Servicemembers' & Veterans' Group Life Insurance
VGLI Online Policy Access
Coverage and Features
-
Insurance Coverage
- SGLI
- VGLI
- Family SGLI
- SGLI Traumatic Injury Protection
Servicemembers' and Veterans' Group Life Insurance Handbook
APPENDICES
APPENDIX A: SGLI and VGLI Forms
APPENDIX B: Addresses for Branch of Service Casualty Offices
APPENDIX C: Premium Rate Tables for VGLI
APPENDIX D: Premium Rate Tables for Spousal Coverage
APPENDIX E: Premium Rates for SGLI and Traumatic Injury Coverage
APPENDIX F: Conditions Excluded from TSGLI Coverage
APPENDIX A: SGLI and VGLI Forms
1. SGLV 8283, Claim for Death Benefits (SGLI/VGLI)
2. SGLV 8283A, Claim for Family Coverage Death Benefits (SGLI)
3. SGLV 8284, Servicemember/Veteran Accelerated Benefits Option Form
4. SGLV 8284A, Servicemember Family Coverage Accelerated Benefits Option Form
5. SGLV 8286, Servicemembers' Group Life Insurance Election & Certificate*
6. SGLV 8286A, Family Coverage Election (SGLI)
7. SGLV 8700, Report of Death of Family Member
8. SGLV 8714, Application for Veterans' Group Life Insurance
9. SGLV 8721, Beneficiary Designation Form (VGLI)
10. Application for SGLI Disability Extension
11. SGLV 8600, Application for TSGLI Benefits
APPENDIX B: Addresses for Branch of Service Casualty Offices
|
Address |
|---|---|
| Army Active Duty | US Army Human Resources Command Casualty and Mortuary Affairs Operations Center 1600 Spearhead Division Avenue Fort Knox, KY 40121 |
| Army Reserves/National Guard | US Army Human Resources Command Casualty and Mortuary Affairs Operations Center 1600 Spearhead Division Avenue Fort Knox, KY 40121 |
| Navy Active Duty | Office of the Chief of Naval Operations Attn: OPNAV N135C 5720 Integrity Drive Millington, TN 38055-0621 -6200 |
| Navy Reserves/National Guard | Office of the Chief of Naval Operations Attn: OPNAV N135C 5720 Integrity Drive Millington, TN 38055-0621 -6200 |
| Marine Corps Active Duty | Commandant, U.S. Marine Corps |
Marine Corps Reserves/National Guard |
Commandant, U.S. Marine Corps HQ, U.S. Marine Corps Manpower and Reserve Affairs Casualty Section (MRC) 3280 Russell Road Quantico, VA 22134-5143 |
| Air Force Active Duty | Department of the Air Force Attn: AFPC/DPWCS 550 C Street West, Suite 14 Randolph Field AFB San Antonio, TX 78150-6001 4716 |
| Air Force Air Reserves/National Guard | HQ ARPC/DPTTE 18420 E. Silver Creek Ave Buckley AFB, CO 80011 |
| Coast Guard | Commander (PSC-PSD- FS Casualty) USCG Personnel Service Center Mail Stop 7200 4200 Wilson Blvd. Ste 1100 Arlington, VA 20598-7200 |
| Public Health Service | Public Health Service, Comp Branch Div of Comm. Corps Support Svcs Admin Ops Svc-Program Support Center 8455 Colesville Rd – Rm 935 Silver Spring, MD 20854-0001 |
| NOAA | NOAA Commissioned Personnel Center |
APPENDIX C: Premium Rate Tables for VGLI
| amount of VGLI | Age 29 and below | Age 30 to 34 | Age 35 to 39 | Age 40 to 44 | Age 45 to 49 | Age 50 to 54 | Age 55 to 59 | Age 60 to 64 | Age 65 to 69 | Age 70 to 74 | Age 75 and Above |
|---|---|---|---|---|---|---|---|---|---|---|---|
| $400,000 | $32.00 | $40.00 | $52.00 | $68.00 | $88.00 | $144.00 | $268.00 | $432.00 | $600.00 | $900.00 | $1,800.00 |
| 390,000 | 31.20 | 39.00 | 50.70 | 66.30 | 85.80 | 140.40 | 261.30 | 421.20 | 585.00 | 877.50 | 1,755.00 |
| 380,000 | 30.40 | 38.00 | 49.40 | 64.60 | 83.60 | 136.80 | 254.60 | 410.40 | 570.00 | 855.00 | 1,710.00 |
| 370,000 | 29.60 | 37.00 | 48.10 | 62.90 | 81.40 | 133.20 | 247.90 | 399.60 | 555.00 | 832.50 | 1,665.00 |
| 360,000 | 28.80 | 36.00 | 46.80 | 61.20 | 79.20 | 129.60 | 241.20 | 388.80 | 540.00 | 810.00 | 1,620.00 |
| 350,000 | 28.00 | 35.00 | 45.50 | 59.50 | 77.00 | 126.00 | 234.50 | 378.00 | 525.00 | 787.50 | 1,575.00 |
| 340,000 | 27.20 | 34.00 | 44.20 | 57.80 | 74.80 | 122.40 | 227.80 | 367.20 | 510.00 | 765.00 | 1,530.00 |
| 330,000 | 26.40 | 33.00 | 42.90 | 56.10 | 72.60 | 118.80 | 221.10 | 356.40 | 495.00 | 742.50 | 1,485.00 |
| 320,000 | 25.60 | 32.00 | 41.60 | 54.40 | 70.40 | 115.20 | 214.40 | 345.60 | 480.00 | 720.00 | 1,440.00 |
| 310,000 | 24.80 | 31.00 | 40.30 | 52.70 | 68.20 | 111.60 | 207.70 | 334.80 | 465.00 | 697.50 | 1,395.00 |
| 300,000 | 24.00 | 30.00 | 39.00 | 51.00 | 66.00 | 108.00 | 201.00 | 324.00 | 450.00 | 675.00 | 1,350.00 |
| 290,000 | 23.20 | 29.00 | 37.70 | 49.30 | 63.80 | 104.40 | 194.30 | 313.20 | 435.00 | 652.50 | 1,305.00 |
| 280,000 | 22.40 | 28.00 | 36.40 | 47.60 | 61.60 | 100.80 | 187.60 | 302.40 | 420.00 | 630.00 | 1,260.00 |
| 270,000 | 21.60 | 27.00 | 35.10 | 45.90 | 59.40 | 97.20 | 180.90 | 291.60 | 405.00 | 607.50 | 1,215.00 |
| 260,000 | 20.80 | 26.00 | 33.80 | 44.20 | 57.20 | 93.60 | 174.20 | 280.80 | 390.00 | 585.00 | 1,170.00 |
| 250,000 | 20.00 | 25.00 | 32.50 | 42.50 | 55.00 | 90.00 | 167.50 | 270.00 | 375.00 | 562.50 | 1,125.00 |
| 240,000 | 19.20 | 24.00 | 31.20 | 40.80 | 52.80 | 86.40 | 160.80 | 259.20 | 360.00 | 540.00 | 1,080.00 |
| 230,000 | 18.40 | 23.00 | 29.90 | 39.10 | 50.60 | 82.80 | 154.10 | 248.40 | 345.00 | 517.50 | 1,035.00 |
| 220,000 | 17.60 | 22.00 | 28.60 | 37.40 | 48.40 | 79.20 | 147.40 | 237.60 | 330.00 | 495.00 | 990.00 |
| 210,000 | 16.80 | 21.00 | 27.30 | 35.70 | 46.20 | 75.60 | 140.70 | 226.80 | 315.00 | 472.50 | 945.00 |
| 200,000 | 16.00 | 20.00 | 26.00 | 34.00 | 44.00 | 72.00 | 134.00 | 216.00 | 300.00 | 450.00 | 900.00 |
| 190,000 | 15.20 | 19.00 | 24.70 | 32.30 | 41.80 | 68.40 | 127.30 | 205.20 | 285.00 | 427.50 | 855.00 |
| 180,000 | 14.40 | 18.00 | 23.40 | 30.60 | 39.60 | 64.80 | 120.60 | 194.40 | 270.00 | 405.00 | 810.00 |
| 170,000 | 13.60 | 17.00 | 22.10 | 28.90 | 37.40 | 61.20 | 113.90 | 183.60 | 255.00 | 382.50 | 765.00 |
| 160,000 | 12.80 | 16.00 | 20.80 | 27.20 | 35.20 | 57.60 | 107.20 | 172.80 | 240.00 | 360.00 | 720.00 |
| 150,000 | 12.00 | 15.00 | 19.50 | 25.50 | 33.00 | 54.00 | 100.50 | 162.00 | 225.00 | 337.50 | 675.00 |
| 140,000 | 11.20 | 14.00 | 18.20 | 23.80 | 30.80 | 50.40 | 93.80 | 151.20 | 210.00 | 315.00 | 630.00 |
| 130,000 | 10.40 | 13.00 | 16.90 | 22.10 | 28.60 | 46.80 | 87.10 | 140.40 | 195.00 | 292.50 | 585.00 |
| 120,000 | 9.60 | 12.00 | 15.60 | 20.40 | 26.40 | 43.20 | 80.40 | 129.60 | 180.00 | 270.00 | 540.00 |
| 110,000 | 8.80 | 11.00 | 14.30 | 18.70 | 24.20 | 39.60 | 73.70 | 118.80 | 165.00 | 247.50 | 495.00 |
| 100,000 | 8.00 | 10.00 | 13.00 | 17.00 | 22.00 | 36.00 | 67.00 | 108.00 | 150.00 | 225.00 | 450.00 |
| 90,000 | 7.20 | 9.00 | 11.70 | 15.30 | 19.80 | 32.40 | 60.30 | 97.20 | 135.00 | 202.50 | 405.00 |
| 80,000 | 6.40 | 8.00 | 10.40 | 13.60 | 17.60 | 28.80 | 53.60 | 86.40 | 120.00 | 180.00 | 360.00 |
| 70,000 | 5.60 | 7.00 | 9.10 | 11.90 | 15.40 | 25.20 | 46.90 | 75.60 | 105.00 | 157.50 | 315.00 |
| 60,000 | 4.80 | 6.00 | 7.80 | 10.20 | 13.20 | 21.60 | 40.20 | 64.80 | 90.00 | 135.00 | 270.00 |
| 50,000 | 4.00 | 5.00 | 6.50 | 8.50 | 11.00 | 18.00 | 33.50 | 54.00 | 75.00 | 112.50 | 225.00 |
| 40,000 | 3.20 | 4.00 | 5.20 | 6.80 | 8.80 | 14.40 | 26.80 | 43.20 | 60.00 | 90.00 | 180.00 |
| 30,000 | 2.40 | 3.00 | 3.90 | 5.10 | 6.60 | 10.80 | 20.10 | 32.40 | 45.00 | 67.50 | 135.00 |
| 20,000 | 1.60 | 2.00 | 2.60 | 3.40 | 4.40 | 7.20 | 13.40 | 21.60 | 30.00 | 45.00 | 90.00 |
| 10,000 | 0.80 | 1.00 | 1.30 | 1.70 | 2.20 | 3.60 | 6.70 | 10.80 | 15.00 | 22.50 | 45.00 |
APPENDIX D: Premium Rate Table for Spousal Coverage
| Amount of Insurance | Spouse Age Under 35 |
Spouse Age 35 to 39 |
Spouse Age 40 to 44 |
Spouse Age 45 to 49 |
Spouse Age 50 to 54 |
Spouse Age 55 to 59 |
Spouse Age 60 & Over |
|---|---|---|---|---|---|---|---|
| $100,000 | $5.00 | $6.50 | $8.50 | $13.00 | $25.00 | $37.00 | $50.00 |
| $90,000 | $4.50 | $5.85 | $7.65 | $11.70 | $ 22.50 | $ 33.30 | $ 45.00 |
| $80,000 | $4.00 | $5.20 | $6.80 | $10.40 | $20.00 | $29.60 | $ 40.00 |
| $70,000 | $ 3.50 | $ 4.55 | $ 5.95 | $ 9.10 | $ 17.50 | $ 25.90 | $ 35.00 |
| $60,000 | $ 3.00 | $ 3.90 | $ 5.10 | $ 7.80 | $ 15.00 | $ 22.20 | $ 30.00 |
| $50,000 | $ 2.50 | $ 3.25 | $ 4.25 | $ 6.50 | $ 12.50 | $ 18.50 | $ 25.00 |
| $40,000 | $ 2.00 | $ 2.60 | $ 3.40 | $ 5.20 | $ 10.00 | $ 14.80 | $ 20.00 |
| $30,000 | $ 1.50 | $ 1.95 | $ 2.55 | $ 3.90 | $ 7.50 | $ 11.10 | $ 15.00 |
| $20,000 | $ 1.00 | $ 1.30 | $ 1.70 | $ 2.60 | $ 5.00 | $ 7.40 | $ 10.00 |
| $10,000 | $ 0.50 | $ 0.65 | $ 0.85 | $ 1.30 | $ 2.50 | $ 3.70 | $ 5.00 |
APPENDIX E : Premium Rates for SGLI and Traumatic SGLI Coverage
| Type | Basic SGLI | Traumatic Injury Coverage |
|---|---|---|
| Full-Time | $.065 per $10,000 per month This equates to a monthly premium of: $3.25 for $50,000 of coverage $6.50 for $100,000 of coverage $9.75 for $150,000 of coverage $13.00 for $200,000 of coverage $16.25 for $250,000 of coverage $19.50 for $300,000 of coverage $22.75 for $350,000 of coverage $26.00 for $400,000 of coverage |
$1.00 per month You must have Basic SGLI coverage to obtain Traumatic Injury coverage. |
| Part-Time | $.065 per $10,000 per year This equates to an annual premium of: $3.25 for $50,000 of coverage $6.50 for $100,000 of coverage $9.75 for $150,000 of coverage $13.00 for $200,000 of coverage $16.25 for $250,000 of coverage $19.50 for $300,000 of coverage $22.75 for $350,000 of coverage $26.00 for $400,000 of coverage Funeral Honors Duty Premium: $.25 per $100,000 1 Day Muster Premium: $.25 per $100,000 |
$1.00 per year Funeral Honors Duty Premium: Free - No charge 1 Day Muster Premium: Free - No charge |
APPENDIX F: Conditions Excluded from TSGLI Coverage
The TSGLI benefit will not be paid if a scheduled loss is due to a traumatic injury:
Caused by:
- The member's attempted suicide, while sane or insane
- An intentionally self-inflicted injury or an attempt to inflict such injury
- Medical or surgical treatment of an illness or disease
- Willful use of an illegal or controlled substance, unless administered or consumed on the advice of a medical doctor; or
Sustained while a member was committing or attempting to commit a felony.
Additionally, the benefit will not be paid for a scheduled loss resulting from:
- A physical or mental illness or disease, whether or not caused by a traumatic injury, other than a pyogenic (wound) infection or physical illness or disease caused by biological, chemical, or radiological weapons or accidental ingestion of a contaminated substance; or
- A mental disorder whether or not caused by a traumatic injury.