Life Insurance Contact Information

Insurance Carrier:  Mutual of Omaha Insurance Company
Carrier Website:  www.mutualofomaha.com
Customer Service:  1-800-769-7159
Policy Anniversary - December 1
Group Number:  G000ABWE

Your plan includes...

  • Guaranteed-issue coverage from $10,000 up to five times your salary up to $100,000 maximum, for Employee Only; Spouse/Dependent maximum: $50,000
  • Offered “not subject to insurability”—no medical disclosure required
  • Higher coverage available with disclosure
  • Funded through payroll as a pre-tax benefit (up to $50,000 coverage)
  • Your spouse, children, or both, can also be covered
  • May be converted to an individual policy if your current employment ends

Eligibility and Enrollment

If you work at least 30 hours per week, you are eligible for life insurance. You must submit the Life Insurance Election Form to Outstaffing, whether you choose to waive or apply for coverage.

IMPORTANT! You are eligible for the guaranteed-issue coverage only if you apply within 30 days of your hiring date.
If your application is late, you will be required to provide evidence of insurability.

Note: if you require coverage in excess of the guaranteed-issue amounts, Mutual of Omaha offers employee coverage up to $250,000, and spouse coverage up to $100,000. You will be required to provide the Evidence of Insurability Form. (This form will also be required if you wish to increase coverage later, or are a late entrant.) Your coverage will go into effect on the first day of the calendar month that follows your 30-day eligibility period.

For those who elect coverage:

On completion of your application we will email you the Certificate Validation Form issued by the carrier. For your records we also suggest you print the following two documents, Life Insurance Master Policy and Group Voluntary Term Life Certificate Summary. (If you elected in excess of the guaranteed issued amount, the initial form will reflect $100,000.00 until the requested coverage level is approved by carrier.)

NOTICE:  Should you ever need to modify your beneficiaries, simply complete the Designation of Beneficiary Form and Fax or Email to Outstaffing.

PORTABILITY

If your employment is terminated, your group policy may be converted to an individual policy.  You will have 60 days from the coverage end date to have the complete paperwork and initial payment received to Mutual of Omaha upon coverage ending or reducing.

1) Mail the completed and signed Portability Request Form with the Initial Premium Payment to Mutual of Omaha as soon as possible after insurance has ceased under the group plan. The form and payment must be received by Mutual of Omaha within 31 days of the date insurance under the group plan ended.

2) Make the check or money order for the Initial Premium Payment payable to United of Omaha Life Insurance Company. Be sure to include the Group ID Number (from Section 1) on the payment.

3) Submit the form and payment to:
Mutual of Omaha
Policyowner Services
P.O. Box 2147
Omaha, NE 68103-2147

If you have any questions regarding this form, please contact Mutual of Omaha toll-free at (877) 466-8367.