Page 16 - 2022 Citizens Bank Benefit Guide

Life / AD&D Insurance:

Mutual of Omaha

Basic Life Insurance and Accidental Death & Dismemberment (AD&D)
Citizens Bank of Ada provides full-time employees a life insurance benefit of $30,000 and a
matching AD&D policy equal to the life insurance benefit. Citizens Bank of Ada pays the full cost of
this benefit. Your benefits will reduce to 67% at age 70, and to 50% at age 75. Benefits terminate at
retirement.

Voluntary Life Insurance and Accidental Death & Dismemberment (AD&D)
Citizens Bank of Ada offers full-time employees a Voluntary Life / AD&D policy for themselves, their
spouse, and their dependent child(ren). In order to elect coverage for a spouse or child, you must
elect coverage for yourself. This is an affordable group policy by your employer. This is 100%
employee paid and will be paid through payroll deduction. Your benefits will reduce to 67% at age
70, and to 50% at age 75. Benefits terminate at retirement. Spouse’s benefits do not have age
reductions and will terminate at Employee’s age of 70 or retirement, whichever comes first.
Guaranteed Issue for spouses apply to new hire employees.

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

Maximum Benefit 5x Annual Salary, up to 100% of Employees benefit, up
Amount $500,000 to $250,000 $10,000

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

5x Annual Salary, up to
Guarantee Issue $100,000 for New Hires. 100% of the Employees Benefit
(GI) Amount during $10,000 New Hire and
For New Hires and Open Enrollment (If already up to $30,000 at New Hire Open Enrollment
enrolled, you can increase
Enrollment.
Current Employees
by $10,000 per year)
Living Care /
Accelerated Death 80% of Life Benefit is available if diagnosed with a terminal illness not to exceed your
life benefit amount.
Benefit

If it is determined that you are totally disabled, your life insurance benefit will continue
Waiver of Premium
without payment of premium, subject to certain conditions.

In addition to basic AD&D benefits, you are protected by the following benefits:
Additional AD&D
Benefits Child & Spouse Education * Seat Belt * Airbag * Coma * Common Carrier * Paralysis
(Basic Employer AD&D Includes Hospital Confinement benefit)

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
without having to provide evidence of insurability (information about your health). This feature
requires the member to contact your plan administrator to complete forms.

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