Page 12 - Enrollment Guide Example
P. 12
2016 Benefits Enrollment
Life, AD&D, STD, and LTD
If you are newly eligible
and have not previously
waived your opportunity Insurance
to elect additional term
life insurance, you can Life and AD&D Insurance
elect coverage up to the
guaranteed issue amounts We know inancial security and planning is a top priority for you. This is why
without submitting evidence we offer life insurance beneits to help inancially protect you and your family
of insurability (EOI). If if your income were suddenly lost.
you are a late entrant
and have previously [Client Name] provides, at no cost to you, basic term life and accidental death
waived the opportunity to and dismemberment (AD&D) insurance equal to your annual salary (including
purchase additional term
life insurance, you will be commissions) to a maximum of $250,000. You can also purchase additional
required to submit EOI. term life and AD&D insurance for yourself, spouse, and dependent children.
Life Insurance At-a-Glance
[Carrier]
Eligibility Active full-time employee working at least 30 hours per week
Employee Life Insurance
Basic 1 x annual salary
Maximum $250,000
Supplemental Increments of $10,000 to the lesser of 5x annual salary or $500,000;
if you are in your newly eligible period you can elect up to the
lesser of 3x annual salary or $100,000 without completing medical
underwriting
Living Beneit
If you become terminally ill while covered, you can claim up to 75% of the combined
value of your basic and voluntary life coverage up to $500,000 while you are still living;
terminally ill means you are expected to live 24 months or less
Dependent Life Insurance
Spouse $5,000 increments to a max of $100,000 (not to exceed 50% of
employee beneit) if you are in your newly eligible period you can
elect up to $20,000 without completing medical underwriting
Child (children from $1,000 increments not to exceed the lesser of 50% of the employee
live birth to 26 elected amount or $10,000
years are eligible)
AD&D Insurance At-a-Glance
[Carrier]
Guaranteed Issue Eligibility Active full-time employee working at least 30 hours per week
Amounts AD&D Insurance
Employee Lesser of $100,000 Basic Employees receive 1 x annual salary up to a maximum of $250,000
or 3x basic annual Supplemental If you elect voluntary life insurance you will receive an AD&D beneit
earnings with a principal sum equal to the voluntary life amount
Spouse $20,000 Note: age restrictions may apply. Please contact Human Resources for additional details regarding the
Child(ren) $10,000 beneits and rates.
12
Life, AD&D, STD, and LTD
If you are newly eligible
and have not previously
waived your opportunity Insurance
to elect additional term
life insurance, you can Life and AD&D Insurance
elect coverage up to the
guaranteed issue amounts We know inancial security and planning is a top priority for you. This is why
without submitting evidence we offer life insurance beneits to help inancially protect you and your family
of insurability (EOI). If if your income were suddenly lost.
you are a late entrant
and have previously [Client Name] provides, at no cost to you, basic term life and accidental death
waived the opportunity to and dismemberment (AD&D) insurance equal to your annual salary (including
purchase additional term
life insurance, you will be commissions) to a maximum of $250,000. You can also purchase additional
required to submit EOI. term life and AD&D insurance for yourself, spouse, and dependent children.
Life Insurance At-a-Glance
[Carrier]
Eligibility Active full-time employee working at least 30 hours per week
Employee Life Insurance
Basic 1 x annual salary
Maximum $250,000
Supplemental Increments of $10,000 to the lesser of 5x annual salary or $500,000;
if you are in your newly eligible period you can elect up to the
lesser of 3x annual salary or $100,000 without completing medical
underwriting
Living Beneit
If you become terminally ill while covered, you can claim up to 75% of the combined
value of your basic and voluntary life coverage up to $500,000 while you are still living;
terminally ill means you are expected to live 24 months or less
Dependent Life Insurance
Spouse $5,000 increments to a max of $100,000 (not to exceed 50% of
employee beneit) if you are in your newly eligible period you can
elect up to $20,000 without completing medical underwriting
Child (children from $1,000 increments not to exceed the lesser of 50% of the employee
live birth to 26 elected amount or $10,000
years are eligible)
AD&D Insurance At-a-Glance
[Carrier]
Guaranteed Issue Eligibility Active full-time employee working at least 30 hours per week
Amounts AD&D Insurance
Employee Lesser of $100,000 Basic Employees receive 1 x annual salary up to a maximum of $250,000
or 3x basic annual Supplemental If you elect voluntary life insurance you will receive an AD&D beneit
earnings with a principal sum equal to the voluntary life amount
Spouse $20,000 Note: age restrictions may apply. Please contact Human Resources for additional details regarding the
Child(ren) $10,000 beneits and rates.
12
