Page 16 - Sample Calendar Layout EE Guide

Life Insurance provides your beneficiary(ies) with a benefit in the event of your death. You are provided with Short-Term and Long-Term Disability
Accidental Death and Dismemberment (AD&D) Insurance provides specified benefits to Insurance at NO COST to you. Disability Insurance provides
you in the event of a covered accidental bodily injury that directly causes dismemberment benefits that replace part of your lost income when you
(i.e., the loss of a hand, foot, or eye). In the event that your death occurs due to a covered become unable to work due to a covered injury or illness.
accident, both the Life and the AD&D benefit would be payable. Business Travel Accident
is an additional benefit that will be paid in the event of your death if you if you are
traveling on behalf of the company. SHORT TERM DISABILITY
Benefit Percentage 66 2/3%
Company-Paid
Basic Life/AD&D & Business Travel Accident. This benefit is provided at NO COST to you. Weekly Benefit Maximum $2,309
Day 1 for accident
BASIC LIFE/AD&D BUSINESS TRAVEL ACCIDENT When Benefits Begin Day 8 for illness

$50,000 Life $250,000: Mangers, Directors, Senior & Sales Maximum Benefit Duration 26 weeks
Staff

$100,000 Life/AD&D: If your death is LONG TERM DISABILITY
due to a covered accident or injury $100,000: All Other Employees
Benefit Percentage 66 2/3%
Employee-Paid
Voluntary Life/AD&D. If you determine you need more than the Company-Paid Basic Life Monthly Benefit Maximum $10,000
coverage, you may purchase additional coverage for you and your eligible dependents. When Benefit Begin 181st day
To the end of the benefit
VOLUNTARY LIFE/AD&D GUARANTEE ISSUE* period, or until you no
Employee $10,000 increments up to 5x annual salary to a $200,000 Maximum Benefit Duration longer qualify for benefits,
Life/AD&D maximum of $500,000 ($50,000 if age 70+) whichever occurs first
Spouse/DP $5,000 increments, maximum 50% of employee $40,000
Life/AD&D coverage to a maximum of $250,000 ($10,000 if age 70+)
Child(ren) Coverage available at a flat amount of $10,000 $10,000
Life Only

Group life and voluntary employee/spouse life benefits reduce to 65% at age 70.
You must elect Voluntary Employee Life/AD&D to elect Voluntary Spouse/DP or Child
Voluntary Life. Voluntary Life and Voluntary AD&D are separate elections.

*During your initial eligibility period only, you can receive coverage up to the Guarantee
Issue amounts without having to provide Evidence of Insurability (information about your
health). Coverage amounts that require Evidence of Insurability will not be effective unless
approved by the insurance carrier.