Page 19 - 2016 Open Enrollment Non-Union
P. 19
Hussmann Corporation
Basic, Supplemental Life, Important Benefit Terms
and AD&D to Know
Benefit Base Pay
Basic Life Insurance Your base pay is used to determine
You will receive company-paid basic life insurance in the amount the amounts of basic life and accident
of one times your base pay (rounded to the nearest $1,000) with a insurance, and long term disability
coverage. The base pay is deined in your
minimum of $50,000. The beneit maximum is $500,000. If your summary plan description, please see for
beneit is more than $50,000 then according to IRS regulations, details.
the value of your life insurance in excess of $50,000 is considered
imputed income. Imputed income is the value of non-cash Evidence of Good Health/
Evidence of Insurability
compensation. It is added to your taxable wages and will appear on
your W-2. This is where a statement of medical
history and related information is
requested which will be used to determine
Basic Accidental Death and Dismemberment whether an applicant will be approved for
(AD&D) Insurance coverage.
You will receive company-paid basic AD&D insurance in the amount If you apply for coverage or choose to
of one times your base pay (rounded to the nearest $1,000) with a increase your coverage during beneits
minimum of $50,000. The beneit maximum is $500,000. enrollment, coverage amounts will not
be issued until Liberty Mutual approves
Supplemental Life Insurance acceptable evidence of good health.
Evidence of good health may include
Purchasing supplemental life coverage through Liberty Mutual allows a paramedical exam or physician’s
you to add to your company provided basic coverage. statement, in addition to completing a
medical history questionnaire.
You may purchase supplemental life insurance from one to
eight times your base pay (rounded to the nearest $1,000), up to
$1,000,000. Rates are based on the amount of insurance you purchase Beneficiary Reminder
and your age. You may purchase up to the guarantee issue amounts Please ensure your beneiciary
listed below without completing evidence of insurability (EOI) if you information is up to date. For each
are in your newly eligible period as a new hire. Later elections during beneiciary you designate, you’ll need
beneits enrollment or coverage increases will require EOI. to have the following information
available: name, address, date of birth,
Guarantee Issue Amount
Employee Lesser of 3x your annual salary or $500,000 and social security number.
Spouse $30,000
Children $10,000
Note: if you apply for an amount of coverage for yourself or your spouse greater than
the guaranteed issue amount, coverage in excess of the guaranteed issue amount
will not be issued until Liberty Mutual approves acceptable evidence of good
health.
19
Basic, Supplemental Life, Important Benefit Terms
and AD&D to Know
Benefit Base Pay
Basic Life Insurance Your base pay is used to determine
You will receive company-paid basic life insurance in the amount the amounts of basic life and accident
of one times your base pay (rounded to the nearest $1,000) with a insurance, and long term disability
coverage. The base pay is deined in your
minimum of $50,000. The beneit maximum is $500,000. If your summary plan description, please see for
beneit is more than $50,000 then according to IRS regulations, details.
the value of your life insurance in excess of $50,000 is considered
imputed income. Imputed income is the value of non-cash Evidence of Good Health/
Evidence of Insurability
compensation. It is added to your taxable wages and will appear on
your W-2. This is where a statement of medical
history and related information is
requested which will be used to determine
Basic Accidental Death and Dismemberment whether an applicant will be approved for
(AD&D) Insurance coverage.
You will receive company-paid basic AD&D insurance in the amount If you apply for coverage or choose to
of one times your base pay (rounded to the nearest $1,000) with a increase your coverage during beneits
minimum of $50,000. The beneit maximum is $500,000. enrollment, coverage amounts will not
be issued until Liberty Mutual approves
Supplemental Life Insurance acceptable evidence of good health.
Evidence of good health may include
Purchasing supplemental life coverage through Liberty Mutual allows a paramedical exam or physician’s
you to add to your company provided basic coverage. statement, in addition to completing a
medical history questionnaire.
You may purchase supplemental life insurance from one to
eight times your base pay (rounded to the nearest $1,000), up to
$1,000,000. Rates are based on the amount of insurance you purchase Beneficiary Reminder
and your age. You may purchase up to the guarantee issue amounts Please ensure your beneiciary
listed below without completing evidence of insurability (EOI) if you information is up to date. For each
are in your newly eligible period as a new hire. Later elections during beneiciary you designate, you’ll need
beneits enrollment or coverage increases will require EOI. to have the following information
available: name, address, date of birth,
Guarantee Issue Amount
Employee Lesser of 3x your annual salary or $500,000 and social security number.
Spouse $30,000
Children $10,000
Note: if you apply for an amount of coverage for yourself or your spouse greater than
the guaranteed issue amount, coverage in excess of the guaranteed issue amount
will not be issued until Liberty Mutual approves acceptable evidence of good
health.
19
