You were protected with group insurance from Principal®&²Ô²ú²õ±è;&²Ô²ú²õ±è;as part of the benefits package from your former employer.
This may have included:
| • Group life | • Hospital indemnity and/or |
| • Critical illness1 | • Long-term disability insurance |
| •&²Ô²ú²õ±è;´¡³¦³¦¾±»å±ð²Ô³Ù |
Coverage without answering medical questions
And even though your employment has ended, you may have options for continuing these benefits—through portability and/or conversion.
- Portability – Extend your current coverage to another policy, without answering medical questions.
- Conversion – Change your coverage to an individual policy, without answering medical questions.
You have a limited amount of time (generally 1-2 months) to port or convert your coverage without proof of good health. That’s why it’s important to enroll in insurance as soon as possible after your group coverage ends.
- Dental and/or vision coverage - If you’re interested in continuing your dental and/or vision coverage after your employment ends, coverage may be available to you through the Consolidated Omnibus Budget Reconciliation Act (COBRA). Contact your former employer or ÑÇÖÞÎÞÂëat GroupBenefitsAdmin@principal.com.
The benefits under your new coverage will vary from your former policy. These changes will be reflected in the benefit booklet you’ll receive after you’ve enrolled.
If eligible2, you may convert your term life coverage to an individual life insurance policy. And your spouse and children may also convert their coverage—even if you don’t convert yours. Minimum and maximum coverage requirements may apply and may vary by state. Follow these steps to enroll:
- Review the application instructions/rate sheet for your state (see table below) and the group life conversion .
- Complete the application for individual life insurance—group conversion for your state (see table below).
- Mail the completed application and your first premium to the address listed on the application.
You have 31 days after the date your group coverage ends to convert coverage without proof of good health. Conversion rates will be based on your current age and smoking status. Refer to the documents above for additional details regarding rates.
.
Questions? Contact us at:
Email: BenefitContinuation@principal.com
Phone: 800-843-1371
| State (Use your resident state.) |
Application | Application instructions/ rate sheet |
|
Alabama |
||
|
Alaska |
||
|
Arizona |
||
|
Arkansas |
||
|
California |
||
|
Colorado |
||
|
Connecticut |
||
|
Delaware |
||
|
District of Columbia |
||
|
Florida |
||
|
Georgia |
||
|
Hawaii |
||
|
Idaho |
||
|
Illinois |
||
|
Indiana |
||
|
Iowa |
||
|
Kansas |
||
|
Kentucky |
||
|
Louisiana |
||
|
Maine |
||
|
Maryland |
||
|
Massachusetts |
||
|
Michigan |
||
|
Minnesota |
||
|
Mississippi |
||
|
Missouri |
||
|
Montana |
||
|
Nebraska |
||
|
Nevada |
||
|
New Hampshire |
||
|
New Jersey |
||
|
New Mexico |
||
|
New York |
||
|
North Carolina |
||
|
North Dakota |
||
|
Ohio |
||
|
Oklahoma |
||
|
Oregon |
||
|
Pennsylvania |
||
|
Rhode Island |
||
|
South Carolina |
||
|
South Dakota |
||
|
Tennessee |
||
|
Texas |
||
|
Utah |
||
|
Vermont |
||
|
Virginia |
||
|
Washington |
||
|
West Virginia |
||
|
Wisconsin |
||
|
Wyoming |
If eligible,3 you may extend, or port, your voluntary term life coverage to another group term life policy. And if you port your coverage, your spouse and children may also port their coverage. You may port any amount—up to the amount of your current voluntary term life coverage (not to exceed $500,000 for employees and $250,000 for spouses).
Follow these steps to enroll:
- Complete the group term life insurance portability application for the appropriate state (see table below).
- Mail the completed application and your first premium to the address listed on the application.
You have 60 days (31 days in New York) after the date your group coverage ends to port coverage without proof of good health.
Once ported, your coverage renews annually in May until the date noted in your summary of benefits. And each year, you’ll receive a letter about any changes for the upcoming year. Rates may change on renewal, based on your age and new pricing.
.
Questions? Contact us at:
Email: BenefitContinuation@principal.com
Phone: 800-843-1371
| State (Use the state of your former employer.) |
Application |
| Alabama | |
| Alaska | Not available |
| Arizona | |
| Arkansas | |
| California | |
| Colorado | |
| Connecticut | |
| Delaware | |
| District of Columbia | |
| Florida | |
| Georgia | |
| Hawaii | |
| Idaho | |
| Illinois | |
| Indiana | |
| Iowa | |
| Kansas | |
| Kentucky | |
| Louisiana | |
| Maine | |
| Maryland | |
| Massachusetts | |
| Michigan | |
| Minnesota | |
| Mississippi | |
| Missouri | |
| Montana | |
| Nebraska | |
| Nevada | |
| New Hampshire | |
| New Jersey | |
| New Mexico | |
| New York | |
| North Carolina | |
| North Dakota | |
| Ohio | |
| Oklahoma | |
| Oregon | |
| Pennsylvania | |
| Rhode Island | |
| South Carolina | |
| South Dakota | |
| Tennessee | |
| Texas | |
| Utah | |
| Vermont | |
| Virginia | |
| Washington | |
| West Virginia | |
| Wisconsin | |
| Wyoming |
If eligible4, you may extend, or port, your critical illness1 coverage to another group critical illness policy. And if you port your coverage, your spouse and children may also port their coverage.
Your scheduled benefits will be the same as they were previously, although the continued coverage may have provisions that differ from your prior coverage. For example, health screening benefits won’t be available.
Follow these steps to enroll:
- Complete the group critical illness insurance portability application for the appropriate state (see table below).
- Mail the completed form and your first to the address listed on the form.
You have 60 days after the date your group coverage ends to port coverage.
Once ported, your coverage renews annually in May until the date noted in your summary of benefits. And each year, you’ll receive a letter about any changes for the upcoming year. Rates may change on renewal, based on your age and new pricing.
Questions? Contact us at:
Email: BenefitContinuation@principal.com
Phone:800-843-1371
|
State |
Application |
|
Alabama |
|
|
Alaska |
|
|
Arizona |
|
|
Arkansas |
|
|
California |
|
|
Colorado |
Not available |
|
Connecticut |
|
|
Delaware |
|
|
District of Columbia |
|
|
Florida |
|
|
Georgia |
|
|
Hawaii |
|
|
Idaho |
|
|
Illinois |
|
|
Indiana |
|
|
Iowa |
|
|
Kansas |
|
|
Kentucky |
Not available |
|
Louisiana |
|
|
Maine |
|
|
Maryland |
|
|
Massachusetts |
|
|
Michigan |
|
|
Minnesota |
|
|
Mississippi |
|
|
Missouri |
|
|
Montana |
Not available |
|
Nebraska |
|
|
Nevada |
|
|
New Hampshire |
Not available |
|
New Jersey |
|
|
New Mexico |
Not available |
|
New York |
|
|
North Carolina |
|
|
North Dakota |
|
|
Ohio |
|
|
Oklahoma |
|
|
Oregon |
Not available |
|
Pennsylvania |
|
|
Rhode Island |
|
|
South Carolina |
|
|
South Dakota |
|
|
Tennessee |
|
|
Texas |
|
|
Utah |
Not available |
|
Vermont |
|
|
Virginia |
|
|
Washington |
|
|
West Virginia |
|
|
Wisconsin |
|
|
Wyoming |
If eligible,4 you may extend, or port, your accident coverage to another group accident policy. And if you port your coverage, your spouse and children may also port their coverage.
Your scheduled benefits will be the same as they were previously, although the continued coverage may have provisions that differ from your prior coverage. For example, only accidental injuries incurred off-the-job will be covered, and wellness/screening benefits won’t be available.
Follow these steps to enroll:
- Complete the group accident insurance portability enrollment form for the appropriate state (see table below).
- Mail the completed form and your first to the address listed on the form.
You have 60 days after the date your group coverage ends to port coverage.
Once ported, your coverage renews annually in May until the date noted in your summary of benefits. And each year, you’ll receive a letter about any changes for the upcoming year. Rates may change on renewal.
Questions? Contact us at:
Email: BenefitContinuation@principal.com
Phone:800-843-1371
|
State |
Enrollment form |
|
Alabama |
|
|
Alaska |
|
|
Arizona |
|
|
Arkansas |
|
|
California |
|
|
Colorado |
Not available |
|
Connecticut |
|
|
Delaware |
|
|
District of Columbia |
|
|
Florida |
|
|
Georgia |
|
|
Hawaii |
|
|
Idaho |
|
|
Illinois |
|
|
Indiana |
|
|
Iowa |
|
|
Kansas |
|
|
Kentucky |
Not available |
|
Louisiana |
|
|
Maine |
|
|
Maryland |
|
|
Massachusetts |
|
|
Michigan |
|
|
Minnesota |
|
|
Mississippi |
|
|
Missouri |
|
|
Montana |
Not available |
|
Nebraska |
|
|
Nevada |
|
|
New Hampshire |
Not available |
|
New Jersey |
|
|
New Mexico |
Not available |
|
New York |
|
|
North Carolina |
|
|
North Dakota |
|
|
Ohio |
|
|
Oklahoma |
|
|
Oregon |
Not available |
|
Pennsylvania |
|
|
Rhode Island |
|
|
South Carolina |
|
|
South Dakota |
|
|
Tennessee |
|
|
Texas |
|
|
Utah |
Not available |
|
Vermont |
Not available |
|
Virginia |
|
|
Washington |
|
|
West Virginia |
Not available |
|
Wisconsin |
|
|
Wyoming |
You may be eligible to convert your long-term disability coverage to an individual disability insurance policy. Contact your former employer to see if you’re eligible for this option. You have 31 days after the date your group coverage ends to convert coverage without proof of good health. Once converted, your coverage remains in force until the date noted in your benefit summary.
Refer to this for additional details.
Questions? Contact us at 800-843-1371.
If eligible4, you may extend, or port, your hospital indemnity coverage to another group hospital indemnity policy. And if you port your coverage, your spouse and children may also port their coverage.
Your scheduled benefits will be the same as they were previously, although the continued coverage may have provisions that differ from your prior coverage. For example, only accidental injuries off the job will be covered and health screening benefits won’t be available.
Follow these steps to enroll:
1. Complete the group hospital indemnity insurance portability application for the appropriate state (see table below).
2. Mail the completed form and your first premium to the address listed on the form.
You have 60 days after the date your group coverage ends to port coverage.
Once ported, your coverage renews annually at your policy anniversary date noted in your summary of benefits. And each year, you’ll receive a letter about any changes for the upcoming year. Rates may change on renewal, based on new pricing.
Questions? Contact us at:
Email: BenefitContinuation@principal.com
Phone: 800-843-1371
| State (Use the state of your former employer.) |
Application |
| Alabama | |
| Alaska | |
| Arizona | |
| Arkansas | |
| California | |
| Colorado | Not available |
| Connecticut | |
| Delaware | |
| District of Columbia | |
| Florida | |
| Georgia | |
| Hawaii | |
| Idaho | |
| Illinois | |
| Indiana | |
| Iowa | |
| Kansas | |
| Kentucky | Not available |
| Louisiana | |
| Maine | |
| Maryland | |
| Massachusetts | |
| Michigan | |
| Minnesota | |
| Mississippi | |
| Missouri | |
| Montana | Not available |
| Nebraska | |
| Nevada | |
| New Hampshire | Not available |
| New Jersey | |
| North Carolina | |
| North Dakota | |
| Ohio | |
| Oklahoma | |
| Oregon | Not available |
| Pennsylvania | |
| Rhode Island | |
| South Carolina | |
| South Dakota | |
| Tennessee | |
| Texas | |
| Utah | Not available |
| Vermont | Not available |
| Virginia | |
| Washington | |
| West Virginia | |
| Wisconsin | |
| Wyoming |
1 Specified disease in New York.
2 Refer to your booklet for eligibility details.
3 Not available if you are over 70 or your employer terminated the policy and replaced it with another carrier.
4 Requirements typically include being insured for 12 months and under age 70.
This summary is intended as a general statement of the group insurance you can purchase from Principal® under the terms of your current group coverage. It does not summarize all of the provisions required by law, nor does it contain all of the qualifications and limitations that apply to the insurance being offered to you. If any provision presented here is found to be in conflict with federal or state law, that provision will be applied to comply with the respective federal or state law. CRITICAL ILLNESS, ACCIDENT AND HOSPITAL INDEMNITY INSURANCE PROVIDE LIMITED BENEFITS. The policy determines all rights, benefits, limitations and exclusions of the insurance described here.
Insurance from Principal® is issued by ÑÇÖÞÎÞÂëNational Life Insurance Company (except in New York) and ÑÇÖÞÎÞÂëLife Insurance Company®. Referenced companies are members of the ÑÇÖÞÎÞÂëFinancial Group®.
ÑÇÖÞÎÞÂëNational Life Insurance Company Policy Form: SN 77; Rider Forms: SN 7, SN 9, SN 10, SN 11, SN 25, SN 38, SN 49, SN 50, SN 54, SN 90, ICC14 SN 92/SN 92 and ICC14 SN 93/SN 93
ÑÇÖÞÎÞÂëLife Insurance Company Policy Form: SF 914NY/SF 914 NY U; Rider Forms: SF 612NY, SF 729NY A, SF794NY, SF 803NY/SF 803 NY U, SF 804NY, SF 892NY, SF 898NY, SF 933NY
2823476-042023