Lake Superior State University
Lake Superior State University
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Section: Employee/Labor Relations Section Number: 4.9.2
Subject: Other Working Conditions - Beneficiary Designation Date of Present Issue: 04/11/11
  Date of Previous Issues:
03/01/87, 10/15/01


All new employees of the University must complete the Beneficiary Designation form as part of the orientation procedure. At the death of an employee, all earned compensation due from the University will be paid to the designated beneficiary.

At the death of an employee while in authorized travel status, the University's Business Travel Accident Insurance benefit will be paid to the designated beneficiary.

An employee may designate different individuals for earned compensation and business travel accident insurance by completing a separate form for each benefit. If a beneficiary designation form is not executed by an employee, payment of compensation due at the time of death will be made to the executor or administrator of the employee's estate.

Beneficiaries for life and other insurance benefits will be designated by the employee on the application card of the specific benefit at time of enrollment, where applicable.


New Employee 1. Completes items in Section I of the Beneficiary Designation form.
Notary Public 2. Completes Section II if the designated beneficiary is not the employee's spouse.
Office of Human Resources 3. Completes Section III in all cases. Retains original for permanent personnel file.
Employee 4. May change beneficiary designation at any time by completing a new form. (Death of beneficiary, or divorce from spouse if designated as beneficiary, voids this designation and a new form must be completed).
Home » 4.9.2 - Other Working Conditions - Beneficiary Designation
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