Page 21 - Deweys Benefits Enrollments Guide

Voluntary Supplemental Term Life
Group# 907-14-00149-002

You have available to you additional Supplemental Life insurance for you and your family.
Benefit choice of $10,000, $25,000, $50,000, $75,000, $100,000 not to exceed 7x annual earnings.
• The dependent child benefit is a choice of $2,500, $5,000, $7,500 or $10,000. Rate is $.25 per
$1,000.
• Spouse benefit: choice of $5,000, $10,000, $25,000 not to exceed 50% of the employee
amount. Guaranteed Issue amount is $25,000.

• Accelerated benefit provision: You may access up to 75% of the benefit in the event of a terminal
illness (maximum $100,000).

• Portability provision: You may continue the policy for you and your spouse at the same group rates if
your employment ends, policy continues until the employer’s policy cancels.
• Waiver of premium provision: You may stop paying premiums if you become totally disabled.

• Conversion privilege: Conversion to permanent insurance available.

• Age reduction formula: Employee and spouse life insurance benefit reduces to 65% at the employee’s
age 65, reduces to 50% of the original amount at age 70, to 35% at age 75, to 20% at age 80, and
terminates at the employee’s retirement, whichever occurs first.

For added protection and value, you can include our Accidental Death & Dismemberment (AD&D)
option. The amount of AD&D coverage must be equal to the Voluntary Life benefits the employees
select for themselves and their covered spouses. AD&D benefit is selected at the group level. AD&D rate
is $0.03 per $1,000 (not included in rate chart on next page).

 You have the opportunity to elect the Voluntary Supplemental Term Life coverage without
proof of good health up to the Guarantee Issue Amount of $100,000 for Employee and for
Spouse, 50% of employee coverage with $25,000 Guarantee Issue, when first eligible. If
you enroll as a late entrant, proof of good health will be required. Your application for
coverage will be reviewed and either approved or declined as a late entrant.
 Rates are structured for you and your spouse in 5 year age bands. Your payroll deduction for
the above coverages could change during the plan year if you move into the next age band or
adjust your coverage amount.

20 |