Eligible employee in active employment on or before Effective Date

3 months of continuous active employment

Eligible employee in active employment after Effective Date

3 months of continuous active employment

Benefit

Benefit Detail Overview

Employee Basic Term Life

Employee: The greater of $25,000 or an amount equal to 200% of the employee’s annual earnings, rounded to the next higher $1,000, if not already a multiple of $1,000.

Employee Basic Accidental Death and Dismemberment (AD&D)4

The greater of $25,000 or an amount equal to 200% of the employee’s annual earnings. rounded to the next higher $1,000, if not already a multiple of $1,000.

Dependent Basic Term Life

Spouse: $5,000
Each Child: $2,500

Long Term Disability (LTD)

• Elimination period: 119 calendar days.
• Regular occupation period: 2 years.
• Benefit amount is 60% of employee’s pre-tax monthly earnings, with a benefit amount minimum of $100 and up to the maximum of $5,000.
• Some disabilities may not be covered or may have limited insurance under this policy.
• If an employee’s gross monthly benefit increases because of an increase to the no-evidence maximum, the increase to the employee’s gross monthly benefit may be limited by the Pre-existing Condition Limitation.

Benefit

Benefit Detail Overview

Optional Term Life

You can apply for the following benefit amounts:

• Employee in $10,000 units, up to $250,000.
• Spouse in $5,000 units, up to $250,000.
• Child in $2,000 units, up to $10,000.

Evidence of Insurability form must be completed and submitted for employee and each dependent when applying for Optional Term Life Insurance.

Enrollment in Optional Term Life Insurance will be effective after approval is received by the insurance company.