Pechanga 2013-2014 Benefits Guide - page 9

9
Vision and Life Insurance
Vision Plan
In addition to the medical and dental plan options, PR&C offers a vision plan to all full-time Team Members. The vision
insurance is administered by Vision Service Plan (VSP), one of the nation’s largest providers of vision care coverage. The
plan provides a comprehensive list of vision care benefits including eye exams, lenses, frames, and contacts.
Life and Accidental Death & Disability Insurance
Life insurance is an important part of your financial security, especially if others depend on
you for support. Even if you are single, your beneficiary can use your life insurance to pay off your debts—like credit
cards, mortgages and other financial expenses.
Basic Life and Accidental Death & Disability (AD&D)
insurance is provided through Cigna to all full-time Team
Members at no cost. You also have the option to purchase additional coverage through the
Voluntary Life Insurance
and Voluntary AD&D Insurance
plans for you and your family.
Benefit Provisions
Vision Service Plan (Choice Network)
Benefit Available Every 12 Months
VSP Provider
Non-VSP Provider
Eye Exam
Covered in full
$45 allowance
Lenses
Covered in full
$30—$100 allowance based on lens type
Frames
Up to $150 allowance
$70 allowance
Elective Contact Lenses
(in lieu of eyeglasses)
Up to $150 allowance
$105 allowance
* Frame allowance at retail chain affiliate Costco is $80.
Note
: Discounts are available for laser vision correction and additional glasses.
Coverage
Benefit
Basic Life and AD&D Insurance
• $25,000 life benefit
• An additional $25,000 benefit is payable for an accidental death
• Dismemberment benefits are based on a schedule
Supplemental Voluntary Life Insurance
• For you
• Purchase $25,000 increments up to $250,000. Guaranteed issue of $150,000 when
first eligible. If you choose a coverage amount above $150,000 or wish to enroll in or
increase coverage after you are first eligible, you will need to provide proof of good
health.
You must complete a Beneficiary Designation Form. Important Note: If you are married, you must select your spouse as primary beneficiary, otherwise PR&C will require
authorization from your spouse. Beneficiaries under the age of 18 will not have access to the benefit until after their 18th birthday.
Voluntary Dependent Life Insurance
• For your spouse
• For your dependent children
(to age 26)
• Purchase $25,000 increments up to $125,000. Guaranteed issue of $50,000, when first
eligible. Spouse benefit cannot exceed 50% of your Basic and Supplemental benefit
amount. If you choose spouse coverage above $50,000 or wish to enroll in or increase
coverage after first eligible, you will need to provide evidence of good health.
• $5,000 or $10,000 for children over the age of 6 months. If less than 6 months of age,
coverage is limited to $500.
You (Team Member) are automatically the beneficiary for all dependent life insurance.
Voluntary AD&D Insurance
• For you
• For you and your family
• Purchase coverage for you in $25,000 increments up to $250,000.
• Spouse benefit is 40% of your elected amount if coverage includes spouse and children
or 50% if no children. Child benefit is 10% of your elected amount if coverage includes
spouse and children or 15% if no spouse. Maximum benefit for children is $10,000
Important Note: The amount of life and AD&D insurance coverage you choose is reduced by 35% after age 65. When you reach age 70 it is reduced by 60% of the original
amount and at age 75 it is reduced by 75% of the original amount.
VSP
Providers
To locate
participating VSP
providers go to
Select VSP Choice
from the "Select
Your Network"
drop down menu.
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