Page 14 - Revelations Group 2 - 2021 Arl. Res. Benefit Guide (R3)

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

Guarantee Issue
Amount—2021 Open
100% of Employee’s Benefit, up to
Enrollment 5x Annual Salary, up to $150,000 $10,000
$30,000
Over Amount requires (EOI)
Evidence of Insurability form

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

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.
In addition to basic AD&D benefits, you are protected by the following benefits:
Additional AD&D
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.

14