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Terms of Optional Personal Coverage

  • Full payment must be sent with your application.
  • Coverage is effective the date we approve your application, OR from the coverage date you requested in the application, whichever is latest.
  • Premiums for the period of coverage must be paid in full and submitted with the application.
  • Coverage automatically expires on December 31 of each year, or on the date specified on the application, whichever is earliest.
    • If you are injured at work, you must submit proof of your earnings when you submit a claim for lost-time benefits. Your benefits will be based on actual earnings lost, but cannot exceed the amount of coverage requested and cannot be more or less than the minimum or the maximum compensable earnings specified by the Act.
    • For example, in 2017:
        • The maximum coverage is $63,420 per year or $173.75 per day.
        • The minimum coverage is $12,001.20 per year or $32.88 per day.
        • The maximum period of coverage is January 1 to December 31.
        • The minimum period of coverage is 28 days.
        • There is a non-refundable minimum assessment of $50.

For inquiries or assistance call: 709-778-1291.  To renew existing coverage call: 709-778-1140, or toll free: 1-800-563-9000.