Page 21 - Pampa 2024 Benefit Guide Final
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Life / AD&D Insurance:

         Guardian



            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 $250,000                                        $10,000
          Amount                                                       up to $250,000

          Minimum Benefit
                                             $10,000                       $10,000                   $1,000
          Amount

          Guarantee Issue                                         100% of Employee’s Benefit,
          Amount—New Hires         5x Annual Salary, up to $150,000    up to $25,000                 $10,000

                                    If previously enrolled, you can
          Guarantee Issue
                                  increase your amount by $10,000
          Amount—
                                  up to $50,000 up to the GI amount   (EOI) Evidence of Insurability
          Open Enrollment          limit of $150,000. If you did not   form applies for employees    $10,000
          (EOI) Evidence of         make a voluntary life election    that are NOT new hires
                                   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        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 Guardian to initiate.

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