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LIFE AND AD&D

Available to Store Managers & MIT’s only

CIGNA BASIC LIFE AND AD&D

United Pacific provides employees Basic Life and AD&D insurance at 1x your annual salary, to a maximum benefit of RATE PER MONTH RATE PER MONTH
$100,000. This coverage would be paid out to your beneficiary(ies) in the event of your death or accidental death VOLUNTARY LIFE RATE PER $1,000 VOLUNTARY LIFE RATE PER $1,000
and dismemberment. Age EMPLOYEE/SPOUSE* Age EMPLOYEE/SPOUSE*
<35 $0.082 60-64 $0.853
CIGNA VOLUNTARY LIFE AND AD&D 35-39 $0.101 65-69 $1.447
70-74
In addition to the company provided Basic Life and AD&D benefits, you may elect to purchase additional Term Life 40-44 $0.145 75-79 $2.745
$5.184
$0.218
45-49
and AD&D insurance at discounted group rates provided by Cigna. If elected, you pay for this coverage with after- 50-54 $0.346 Age ALL CHILDREN
tax dollars through payroll deductions. 55-59 $0.557 0-26 $0.245
*Spouse life terminates at the age of 70.
Employee
You may purchase coverage for yourself in increments of $10,000 up to a maximum benefit of $750,000. VOLUNTARY AD&D
Employee/Spouse/Child(ren) $0.030
Spouse/Domestic Partner
If you buy coverage for yourself, you may also purchase coverage for your eligible spouse/domestic partner. Benefits
for your spouse are available in increments of $25,000 to a maximum benefit of $150,000 and may not exceed
50% of your employee election.

Child(ren)
If you buy coverage for yourself, you may also purchase coverage for your eligible dependent child(ren). Benefits
for your child(ren) are available in the following amounts:
• 14 Day to 6 months of age: Flat $500
• 6 months to 26 years of age: Flat $5,000 or $10,000

Guarantee issue is a pre-approved amount of coverage that does not require you to provide proof of good health, and
is available to you during your initial eligibility period (upon hire). Guarantee issue is available in the following amounts:
• Employee = The lesser of 3x your annual salary or $300,000
• Spouse/Domestic Partner = $25,000
• Child(ren) = All guarantee issue

If you are no longer in your initial eligibility period, you may enroll in Voluntary Life and AD&D insurance anytime
during the year as long as you provide proof of good health. To provide proof of good health, you will be asked
to complete a health questionnaire and are subject to insurance carrier approval. Cigna may approve or decline
coverage based on a review of your health history.

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