Benefits Plans - Group Life Insurance: Health Statements

Depending on when you enroll in life insurance and the amount of coverage, you may be required to submit a health statement as proof of your insurability. Your coverage becomes effective when the health statement is approved, the Benefits Office has been notified, and you are actively at work. You need only submit a health statement for your initial enrollment. You do not need to resubmit a health statement for continuation of coverage.

Insurance Coverage for You

If you enroll in life insurance within 30 days of the date you become eligible and choose less than $500,000 of coverage, you will not need to provide a satisfactory health statement as proof of insurability. Therefore, it is to your advantage to enroll in life insurance at the time you become eligible, either when you are a new faculty or staff member at the University or when you become newly eligible for this benefit as the result of a change in appointment.

In all other cases, you will need to furnish evidence of insurability that is satisfactory to the MetLife. MetLife may also require a physical examination.

Proof of good health consists of either a short form health statement or a long form health statement. The type of statement you need depends on the amount of coverage you purchase. You may enroll in the University Plan first and then add the Optional Plan at a later date. You would need to complete a long form health statement.

Insurance Coverage for Your Dependents

Your spouse or other qualified adult will need to provide satisfactory evidence of insurability in order to enroll in the Dependent Life Insurance Plan.

Dependent children do not need to submit a health statement.

Health Statement Forms

The short form and long form health statements are available for download from the Life Insurance Forms page or by request from the SSC Contact Center.

Health Statement Needed
Coverage Choices Short Form Long Form
If you elect the University Plan and you were not automatically enrolled as a new hire (hire date after January 1, 2001) and have not previously enrolled in the University Plan1 X  
You elect Optional Life Insurance coverage and the amount of coverage is over $500,000   X
You enroll in or increase your Optional coverage to less than $500,0001 X  

Dependent Spouse or OQA1


Dependent Children from age 15 days to the end of the calendar year in which the child turns 25 NA2 NA2

1 A long form health statement may be required if you do not successfully pass the short form.

2 No health statement is required for children.

The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.