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Benefits: Life & Accident Insurance

Prudential Website
Prudential: 1-800-524-0542


Group Contract No.: G-53939-OH


Life Insurance
Montgomery County's life insurance program is administered by Prudential. In addition to Basic Life and Accidental Death & Dismemberment coverage, you may purchase supplemental life insurance for you, your spouse, and your dependent children at affordable group rates.

Basic Life & AD&D for Employees:
Montgomery County provides term life insurance and AD&D coverage. (Not applicable to PHDMC employees.)

  • Certain bargaining unit groups and all non-bargaining benefits-eligible employees will have $60,000 in basic life and AD&D coverage.
  • All other bargaining unit groups will have $50,000 in basic life and AD&D coverage.
  • Bargaining unit employees should check the union contract for details.
  • Additional taxes apply to benefit amounts above $50,000.

Supplemental Life Insurance for Employees:
The County offers employees the opportunity to purchase supplemental life insurance at low group rates through payroll deductions. (Not applicable to PHDMC employees.)

You may apply for additional life insurance for yourself in increments of $10,000 up to a maximum of $500,000.* Keep in mind that if you wish to increase your coverage due to a qualifying life event or during open enrollment, you will be required to complete an EOI (Evidence of Insurability) form with Prudential.

You may apply for spouse supplemental life coverage in increments of $5,000 up to a maximum of $250,000.* You must have employee supplemental life insurance coverage to qualify for spouse supplemental life coverage, and your spouse coverage cannot exceed 50% of your supplemental life insurance coverage. If you and your spouse are both employed by Montgomery County, you cannot be covered as both an insured person and as a dependent at the same time.

*New hire employees can purchase supplemental life insurance up to $300,000, and spouse coverage up to $50,000, without providing an EOI form to Prudential if coverage is elected within the first 30 days of employment.

Coverage for dependent child(ren) is available in the amount of $10,000 or $20,000. One rate covers all eligible dependent children. A child will not be considered the Qualified Dependent of more than one Employee. See Certificate of Coverage for details.

STD Supplemental Life Calculator

Beneficiary Change Form

Conversion and Portability Information

Certificate of Coverage - Supplemental Life Insurance 60K

Certificate of Coverage - Supplemental Life Insurance 50K

Prudential Short Form Health Statement

Summary of
Prudential Benefits

Voluntary Withdrawal from Supplemental Life Plan Form

*Does not apply to PHDMC
**Does not apply to DDS or PHDMC