Coverage Effective July 1, 2023

Short Term Disability Coverage

Are you financially prepared if you can’t work? Even if you’re healthy now, it’s important to protect you and the people who count on your paycheck. If you’re unable to work due to a non-work related injury or illness, disability insurance may help you pay for ongoing expenses such as: Mortage/Rent | Groceries | Child(ren) Care | Car Insurance & MORE

Weekly Benefit

60% of weekly earnings (Excludes Bonuses and Overtime) up to a maximum of $200.

Maximum Benefit Period

26 Weeks

Waiting Period

7 Days (Accidents and Illness)

Claims are subject to a 60 day benefit waiting period for pre-existing conditions in the first 12 months of the policy.

Short Term Disability  $6.78 per pay period

Life Insurance

The life insurance benefit provides cash for final expenses in the event of your death. 

Coworker

Plan Pays $10,000 

$1.52 per pay period

Spouse

Plan Pays $5,000

$0.83 per pay period

Child(ren)

Plan Pays $2,000

$0.33 per pay period

Enrollment Application - Expires June 30, 2023 at 11:59pm

Name(Required)
Enrollment - Short Term Disability Coverage(Required)
Pay Per Period: $6.78

Enrollment - Life Insurance(Required)
Who is the Life Insurance for?(Required)
*Coworker must be checked if enrolling.

I acknowledge the opportunity Kwik Trip has given me to enroll in short term disability coverage and life insurance. If selecting coverage, I authorize Kwik Trip to deduct the above premiums from my paycheck. If waiving, I understand I will not have another opportunity to enroll until the next open enrollment or if I have a qualifying event. Additional plan information can be found in the Kwik Trip benefits portal.