Choice of Beneficiary
The benefits payable at your death will be paid according to the beneficiary you designate on your Enrollment Form unless you change your beneficiary in writing at a later date. If no beneficiary designation has been made, the benefits payable at your death will be paid to the survivors, in equal shares, in the first of the following classes to have a survivor at your death: your spouse, your children, your parents and siblings. If there is no survivor in these classes, payment will be made to your estate. The Member is automatically the beneficiary for spouse coverage.
Acceptance into this plan and premium rate is subject to medical evidence of insurability as determined by the Hartford and underwriting guidelines. As part of the evidence of insurability process, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at no expense to you.
Conversion Privilege
After you’ve been covered for ten years, you will have the right to request an individual conversion policy from the insurer without giving medical evidence of insurability as long as your coverage did not end due to nonpayment of premium or termination of the Master Policy. Please refer to your Certificate of Insurance for more information.
Exclusion for Term Life Benefit
There are no military exclusions in this special MCA program. Suicide is the only exclusion during the first two years of coverage. Benefits paid for death caused by suicide while sane or insane within the first two years of the effective date of insurance are limited to a refund of the premiums paid for the insured’s insurance.
Termination Coverage will terminate on the earliest to occur:
- the Premium Due Date the required premium contribution is not made, subject to the Grace Period provision; or
- the tenth anniversary of the certificate effective date shown in the Schedule.
Notice of Insurance Information Practices
Your application is our major source of information. However, the Hartford may also collect or verify information by contacting individuals or organizations that have information or records about you or others to be insured.
Information regarding your insurability will be treated as confidential. Such information will not be disclosed to others without your authorization, except to the extent necessary for the conduct of our business. The Hartford or its re-insurer(s) may, however, make a brief report thereon to the Medical Information Bureau, a non-profit membership organization of life insurance companies, which operates an information exchange on behalf of its members. If you apply to another Bureau member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, the Bureau, upon request, will supply such company with the information in its file.
Upon receipt from you, the Bureau will arrange disclosure of any information it may have in your file within 15 days. Medical information will be disclosed only to your attending physician. If you question the accuracy of information in the Bureau’s file, you may contact the Bureau and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of the Bureau’s information office is MOV, Inc., P.O. Box 105, Essex Station, Boston, MA 02110; telephone number 1-866-692-6901 (TTY 866-346-3642 for hearing impaired).
The Hartford or its re-insurer(s) may also release information in your file to other insurance companies to which you may apply for life or health insurance, or to which a claim for benefits may be submitted. Upon written request, The Hartford will provide you with information in your file. Medical information will be disclosed only through a physician you designate. Details regarding your right to correct or amend information in your file will be furnished upon written request. If you would like further details, contact The Hartford, P.O. Box 2999, Hartford, CT 06104-2999, Attn: Group Benefits Department.
NOTE: This information explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this website and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
This is private insurance. This insurance is not associated with SGLI.
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Endorsed by:
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Underwritten by:
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Hartford Life and Accident Insurance Company
Simsbury, CT 06089
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The Hartford® is The Hartford Financial Services Group, Inc., and its subsidiaries, including issuing company Hartford Life and Accident Insurance Company.
John B. Wigle, License No. 0482924
MCA Insurance Program Administered by:
A.G.I.A., Inc.
P.O. Box 21357, Santa Barbara, CA 93121-9911
Questions? Call toll-free 1-866-340-4360
Policy Form # SRP-1153A (HLA)(1015)