Page 13 - Hussmann- Bridgeton OE Guide 2015 Plan Year
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Hussmann Corporation
Basic and Supplemental Life and AD&D
Basic Life Insurance Evidence of Good Health/
To protect you and your family against inancial loss, Hussmann provides Evidence of Insurability
you with $38,000 company-paid Basic Life Insurance coverage. This is where a statement of medical
history and related information is
Basic Accidental Death and Dismemberment requested which will be used to
(AD&D) Insurance determine whether an applicant will
be approved for coverage.
You will also receive company-paid Basic AD&D Insurance in the If you apply for coverage or
amount of $38,000. choose to increase your coverage
during open enrollment, coverage
Supplemental Life Insurance amounts will not be issued until
Cigna approves acceptable evidence
Purchasing supplemental life coverage through Cigna allows you to add of good health. Evidence of Good
to your company provided basic coverage. Health may include a paramedical
exam or Physician’s statement, in
You may purchase Supplemental Life Insurance from one to eight times addition to completing a medical
your base pay (rounded to the nearest $1,000), up to $1,000,000. Rates history questionnaire.
are based on the amount of insurance you purchase and your age. You
may purchase up to the guarantee issue amounts listed below without
completing Evidence of Insurability (EOI) if you are in your newly
eligible period as a new hire. Later elections during open enrollment or
coverage increases will require EOI.
Guarantee Issue Amount
Employee Lesser of 3x your annual salary or $500,000
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 Cigna approves acceptable evidence of good health.
Beneficiary Reminder
Beneiciary information for Life and AD&D coverages are kept in
Workday. You can update your beneiciary information throughout
the year by accessing Workday or calling OneSourceVirtual at
1-855-994-4877.
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Basic and Supplemental Life and AD&D
Basic Life Insurance Evidence of Good Health/
To protect you and your family against inancial loss, Hussmann provides Evidence of Insurability
you with $38,000 company-paid Basic Life Insurance coverage. This is where a statement of medical
history and related information is
Basic Accidental Death and Dismemberment requested which will be used to
(AD&D) Insurance determine whether an applicant will
be approved for coverage.
You will also receive company-paid Basic AD&D Insurance in the If you apply for coverage or
amount of $38,000. choose to increase your coverage
during open enrollment, coverage
Supplemental Life Insurance amounts will not be issued until
Cigna approves acceptable evidence
Purchasing supplemental life coverage through Cigna allows you to add of good health. Evidence of Good
to your company provided basic coverage. Health may include a paramedical
exam or Physician’s statement, in
You may purchase Supplemental Life Insurance from one to eight times addition to completing a medical
your base pay (rounded to the nearest $1,000), up to $1,000,000. Rates history questionnaire.
are based on the amount of insurance you purchase and your age. You
may purchase up to the guarantee issue amounts listed below without
completing Evidence of Insurability (EOI) if you are in your newly
eligible period as a new hire. Later elections during open enrollment or
coverage increases will require EOI.
Guarantee Issue Amount
Employee Lesser of 3x your annual salary or $500,000
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 Cigna approves acceptable evidence of good health.
Beneficiary Reminder
Beneiciary information for Life and AD&D coverages are kept in
Workday. You can update your beneiciary information throughout
the year by accessing Workday or calling OneSourceVirtual at
1-855-994-4877.
13
