-time employees are covered by an amount of basic insurance (and an equivalent amount of accidental death and dismemberment insurance) based on their annual basic pay in effect at the end of any given pay period. The insurance of an employee who dies while serving in a higher level position is based on the basic pay of the higher level position. (Basic pay for insurance purposes excludes such additional pay as overtime pay, holiday pay, etc.)
Employees who are paid at other than an annual rate are covered by an amount of basic insurance (and an equivalent amount of accidental death and dismemberment insurance) based on an annual rate determined as follows:
- Part-time regular. The annual basic pay of part-time regular schedule employees is computed by multiplying the basic hourly rate of pay for their levels and steps by the number of scheduled hours of service in a 52-week work year.
- Part-time flexible. The annual basic pay of part-time flexible schedule employees is computed by multiplying the basic hourly rate of pay for their level and step by 2,000 hours.
Note: Effective July 21, 1985, as a result of the 1984 collective–bargaining agreements, the number of hours used in converting the basic hourly rate of pay to an annual rate for life insurance purposes changed from 2,008 to 2,000 hours.
Insured employees who legally and concurrently hold more than one appointment, of which at least one is for a part-time flexible schedule position, are covered by an amount of basic insurance (and an equivalent amount of accidental death and dismemberment insurance) based on the position with the highest annual salary rate.
Insured employees who legally and concurrently serve in more than one covered position (other than as part-time flexible schedule employees), whether in the same or in different agencies, are covered by an amount of basic insurance (and an equivalent amount of accidental death and dismemberment insurance) based on the sum of their annual basic pay for all positions.
If annual basic pay is $8,000 or less, employees are insured for $10,000. $10,000 is the minimum amount of basic insurance coverage available plus an equivalent amount of accidental death and dismemberment insurance.
If annual basic pay is more than $8,000, employees are insured for an amount equal to the sum of annual basic pay rounded to the next higher thousand plus $2,000 plus an equivalent amount of accidental death and dismemberment insurance.
The extra benefit doubles the amount of Basic Life Insurance payable if the employee is age 35 or younger. Beginning on the employee’s thirty–sixth birthday, the extra benefit decreases 10 percent each year until, at age 45, there is no extra benefit.
The amount of basic insurance coverage (and equivalent amount of accidental death and dismemberment insurance) changes automatically whenever the employee’s annual basic compensation is increased or decreased to the next $1,000 bracket.
The following outlines coverage under the Accidental Dismemberment Provision:
- Allowance. The Accidental Dismemberment Provision allows for insurance payments for loss resulting from bodily injuries incurred solely through violent, external, and accidental means provided the loss occurs within 90 days after the date of the accident.
- Disallowance. The Accidental Dismemberment Provision does not allow insurance payment for bodily injuries attributed to the following causes:
- Disease or bodily or mental infirmity, medical or surgical treatment, or diagnoses thereof.
- Ptomaine or bacterial infection, except for septic infection from a visible wound sustained through violent, external, and accidental means.
- Hernia, no matter how sustained.
- Bodily injuries sustained during:
- Armed aggression or insurrection.
- War, declared or undeclared.
- Any act of war.
- Any aggression by armed forces against the United States in which nuclear weapons are being used.
- Intentional self-destruction or intentionally self-inflicted injury, while sane or insane.
- Self–administration of illegal or illegally obtained drugs.
- Amount of Payment. The amount of accidental dismemberment payment depends on (1) the amount for which an employee is insured on the date that the accident occurs and (2) the extent of loss. (The maximum for any one accident is 100 percent.)
- Payment Schedule:
- Supplemental Benefits. Employees or survivors who are entitled to a dismemberment or accidental death insurance benefit may receive the benefit even though they are entitled to payment under another federal law for the same loss.
Example: An employee who loses a hand in an on-the-job accident may receive the insurance payment for the dismemberment. An employee who qualifies may also receive either disability annuity payments or OWCP benefits.
The amount of Option A — Standard is $10,000. Option A includes coverage for accidental death and dismemberment. Option A may be continued after retirement, but there is no accidental death and dismemberment coverage.
Option B — Additional may be elected in an amount equal to one, two, three, four, or five times the employee’s annual rate of basic pay after first rounding to the next higher multiple of $1,000 if the pay is not an exact multiple of $1,000. A “multiple” under Option B is limited to no more than the annual rate of basic pay payable to positions at Level II of the Executive Schedule (section 5313, Title 5, U.S. Code) rounded to the next higher $1,000. There is no accidental death and dismemberment coverage. Option B — Additional may be continued after retirement.
Option C may be elected to cover eligible family members: Multiples of one, two, three, four, or five may be elected. Each multiple is equal to $5,000 for spouse and $2,500 for each eligible dependent child. Additional Death and Dismemberment coverage is not included. Option C may be continued after retirement.
