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Voluntary Supplemental AD&D Insurance Summary of Benefits—
Voluntary Supplemental AD&D insurance is available in amounts AD&D
equal to one, two, three, four, or ive times your annual base pay. Type of Loss Percentage
If the coverage amount you elect is not a multiple of $1,000, then Payable
it is rounded to the next higher multiple of $1,000. The maximum Life 1 2 100%
amount of voluntary supplemental AD&D insurance is $500,000. One hand or foot , sight in one 50%
eye, audible speech, hearing
AD&D is insured through The Standard. in both ears
Two or more of the losses 100%
listed above
Your Cost Thumb and index inger of 25%
Supplemental life/AD&D insurance, and dependent supplemental same hand 3
life/AD&D insurance are deducted from your pay on an after-tax 1 This beneit includes loss of life due to exposure
or disappearance. Disappearance must be
basis. Refer to page 46 titled “Employee Contributions” for the cost caused directly by an accident which could have
reasonably resulted in death and must occur
applicable to supplemental life insurance and dependent supplemental independently of all other causes continuing
life insurance offered by The Carlstar Group. for a period of 365 days after the date of the
accident despite reasonable search efforts.
2 This beneit is payable whether or not the hand
Spouse and/or Child(ren) or foot is surgically reattached.
3 This beneit is not payable if a AD&D insurance
As long as you apply for Supplemental AD&D coverage, Dependent beneit is payable for the loss of the entire
hand.
Supplemental AD&D coverage is available for your spouse and
dependent children as well. The coverage amount for each dependent These beneits are also available to
is as follows. your dependents. At no time will more
than 100% of the available AD&D
Spouse only—60% of employee’s voluntary coverage amount insurance beneit be paid for all losses
Children only—20% of employee’s voluntary coverage amount resulting from one accident.
Spouse and child(ren)—50% of employee’s voluntary coverage
amount for spouse and 10% voluntary coverage amount for each
child
The amount of this AD&D insurance beneit for other covered
losses is a percentage of the amount payable for additional AD&D
insurance coverage on the date of the accident, as shown in the
following table.
39
Voluntary Supplemental AD&D insurance is available in amounts AD&D
equal to one, two, three, four, or ive times your annual base pay. Type of Loss Percentage
If the coverage amount you elect is not a multiple of $1,000, then Payable
it is rounded to the next higher multiple of $1,000. The maximum Life 1 2 100%
amount of voluntary supplemental AD&D insurance is $500,000. One hand or foot , sight in one 50%
eye, audible speech, hearing
AD&D is insured through The Standard. in both ears
Two or more of the losses 100%
listed above
Your Cost Thumb and index inger of 25%
Supplemental life/AD&D insurance, and dependent supplemental same hand 3
life/AD&D insurance are deducted from your pay on an after-tax 1 This beneit includes loss of life due to exposure
or disappearance. Disappearance must be
basis. Refer to page 46 titled “Employee Contributions” for the cost caused directly by an accident which could have
reasonably resulted in death and must occur
applicable to supplemental life insurance and dependent supplemental independently of all other causes continuing
life insurance offered by The Carlstar Group. for a period of 365 days after the date of the
accident despite reasonable search efforts.
2 This beneit is payable whether or not the hand
Spouse and/or Child(ren) or foot is surgically reattached.
3 This beneit is not payable if a AD&D insurance
As long as you apply for Supplemental AD&D coverage, Dependent beneit is payable for the loss of the entire
hand.
Supplemental AD&D coverage is available for your spouse and
dependent children as well. The coverage amount for each dependent These beneits are also available to
is as follows. your dependents. At no time will more
than 100% of the available AD&D
Spouse only—60% of employee’s voluntary coverage amount insurance beneit be paid for all losses
Children only—20% of employee’s voluntary coverage amount resulting from one accident.
Spouse and child(ren)—50% of employee’s voluntary coverage
amount for spouse and 10% voluntary coverage amount for each
child
The amount of this AD&D insurance beneit for other covered
losses is a percentage of the amount payable for additional AD&D
insurance coverage on the date of the accident, as shown in the
following table.
39
