Page 14 - EMSAR 2022 Benefits Guide
P. 14
Life/AD&D
BlueCross BlueShield of Texas/Dearborn National | Group Number: F025112
Basic Life & AD&D Voluntary Life and AD&D
Minimum of $10,000 up to $500,000 in
EMSAR provides eligible Associates with a $50,000 Associate increments of $10,000, not to exceed
Life and Accidental Death and Dismemberment 5 times salary
(AD&D) insurance. This beneit provides security to Minimum of $5,000 up to $100,000 in
those families that have sufered the loss of a loved Spouse increments of $5,000, not to exceed 100%
of the Associate beneit amount
one. Beneits reduce by 35% at age 65 and to 50% at Minimum of $1,000 up to $10,000 in
age 70. Child(ren) increments of $1,000 for child(ren) up to
the age of 26
Voluntary Life & AD&D Guarantee Issue Associate—$150,000, Spouse—$30,000,
Insurance Age Reduction Child(ren)—$10,000
Beneits reduce by 35% at age 65 and to
Associates who want to supplement their group Rules 50% at age 70
term life insurance beneits may purchase additional Portability/ Included—member must request within
30 days of termination
Conversion
coverage. To purchase dependent or spouse
coverage, Associates must purchase coverage
as well. Dependent Life (Children)
Life AD&D
Age Rates (monthly rates) Per $1,000 $0.160 $0.040
Age Associate Age Associate $10,000 $1.600 $0.400
<20-29 $0.066 50–54 $0.258
30–34 $0.070 55-59 $0.404
35–39 $0.083 60–64 $0.581
40–44 $0.117 65–69 $1.032
45–49 $0.175 70+ $1.650
Monthly cost for each $1,000 of associate and
spouse life insurance coverage (based on age as of
efective date).
Spouse rate is based on spouse’s age.
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BlueCross BlueShield of Texas/Dearborn National | Group Number: F025112
Basic Life & AD&D Voluntary Life and AD&D
Minimum of $10,000 up to $500,000 in
EMSAR provides eligible Associates with a $50,000 Associate increments of $10,000, not to exceed
Life and Accidental Death and Dismemberment 5 times salary
(AD&D) insurance. This beneit provides security to Minimum of $5,000 up to $100,000 in
those families that have sufered the loss of a loved Spouse increments of $5,000, not to exceed 100%
of the Associate beneit amount
one. Beneits reduce by 35% at age 65 and to 50% at Minimum of $1,000 up to $10,000 in
age 70. Child(ren) increments of $1,000 for child(ren) up to
the age of 26
Voluntary Life & AD&D Guarantee Issue Associate—$150,000, Spouse—$30,000,
Insurance Age Reduction Child(ren)—$10,000
Beneits reduce by 35% at age 65 and to
Associates who want to supplement their group Rules 50% at age 70
term life insurance beneits may purchase additional Portability/ Included—member must request within
30 days of termination
Conversion
coverage. To purchase dependent or spouse
coverage, Associates must purchase coverage
as well. Dependent Life (Children)
Life AD&D
Age Rates (monthly rates) Per $1,000 $0.160 $0.040
Age Associate Age Associate $10,000 $1.600 $0.400
<20-29 $0.066 50–54 $0.258
30–34 $0.070 55-59 $0.404
35–39 $0.083 60–64 $0.581
40–44 $0.117 65–69 $1.032
45–49 $0.175 70+ $1.650
Monthly cost for each $1,000 of associate and
spouse life insurance coverage (based on age as of
efective date).
Spouse rate is based on spouse’s age.
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