Page 23 - Pampa Benefit Guide 4-1-24a

Life / AD&D Insurance:

Principal Life Insurance

*NEW* Basic Life Insurance and Accidental Death & Dismemberment (AD&D)

We are now providing all full-time employees with a 100% Employer Paid life insurance benefit of $10,000; including
matching AD&D. Your benefits will reduce to 65% at age 65, and to 50% at age 70. Benefits terminate at retirement.
This coverage is Guarantee Issue for the entire face amount and cannot be turned down for qualified enrollees.

Voluntary Life Insurance and Accidental Death & Dismemberment (AD&D)
SkyBlue Healthcare 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 pay-
roll deduction. Rates are based on Employees age. Your benefits will reduce to 50% at age 70. Spouse coverage ends
at age 70. RATES ARE CALCULATED THROUGH EMPLOYEE NAVIGATOR.

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

Maximum Benefit 100% of Employee’s Benefit,
$10,000 up to $500,000 $20,000
Amount up to $200,000

Minimum Benefit $10,000 $5,000 $2,000

Guarantee Issue Under Age 70: $150,000 Under Age 70: $30,000
$2,000 up to $20,000
Amount—New Hires Over Age 70: $10,000 Over Age 70: $10,000

Guarantee Issue
Amount— Anyone can enroll now for the Anyone can enroll now for Anyone can enroll now for
Open Enrollment GI Max: the GI Max: the GI Max:
Under Age 70: $150,000 Under Age 70: $30,000
(EOI) Evidence of Over Age 70: $10,000 Over Age 70: $10,000 $2,000 up to $20,000
Insurability form

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 Airbag

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 Principal to initiate.
23