Page 40 - KCCU Health & Welfare SPD

BENEFIT PROGRAM/ NAME OF INSURER/ POLICY OR CLAIMS
BENEFITS
EFFECTIVE DATE CLAIMS CONTRACT PROVIDED ELIGIBILITY PROCEDURE
OF COVERAGE ADMINISTRATOR NUMBER(S) & BENEFITS
See Plan/SPD See Plan/SPD See Plan/SPD
GROUP TERM LIFE CUNA MUTUAL 021-0898-4 and Certificates and Certificates and Certificates
INSURANCE GROUP of Insurance and of Insurance and of Insurance
BENEFITS other benefit other benefit and other
materials
materials
benefit
INSURER/CLAIMS provided by provided by materials
01/01/2014 ADMINISTRATOR Insurer. Insurer. provided by
Insurer.
See Plan/SPD See Plan/SPD See Plan/SPD
ACCIDENTAL DEATH CUNA MUTUAL 021-0898-4 and Certificates and Certificates and Certificates
AND GROUP of Insurance and of Insurance and of Insurance
DISMEMBERMENT other benefit other benefit and other
INSURANCE INSURER/CLAIMS materials materials benefit
COVERAGE provided by provided by materials
ADMINISTRATOR Insurer. Insurer. provided by

Insurer.
01/01/2014

40