Page 18 - Hussmann- OE Guide 2015 Plan Year
P. 18
Annual
Enrollment
Basic, Supplemental Life, and AD&D
Basic Life Insurance
Important Benefit
Terms to Know You will receive company-paid Basic Life Insurance in the amount
of one times your Base Pay (rounded to the nearest $1,000) with a
Benefit Base Pay minimum of $50,000. The beneit maximum is $500,000. If your
Your Base Pay is used to determine beneit is more than $50,000 then according to IRS regulations, the
the amounts of Basic Life and Accident value of your life insurance in excess of $50,000 is considered imputed
Insurance, and Long-Term Disability income. Imputed income is the value of non-cash compensation. It is
coverage. The Base Pay is deined in
your Summary Plan Description, please added to your taxable wages and will appear on your W-2.
see for details.
Basic Accidental Death and Dismemberment
Evidence of Good Health/ (AD&D) Insurance
Evidence of Insurability
This is where a statement of medical You will receive company-paid Basic AD&D Insurance in the amount
history and related information is of one times your Base Pay (rounded to the nearest $1,000) with a
requested which will be used to minimum of $50,000. The beneit maximum is $500,000.
determine whether an applicant will be
approved for coverage.
Supplemental Life Insurance
If you apply for coverage or choose to
increase your coverage during open Purchasing supplemental life coverage through Cigna allows you to add
enrollment, coverage amounts will to your company provided basic coverage.
not be issued until Cigna approves
acceptable evidence of good health. You may purchase Supplemental Life Insurance from one to eight
Evidence of Good Health may include times your base pay (rounded to the nearest $1,000), up to $1,000,000.
a paramedical exam or Physician’s Rates are based on the amount of insurance you purchase and your
statement, in addition to completing a
medical history questionnaire. age. You may purchase up to the guarantee issue amounts listed below
without completing Evidence of Insurability (EOI) if you are in
your newly eligible period as a new hire. Later elections during open
enrollment or coverage increases will require EOI.
Guarantee Issue Amount
Beneficiary Reminder Employee Lesser of 3x your annual salary or $500,000
Spouse $30,000
Please ensure your beneiciary Children $10,000
information is up to date. For each Note: If you apply for an amount of coverage for yourself or your spouse greater than the
beneiciary you designate, you’ll need guaranteed issue amount, coverage in excess of the guaranteed issue amount will
not be issued until Cigna approves acceptable evidence of good health.
to have the following information
available: name, address, date of birth,
and social security number.
18
Enrollment
Basic, Supplemental Life, and AD&D
Basic Life Insurance
Important Benefit
Terms to Know You will receive company-paid Basic Life Insurance in the amount
of one times your Base Pay (rounded to the nearest $1,000) with a
Benefit Base Pay minimum of $50,000. The beneit maximum is $500,000. If your
Your Base Pay is used to determine beneit is more than $50,000 then according to IRS regulations, the
the amounts of Basic Life and Accident value of your life insurance in excess of $50,000 is considered imputed
Insurance, and Long-Term Disability income. Imputed income is the value of non-cash compensation. It is
coverage. The Base Pay is deined in
your Summary Plan Description, please added to your taxable wages and will appear on your W-2.
see for details.
Basic Accidental Death and Dismemberment
Evidence of Good Health/ (AD&D) Insurance
Evidence of Insurability
This is where a statement of medical You will receive company-paid Basic AD&D Insurance in the amount
history and related information is of one times your Base Pay (rounded to the nearest $1,000) with a
requested which will be used to minimum of $50,000. The beneit maximum is $500,000.
determine whether an applicant will be
approved for coverage.
Supplemental Life Insurance
If you apply for coverage or choose to
increase your coverage during open Purchasing supplemental life coverage through Cigna allows you to add
enrollment, coverage amounts will to your company provided basic coverage.
not be issued until Cigna approves
acceptable evidence of good health. You may purchase Supplemental Life Insurance from one to eight
Evidence of Good Health may include times your base pay (rounded to the nearest $1,000), up to $1,000,000.
a paramedical exam or Physician’s Rates are based on the amount of insurance you purchase and your
statement, in addition to completing a
medical history questionnaire. age. You may purchase up to the guarantee issue amounts listed below
without completing Evidence of Insurability (EOI) if you are in
your newly eligible period as a new hire. Later elections during open
enrollment or coverage increases will require EOI.
Guarantee Issue Amount
Beneficiary Reminder Employee Lesser of 3x your annual salary or $500,000
Spouse $30,000
Please ensure your beneiciary Children $10,000
information is up to date. For each Note: If you apply for an amount of coverage for yourself or your spouse greater than the
beneiciary you designate, you’ll need guaranteed issue amount, coverage in excess of the guaranteed issue amount will
not be issued until Cigna approves acceptable evidence of good health.
to have the following information
available: name, address, date of birth,
and social security number.
18
