Principal Life Insurance Company
If you participate in Voluntary Term Life insurance, you have the option of porting the coverage in lieu of conversion. You select the amount of coverage you wish to maintain. Proof of good health is not required unless you elect to increase your coverage amount. The minimum amount of coverage you may continue is $10,000.
You may also elect to continue coverage for any covered dependents if you continue your coverage. Proof of good health is not required unless you elect to increase a dependent's coverage amount.
To continue this insurance coverage, complete the Portability Application. It's not necessary for you or your former employer to complete the "Employer to Complete" section, as that information has already been provided to the insurance carrier.
The portability rates are included on the Rates document.
Please refer to your certificate of coverage regarding any limitations and termination provisions for this coverage. If you no longer have a copy of this, one will be provided upon your request. You must apply for this coverage within 60 days of losing coverage.
- Portability Application (PDF) - enter account number 1153352
- Rates without AD&D (PDF)
- Rates with AD&D Port (PDF)
After completing the application, send it and your check for the first month's premium to the address listed on your application.
You'll then receive a letter from Principal Life explaining your coverage amounts and benefits as well as when and how to make future direct premium payments.
Individual Purchase Rights (conversion) allow qualifying individuals previously covered under Group Term Life and/or Voluntary Term Life policies, to buy individual life insurance coverage without proof of good health. Coverage is provided through an individual Life Insurance policy issued by Principal Life Insurance Company and Principal National Life Insurance (except in NY). Dependents may also convert their Voluntary Term Life coverage independent of the employee's conversion. The minimum amount of coverage you may convert is $1,000 to the maximum amount of insurance you had under your former employer's policy.
Follow these steps to enroll:
- Review the application instructions/rate sheet for your state (see table below) and the group life conversion FAQ sheet (PDF).
- Complete the application for individual life insurance—group conversion for your state (see table below). Enter the appropriate group account number (refer to the top right corner of this page for the account number) in the “Employer to Complete” section. Other than account number, it’s not necessary for you or your former employer to complete this section.
- Mail the completed application and your first premium to the address listed on the application.
You have 31 days after the date your group coverage ends to convert coverage without proof of good health. Conversion rates will be based on your current age and smoking status. Refer to the documents above for additional details regarding rates.
State
(Use your resident state.) |
Application
|
Application instructions/ rate sheet
|
---|---|---|
Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, Wisconsin, Wyoming | AA1220 | AA933C |
California | AA1220CA | AA933C |
Delaware, North Dakota, South Dakota | AA1220ST | AA933C |
District of Columbia | AA1220DC | AA933C |
Florida | AA1220FL | AA933C |
Louisiana, Montana, West Virginia | AA1220AAATERMUL | AA3401B |
New York | AA1226 | AA3401B |
If you participate in critical illness insurance, you have the option of porting the coverage, without proof of good health. This helps protect your financial security if you’re diagnosed with a covered illness. You may also elect to continue coverage for any covered dependents if you continue your coverage. Refer to your certificate of coverage or the portability application to see if you may qualify.
Your scheduled benefit will be the same as it was previously although the continued coverage may have provisions that differ from your prior coverage (wellness/screening benefits will not be available).
To continue this coverage, complete the portability application. You must apply for this coverage within 60 days of losing coverage.
- Portability Application (PDF) – Enter account number: 1153350
- Rates (PDF) (GP61077WC)
After completing the application, send it and your check for the first month's premium to the address listed on your application.
If you participate in accident insurance , you have the option of porting the coverage, without proof of good health. This helps protect your financial security if you have an accidental injury. You may also elect to continue coverage for any covered dependents if you continue your coverage. Refer to your certificate of coverage or the portability enrollment form to see if you may qualify.
Your scheduled benefits will be the same as they were previously although the continued coverage may have provisions that differ from your prior coverage. Only accidental injuries incurred off-the-job will be covered, and wellness/screening benefits will not be available.
To continue this coverage, complete the portability enrollment form. You must enroll for this coverage within 60 days of losing coverage.
- Portability Enrollment Form (PDF) (GP61558) – Enter account number: 1153350
- Rates (PDF) (GP63130)
After completing the application, send it and your check for the first month's premium to the address listed on your application.
You'll receive a letter from Principal Life once your enrollment is processed. Benefits information and a bill will be mailed separately.
If you participate in the hospital indemnity insurance program, you have the option of porting the coverage, without proof of good health. To be eligible, you must be insured for 12 months. And if you port your coverage, your spouse and children may also port their coverage.
Your scheduled benefits and rates will be the same as they were previously, although the continued coverage may have provisions that differ from your prior coverage. For example, health screening benefits won’t be available.
To continue this coverage, complete the portability application. You must apply for this coverage within 60 days of losing coverage.
- Portability Application (PDF)
Mail the completed form and your first premium to the address listed on the application.