Key Takeaways
- Pennsylvania requires minimum group sizes for employer-sponsored group life insurance
- Group life must be offered on a non-discriminatory basis to all eligible employees
- The conversion period for group life insurance is 31 days from termination
- Certificates of insurance must be provided to all covered group members
- Pennsylvania regulates both contributory and non-contributory group plans
Pennsylvania Group Life Insurance Requirements
Pennsylvania has specific regulations for group life insurance policies to ensure fair treatment of employees and proper plan administration.
Eligible Groups
Pennsylvania allows group life insurance for:
| Group Type | Requirements |
|---|---|
| Employer Groups | Minimum number of employees |
| Labor Unions | Members of bona fide unions |
| Associations | Groups formed for purposes other than insurance |
| Creditor Groups | Debtors of a creditor |
| Multiple Employer Trusts | Approved by Insurance Department |
Employer Group Requirements
Eligibility and Participation
| Requirement | Description |
|---|---|
| Non-Discrimination | Must cover all eligible employees |
| Eligibility Classes | Defined by conditions of employment |
| Waiting Period | Reasonable periods allowed |
| Evidence of Insurability | Limited requirements for eligible employees |
Coverage Structure
Group life coverage may be determined by:
- Salary or compensation (multiples of salary)
- Job classification or position
- Length of service
- Flat amount by category
Exam Tip: Coverage formulas must be applied consistently and cannot discriminate unfairly among eligible employees.
Certificate of Insurance
Certificate Requirements
Every covered employee must receive:
| Element | Description |
|---|---|
| Coverage Summary | Amount and type of coverage |
| Beneficiary Info | How to designate and change |
| Contribution | Employee premium share (if any) |
| Claims | How to file a claim |
| Conversion Rights | Explanation of conversion privilege |
Conversion Rights
Pennsylvania requires conversion privileges for group life insurance:
Conversion Period
| Element | Requirement |
|---|---|
| Timeframe | 31 days from termination |
| Notification | Employer must inform employee |
| Evidence | No evidence of insurability required |
| Coverage Type | Individual permanent life policy |
When Conversion Applies
Employees have conversion rights when:
- Employment terminates (any reason)
- No longer eligible for group coverage
- Policy terminates for their class
- Dependent coverage ends
Conversion Limitations
| Limitation | Description |
|---|---|
| Policy Type | Usually whole life only |
| Premium Basis | Attained age rates |
| Maximum Amount | Up to group coverage (may have limits) |
| Health Questions | None required |
Continuation of Coverage
Situations Requiring Continuation
| Situation | Continuation Required |
|---|---|
| FMLA Leave | Yes, under federal law |
| Military Leave | USERRA protections apply |
| Disability | Per policy provisions |
| Layoff | Per policy provisions |
Premium Arrangements
Contributory Plans
| Feature | Description |
|---|---|
| Employee Pays | Portion of premium |
| Participation | Usually 75% minimum required |
| Payroll Deduction | Standard method |
Non-Contributory Plans
| Feature | Description |
|---|---|
| Employer Pays | 100% of premium |
| Participation | 100% of eligibles covered |
| No Evidence | No insurability questions |
How long does a Pennsylvania employee have to exercise conversion rights for group life insurance?
What document must Pennsylvania employers provide to employees covered by group life insurance?
In a non-contributory group life plan in Pennsylvania, what percentage of eligible employees must be covered?
When a Pennsylvania employee converts group life insurance, they typically receive:
Group life coverage formulas in Pennsylvania must be: