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Life / AD&D Insurance and LTD:

Hartford

Basic Life Insurance and Accidental Death & Dismemberment (AD&D) and Long Term

Disability (LTD)

North Texas Neuroscience and Sleep Center, P.A. provides our full-time employees basic life and matching
AD&D and an LTD benefit; the company pays the full cost of these benefits. Benefits reduce 33% at age 65, 70
and 75 for the basic life.

Voluntary Life Insurance and Accidental Death & Dismemberment (AD&D)
North Texas Neuroscience and Sleep Center, P.A. offers full-time employees a Voluntary Life / AD&D policy
for themselves, their spouse, and their dependent children. In order to elect coverage for a spouse or
child(ren), you must elect coverage for yourself. This plan is offered through competitive group benefits by
your employer. It is paid by you and is accomplished through payroll deductions. Benefits reduce 50% at age
70.

*Child Life /
Employee Life / AD&D Spouse Life / AD&D
AD&D
Maximum Benefit 100% of Employees benefit, up to
5x Annual Salary, up to $500,000 $10,000
Amount $250,000

Minimum Benefit $10,000 to $100,000 $5,000 to $100,000
$2,500
Amount (Increments) then $50,000 to maximum then $25,000 to maximum

Guarantee Issue (GI) $30,000—Cannot Exceed 50% of
5x Annual Salary, up to $100,000 $10,000
Amount - New Hire Employee Election

If you chose an amount at initial If you chose an amount at initial
Qualifying Event In- enrollment less than the GI enrollment less than the GI
crease amount, it can be increased up amount, it can be increased up to N/A
to the GI amount. the GI amount.

Accelerated Death 80% of your Life Benefit up to $500,000 is available if diagnosed with a terminal illness with
Benefit / Living Care a life expectancy of less than 12 months.

If it is determined that you are totally disabled, your life insurance benefit will continue with-
Waiver of Premium
out payment of premium, subject to certain conditions.
The portability feature allows you to continue this insurance for yourself and your depend-
ents (if applicable) should your employment end, subject to the terms of eligibility defined in
Portability
the policy, without having to provide evidence of insurability (information about your health).
Employee must request this through The Hartford.

*Children covered to age 21 or 25 if a full-time student. Limited coverage for children aged 14 days to 6 months.

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