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2017‐2018 Benefits Guide
10
BASIC LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT
INSURANCE
This benefit is paid by the Company for all benefit eligible employees. It will be administered through Cigna. In the
event of your death, your beneficiary will receive $50,000. The Accidental Death and Dismemberment (AD&D)
benefit is equal to your basic group life insurance benefit. Benefit reductions apply upon attaining certain age levels.
VOLUNTARY LIFE AND ACCIDENTAL DEATH &
DISMEMBERMENT INSURANCE
Your voluntary life/AD&D will be administered through Cigna. You must purchase voluntary life on yourself in order to
purchase coverage for your spouse and dependent children. You may purchase voluntary AD&D coverage for
yourself regardless of whether or not you purchase voluntary life coverage.
Employees can purchase up to 5 times salary, not to exceed $500,000 of
coverage, in $1,000 increments with a minimum of $10,000. The Guarantee
Issue amount for newly eligible employees is $100,000.
Spousal/Domestic Partner coverage is available in $1,000 increments not to
exceed 100% of the employee amount up to a maximum of $500,000. There is
a $5,000 minimum. The Guarantee Issue amount for newly eligible spouses is
$30,000. Coverage is available for children from birth to 6 months in the amount
of $1,000. Children age 6 months up to age 19, or 26 if a full-time student, can
purchase coverage in $2,000 increments up to a $10,000 maximum.
Voluntary AD&D coverage is available for the employees/spouses/domestic
partners and dependents. Coverage can be purchased up to 5 times salary,
not to exceed $500,000, in $10,000 increments. Voluntary AD&D coverage is
not available for the spouse or child(ren). All amounts of AD&D coverage are
guarantee issue.
Please note:
Each year you and your spouse may purchase additional life
coverage up to the Guarantee Issue amounts without evidence of insurability if
you are already enrolled in the plan. Otherwise, you will be required to complete
an Evidence of Insurability form and be approved by Cigna before coverage
becomes effective.
This is meant to be a summary of benefits only. Please review to your certificate of coverage for information
pertaining to the policies benefits and limitations.
VOLUNTARY LIFE/AD&D
EMPLOYEE CONTRIBUTION
(Rates are per month)
Age Band
Employee/Spouse
Rate per $1,000*
Under 30
$0.081
30-34
$0.093
35-39
$0.136
40-44
$0.209
45-49
$0.336
50-54
$0.553
55-59
$0.879
60-64
$1.169
65-69
$1.857
70-74
$3.250
Sp & Child Life
$0.03/$1,000
*Benefit reductions apply at certain age
brackets
EE Vol. AD&D
$0.020/$1,000
75+
$5.768