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AD&D Insurance Summary of Benefits

Prepared for: Full-Time Employees of None

Group rates for KCM employees make AD&D insurance more
affordable than ever. Additional benefits and services of the
plan are outlined below.

Your premium comes out of your paycheck, so no money
is due now.

Coverage for You
You can secure AD&D insurance if you are an active None employee. This coverage provides a cash

benefit to the beneficiary/beneficiaries you name if you die in an accident, or to you if you suffer a
covered loss in an accident, such as losing a limb or your eyesight. If you do not name a beneficiary, or
that person dies before you, the cash benefit may go to your estate. See the plan contract for details.

AD&D (Accidental Death & Dismemberment) | Employee
5 times your annual salary ($500,000 maximum) in $5,000
Maximum coverage amount
increments
Minimum coverage amount $5,000

Maximum AD&D (Accidental Death & Dismemberment) Coverage Amount

• You can choose a coverage amount up to 5 times your annual salary ($500,000 maximum) in $5,000
increments.
• Your employee AD&D coverage amount will reduce by 65% when you reach age 65 and an additional
70% of the original amount when you reach age 70. Benefits end when you retire.
• For complete plan details, please see your contract.

Bi-Weekly Premium Calculation for You
Coverage Bi-Weekly
Amount Premium
The estimated bi-weekly premium for AD&D insurance is determined by
$10,000 $0.09
multiplying the desired amount of coverage (in increments of $5,000) by
$50,000 $0.09 the premium rate. See table at right for select coverage amounts.
$200,000 $0.09
$500,000 $0.09
$____________ X 0.0000092 = $_______________
coverage amount premium rate bi-weekly premium

Note: Rates are subject to change and can vary over time.

AD&D Insurance Summary of Benefits
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