(Stand-Alone) Accidental Death & Dismemberment Insurance (AD&D)
The Hartford – Policy #ADD-S06404
If you are currently enrolled in LSU’s AD&D group coverage, your coverage will continue into retirement unless you cancel your coverage in writing. You may cancel at any time. To cancel your coverage, please complete and submit this form to your local LSU Human Resources office.
Click here for 2013 Universal Enrollment form
If you are currently enrolled in LSU’s AD&D group coverage, you and/or your dependents may be eligible to continue all or a portion of that coverage without submitting evidence of good health. To request a premium quote or forms to enroll in conversion coverage, please use this form.
Click here for Stand Alone ADD Conversion Document
PLEASE NOTE THAT YOU MUST SUBMIT THE CONVERSION FORM TO THE HARTFORD WITHIN 31 DAYS OF THE DATE YOUR LSU GROUP AD&D COVERAGE ENDS IN ORDER TO MAINTAIN YOUR ELIGIBILITY.