Page 17 - TriStar Energy-2023-Benefit Guide-V26(WLP)-LRI

Life Insurance and Disability

Basic Life and AD&D Insurance
• Life insurance is an important part of your financial Protect your loved ones
wellbeing, especially if others depend on you for support. • Affordable supplemental coverage –
• Tri Star Energy provides basic life and accidental death Take advantage of the group rates offered
and dismemberment insurance through NY Life to all to get the best deal on your coverage.
eligible associates at no cost as shown below: Investing in insurance give you peace of
• VP and above: $100,000 mind and the financial protection for yourself
• Directors: $75,000 and your loved ones.
• All full-time Managers and Administration: $40,000 • Be sure to designate your beneficiary –
• All full-time Active Guest Service Representatives, You must choose a beneficiary for life and
Hosts and Baristas: $15,000 AD&D insurance. Keep your beneficiaries
up-to-date in Paylocity.
• Coverage is automatic; you do not need to enroll.

Voluntary Life and AD&D Insurance
• You may choose to purchase additional life and Disability Insurance
AD&D coverage through NY Life for yourself and your Disability insurance through NY Life provides income
dependents at affordable group rates. replacement should you become disabled and unable
• Rates are based on age and the coverage level chosen. to work due to a non-work-related illness or injury.
Tri Star Energy offers eligible associates with disability
coverage as shown below.
Voluntary Life and AD&D Insurance for you

Team Member Coverage Benefit
• Increments of $10,000
• Up to a $500,000 maximum Voluntary • Choice of 40% or 60% of your weekly salary,
to a maximum of $1,000 per week for the
Short-Term
• Guaranteed issue up to $200,000 Disability* first 90-days of a disability after the 14 day
waiting period.
Voluntary Life and AD&D Insurance
for your dependents Long-Term • 60% of your base salary, to a maximum of
Disability $10,000 per month if you are disabled and
Spouse Child(ren) Employer are unable to work for more than 90 days.
• Increments of $10,000 • $5,000 or $10,000 Paid • Benefits are offset with other sources
(not to exceed 100% of (Max $10,000) per child of income, such as Social Security and
your voluntary life and • Birth to 6 months $500; Workers’ Compensation.
AD&D coverage) 6 months to age 26
• Maximum of 100% of $5,000 or $10,000 *PRE-EXISTING CONDITION EXCLUSION
A pre-existing condition means any injury or sickness for which you received
Team Member’s • Guaranteed issue up to medical treatment, advice or consultation, care or services, including diagnostic
Approved Amount $10,000 measures, or had drugs or medicines prescribed or taken in the three months
• Guaranteed issue up to prior to the day you become insured under the Policy.
$50,000 NY Life will not provide benefits for any disability caused by, attributable to,
or resulting from a pre-existing condition which begins in the first 12 months after
you are continuously insured under the policy.
Age Reduction applies to basic and voluntary insurance. Please contact the
Benefit Department for the Age reduction Schedule. Example: Anyone that will be newly electing short-term disability, NY Life will look
back for three months prior to the day you became insured under the policy to see
if you had any conditions in the prior three months. If those conditions are present
or shown they will not provide short-term disability benefits for that condition for
12 months.

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