on-the-job accident insurance
On-the-Job Accident Insurance provides a level of income protection due to death or a covered loss resulting from an on-the-job accident.
- Currently, this coverage is provided at no additional cost to eligible employees.
- You do not need to enroll for coverage; it is automatically provided beginning on your first day of work or once you otherwise become eligible to participate.
- This benefit is for employees only; you cannot cover dependents.
The plan pays benefits to you (or your beneficiary) if you suffer a covered loss due to an accident that occurs while you’re at work. The amount the plan pays is based on a schedule of benefits. You may die or suffer a dismemberment or loss of use of a body part as a result of an accident that occurs while you’re at work.
Your On-the-Job Accident Insurance Plan coverage generally equals the greater of the following:
- One times your annualized regular pay
The maximum benefit payable is $1 million.
See the plan's summary plan description and other key plan documents, included below on this page, for further details about the schedule of benefits and what's considered a covered loss.
The summary plan descriptions (SPD) provides specific details about your benefits, such as eligibility, covered services and participation rules. If there recent updates to the SPD since the last publication date, look for the summary of material modification (SMM) included in the very front of the book.
The documents listed below are called a summary of material modification (SMM). An SMM explains recent updates to your plan that are not yet captured or updated in your summary plan description (SPD) since the last publication date. Be sure to review the SMM for an understanding of important plan updates.
- On-the-Job Accident Insurance Plan: New company contribution toward COBRA coverage for surviving dependents (January 1, 2022)
- If you don't name a beneficiary (January 1, 2015)
- New benefits added to coverage (July 1, 2014)
Other General Plan Changes
- New address for benefits correspondence (June 1, 2020)
on-the-job accident insurance plan
- Plan Type Accidental Death and Dismemberment Insurance
- Eligibility U.S. Payroll Employees
- Enrollment Coverage is automatic if eligible
- Claims Administrator/Insurer CIGNA Group Insurance
- Plan Number 504
- Phone For eligibility and enrollment, call the HR Service Center (Choose Manage Benefits, then Health, Disability, Life, Accident Insurance option)
- Phone To report a death, call the HR Service Center
- Phone To talk to CIGNA directly, 1-800-238-2125
- Website Enroll, verify eligibility and coverage amount on BenefitConnect
- Beneficiary Designations Get started here
- Claim Form Contact CIGNA
This communication provides only certain highlights about changes of benefit provisions. It is not intended to be a complete explanation. If there are any discrepancies between this communication and the legal plan documents, the legal plan documents will prevail to the extent permitted by law. Oral statements about plan benefits are not binding on Chevron or the applicable plan. Chevron Corporation reserves all rights, for any reason and at any time, to amend, change or terminate these plans or to change or eliminate the company contribution toward the cost of such plans. Such amendments, changes, terminations or eliminations may be applicable without regard to whether someone previously terminated employment with Chevron or previously was subject to a grandfathering provision. Unless required by applicable law, there are no vested rights with respect to any Chevron health and welfare plan benefit or to any company contributions towards the cost of such health and welfare plan benefits. Some benefit plans and policies described in this document may be subject to collective bargaining and, therefore, may not apply to union-represented employees.