Page 15 - GROUP 2 - 2022 Greenbrier Benefit Guide

Life / AD&D Insurance:

Mutual of Omaha

Voluntary Life Insurance and Accidental Death & Dismemberment (AD&D)

Revelations Health Care offers full-time employees a Voluntary Life / AD&D policy for yourselves, your spouse, and
your dependent children. In order to elect coverage for a spouse or child, you must elect coverage for yourself. This
plan is offered through a competitive group policy by your employer. It is 100% employee cost and will be paid
through payroll deduction. Rates are based on Employees age. Your benefits will reduce to 65% at age 65, and to

Child Life /
Employee Life / AD&D Spouse Life / AD&D
AD&D

Maximum Benefit 100% of Employee’s Benefit, up to
5x Annual Salary, up to $500,000 $10,000
Amount $250,000

Minimum Benefit
$10,000 $5,000 $10,000
Amount

Guarantee Issue 100% of Employee’s Benefit, up to
5x Annual Salary, up to $150,000 $10,000
Amount—New Hires $30,000

If previously enrolled, you can
Guarantee Issue
increase your amount by $10,000
Amount—2022 Open up to $20,000 up to the GI amount (EOI) Evidence of Insurability form
Enrollment limit of $150,000. If you did not applies for employees that are $10,000
make a voluntary life election NOT new hires
(EOI) Evidence of
during your new hire enrollment,
Insurability form
you will need to fill out an EOI.
Living Care Benefit /

Accelerated Death 80% of your Life Benefit can be obtained if diagnosed with a terminal illness.
Benefit

If it is determined that you are totally disabled, your life insurance benefit will continue without
Waiver of Premium
payment of premium, subject to certain conditions.
Additional AD&D In addition to basic AD&D benefits, you are protected by the following benefits:

Benefits Seat Belt Child Education Airbag Common Carrier

The portability feature allows you to continue this insurance for yourself and your dependents (if
applicable) should your employment end, subject to the terms of eligibility defined in the policy,
Portability Benefit
without having to provide evidence of insurability (information about your health). This feature
requires the member to contact Mutual of Omaha to initiate.

You may also convert your policy without having to provide evidence of insurability (information
Conversation Benefit
about your health). This feature requires the member to contact Mutual of Omaha to initiate.

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