AXA Supplemental Life AD&D Enrollment Form

AXA Beneficiary Form - All Districts

AXA LTD Plan - Amherst Staff

AXA LTD Plan - Amherst Administrators

AXA LTD Plan - Mont Vernon Staff

AXA LTD Plan - Mont Vernon Administrators

AXA LTD Plan - SAU Office Staff

AXA LTD Plan - Souhegan Staff

AXA LTD Plan - Souhegan Administrators


  • Portability

    The Portability Option allows participating employees to keep their Basic Life Insurance and AD&D coverage up to age 80 if the participating employee leaves SAU #39 employment, reduces hours at work, or retires.  The employee's application for portability is subject to approval by the insurance company.
    Employees must apply for portability within 31 days of employment termination or reduction of work hours.  If interested, please contact Human Resources at X-2110. 
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