Group and Supplemental Life
- Basic Life Insurance - District Sponsored Coverage (Employer Paid)
- $15,000 for Part-time Classified Employees after 5 years of consecutive permanent employment.
- $30,000 for Classified, Teamsters, and Certificated Employees
- $50,000 for Managment Employees
- Supplemental Life Insurance - Voluntary Coverage (Employee Paid)
- See information listed below.
- May 1, 2026 - Present
- Questions for the our department? Call us at (949) 234-9404 or email us at insurance@capousd.org.
- NY Life Microsite for CUSD
- Monthly Rates and Supplemental Coverage Information
- Formula
- Employee/ Spouse
- Amount of Supplemental Coverage ÷ $1,000 x Rate (based on employee age bracket)
- Child(ren)
- Amount of Supplemental Coverage ÷ $1,000 x Rate ($0.186 per $1,000)
- Enrollment Form (Online)
- ***If you are applying for over the guaranteed amounts ($200,000 Employee/ $50,000 Spouse), you will also need to complete and return the Evidence of Insurability form to NY Life (fax or email, listed on form).
- If you are applying for Supplemental Life coverage outside of your thirty-day new hire period, you will have to go through the underwriting process (assessment of approval/ denial) with NY Life.
- There will be an opportunity to enroll in coverage during the upcoming fall Open Enrollment for 2027. Communication will go out to all employees.
- Dependent Coverage
- Dependent Supplemental Life coverage amounts cannot exceed the employee's.
- If you are adding new Supplemental Life coverage for your dependents and they are not currently enrolled in your health benefits (ex. Medical, Dental, and/ or Vision), you will need to provide copies of dependent documentation to our department. Per board policy (1340), if you bring in an original document without a copy, we can make a copy for $0.25 per page (cash only).
- Beneficiary Form
- If you are not looking to make any changes to your current or past beneficiary form, then no action is necessary.
- If you update this form, you can return it our department via fax, district mail, US mail, or in-person. We cannot accept them via email due to SS #'s.
- Fax: (949) 487-0671
- Address: 33122 Valle Road, ATTN: Ins. Dept., SJC, CA 92675
- Hours of Operation: Monday - Friday, 8am - 4:30pm
- Portability and Conversion Forms
- January 1, 2020 - April 30, 2026
- Group Life
- Brochure for Classified, Teamsters, and Certificated Employees
- Brochure for Managment
- Policy Booklets
- Class 1 (Classified, Teamsters, and Certificated)
- Class 2 (Management)
- Class 3 (Classified Part-time Life)
