- Complete the Personal Accident Insurance Enrollment Form. Be sure to indicate the following:
Monthly or Bi-Weekly Payroll Deduction - Individual or Family Plan - Your Principal Sum Amount.
- Indicate the full name of your beneficiary and his/her relationship to you.
- Return the completed enrollment form to the Duke Benefits office.
Personal Accident Insurance: Eligibility
Employees that fall into one of the following classes are eligible:
Class 1: All active full-time (working 20 hours or more per week) employees of the Policyholder, including those Duke
University employees while serving in the Medical Unit for Life Flight, who are U.S. citizens, lawful permanent resident
(resident aliens) on U.S. payroll or a non-resident alien on U.S. payroll. Eligible dependents of this class of employees
can also be covered.
Class 2: All individuals on Policyholder approved leave of absence for the following reasons providing the appropriate premiums are paid:
- while disabled and receiving salary continuation, sick leave pay, paid time off (PTO), short term disability (STD) or long term disability (LTD) benefits under the Duke non-contributory or voluntary plans;
- while on medical or personal leave for up to one year; and
- while on sabbatical leave for up to two years.
Eligible dependents include your lawful spouse or domestic partner and dependent, unmarried children of you or your
spouse/domestic partner under age 19 (under age 26 if enrolled as a full-time student in an accredited college or university).
Also included are any legally adopted and foster children as long as they are dependent on you for support.
No eligible person may be covered more than once under this Policy. If they are covered as an Employee, they cannot also
be covered as a dependent of another Employee.
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