Page 22 - Mersen Benefit Guide Local 502

Life Insurance

Life and AD&D Insurance
Local ID

Mersen provides Basic Life and Accidental Death & Dismemberment (AD&D) insurance for employees and offers Supplemental Life
insurance election options for employees and their dependents. NY Life (NYL) is our administrator to our welfare plans (Life,
Disability, Leaves and Supplemental Life). If over the age of 70, your Life, AD&D and Supplemental Life benefits are reduced.

Basic Life and AD&D Insurance – New Union Basic Life Benefit!
If you are an eligible full-time non-union employee, Mersen will automatically provide a Basic Life Insurance benefit equal to up
to one time your basic annual earnings (rounded to the next highest $1,000) — at no cost to you.
Maximum Basic Life Benefit is $300,000.
Maximum Accidental Death & Dismemberment (AD&D) benefit is $54,000.

Supplemental Life and AD&D Insurance

Employee
• You can purchase Supplemental Life and AD&D Insurance from one to five times your basic annual earnings.
Maximum Supplemental Life Benefit is $500,000. * Rates are based on age, tobacco use, gender, and tier schedule of
premium. Any changes to this benefit will automatically direct you to NY Life’s portal to complete and submit an EOI.

Spouse Child(ren)
• The maximum benefit is 50% of the employee  Choice of $2,000, $4,000,
Supplemental Life election up to $250,000. $6,000, $8,000 or $10,000 per child.
• All benefits are based on annual salary rounded up
to nearest $5,000. Children can receive this benefit up until the age of 26.

Evidence of Insurability – Supplemental Life Plans Only
New Process for changes to Supplemental Life elections in ADP

• When you elect Supplemental Life changes in ADP, you will automatically receive a pop-up notification that you may
need to complete an EOI.

• If you receive this notification to complete the EOI, in ADP, you will go to the additional details tab and select the
link to complete the form and submit.

• Once submitted, the form will go directly to NY Life for review and approval. NY Life will contact you directly with
any information or concerns.

• You will receive a final determination from NYL. Once received, bring this proof of insurability (approval of increase)
to HR, to be covered by your desired elected additional benefit election.

If you do not bring this approval to HR or receive a denial, you will not be enrolled in any additional elected supplemental
benefits.

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