Click for a no-obligation quote or to enroll for coverage. Be sure to review all of the Accidental Death & Dismemberment Insurance information on the Website before enrolling.
An accidental injury can be severe enough to prevent you from doing the work you do every day. Unfortunately, such an injury can easily happen to anyone. What if you experience the loss of your hand or leg following an automobile accident? Could you continue to work?
That’s where Accidental Death & Dismemberment Insurance comes in. This insurance provides you with a benefit for a covered accidental injury or accidental death. This benefit is paid in addition to any other insurance benefits you might receive.
This economical insurance is an ideal way to give yourself that extra coverage for the unexpected. Accidents can happen to anyone—protect yourself and your family.
These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.
Insurance Enrollment Form and Brochure
Beneficiary Change Form
Your spouse/domestic partner and dependent children (14 days to age 25) are also guaranteed coverage. Your spouse/domestic partner benefits are 40% of the benefit amount you choose and dependent child(ren)'s benefits are 10% of your benefit. If no spouse/domestic partner coverage is elected, each dependent child's coverage is 15% of your benefit. If no child coverage is elected, your spouse's/domestic partners benefits are 50% of your coverage.
Take a look at the enrollment form and brochure under the "Forms" tab for information on additional benefits such as:
Below is the plan's rate chart:
Attorney's Benefit Amount | Attorney's Monthly Premium Contributions | Attorney & Family Monthly Premium Contributions |
$50,000 | $3.50 | $5.00 |
$75,000 | $5.25 | $7.50 |
$100,000 | $7.00 | $10.00 |
$125,000 | $8.75 | $12.50 |
$150,000 | $10.50 | $15.00 |
$175,000 | $12.25 | $17.50 |
$200,000 | $14.00 | $20.00 |
$225,000 | $15.75 | $22.50 |
$250,000 | $17.50 | $25.00 |
$275,000 | $19.25 | $27.50 |
$300,000 | $21.00 | $30.00 |
$325,000 | $22.75 | $32.50 |
$350,000 | $24.50 | $35.00 |
$375,000 | $26.25 | $37.50 |
$400,000 | $28.00 | $40.00 |
$425,000 | $29.75 | $42.50 |
$450,000 | $31.50 | $45.00 |
$475,000 | $33.25 | $47.50 |
$500,000 | $35.00 | $50.00 |
$525,000 | $36.75 | $52.50 |
$550,000 | $38.50 | $55.00 |
$575,000 | $40.25 | $57.50 |
$600,000 | $42.00 | $60.00 |
$625,000 | $43.75 | $62.50 |
$650,000 | $45.50 | $65.00 |
$675,000 | $47.25 | $67.50 |
$700,000 | $49.00 | $70.00 |
$725,000 | $50.75 | $72.50 |
$750,000 | $52.50 | $75.00 |
Rates do not increase with age. Rates shown are guaranteed until 12/31/2023. For your convenience, you will be billed annually. If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment options.
This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of coverage. All coverage is subject to the terms of the group policy. If there is any discrepancy between this document and the group policy documents, the policy documents will govern. Policy Form HP010GP.
Accidental Death and Dismemberment (AD&D) insurance coverage is provided under the terms of a group AD&D insurance policy. Group Policy #63584-7, issued and delivered in the state of California to the State Bar of California as the policyholder. The group AD&D insurance policy is issued by ReliaStar Life Insurance Company (Minneapolis, MN). The policy is administered on behalf of ReliaStar Life Insurance Company by Mercer Heath & Benefts Administration, LLC, an insurance administrator licensed in the state of California.
This is a paid endorsement. The State Bar of California receives a fee from the insurance broker and/or the insurer for its endorsement of this plan.
We're here to help! Please contact us in whatever manner is most convenient for you.
Program Administrator
Address Mercer Consumer 12421 Meredith Drive Urbandale, IA 50398 |
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Phone 1-800-343-0132 |
Hours M-F 7:30a-5p CT |
Email [email protected] |
Insurance Company
ReliaStar Life Insurance Company Minneapolis, MN |
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Application Mailing Address
Address The State Bar of California Insurance Program P.O. Box No 14464 Des Moines, IA 50306-8993 |
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