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UHPA Supplemental Insurance Applications

                     


ONE APPLICATION MUST BE SUBMITTED PER PERSON

SUPPLEMENTAL COVERAGE FOR A SPOUSE and/or DEPENDENT CHILD(REN) CAN ONLY BE ACQUIRED IF THE ACTIVELY WORKING MEMBER HAS SUPPLEMENTAL LIFE INSURANCE.  If a member and their spouse or dependent child(ren) submit an application at the same time, the member's application must be approved in order for the other  applications to be considered.  SPOUSE COVERAGE CANNOT EXCEED 50% OF THE MEMBER'S SUPPLEMENTAL COVERAGE. 


 
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