Page 16 - Kate Somerville Benefits Guide 2020 CA FINAL

LIFE PREPARATION

Life/AD&D

BASIC LIFE AND AD&D
Kate Somerville provides all active employees with a basic life insurance and accidental death and dismemberment (AD&D)
benefit* of 1x your annual salary up to a maximum of $350,000. This benefit provides valuable income protection in the case that
you suffer a severe accident or loss of life. An accelerated death benefit is also included. For a complete benefit summary, please
download the summary from the Benefits Website.

VOLUNTARY LIFE AND AD&D
As an employee of Kate Somerville, you have the option of purchasing additional life insurance* for yourself, a spouse/domestic
partner and/or children. You will automatically receive Accidental Death and Dismemberment with the Life benefit. When you
enroll yourself and your dependents in this benefit, you pay the full cost through post-tax payroll deductions. Please note that you
may need to complete an evidence of insurability form if you elect an amount above the guaranteed issue or if you declined to
enroll at your initial eligibility date. Please note that employees need to elect coverage, before they can elect coverage for a
Spouse/Domestic Partner or their Child(ren).

• EMPLOYEE* Voluntary Life and AD&D Monthly Premiums
Coverage Option: $10,000 Increments Employee Cost Spouse Costs per
Guarantee Issue Amount: $150,000 Age per $1,000 $1,000
Maximum Amount: 5x annual salary up to $500,000 Under 24 $0.089 $0.089
SPOUSE/DOMESTIC PARTNER* 25 – 29 $0.099 $0.099
Coverage Option: $5,000 Increments 30 – 34 $0.121 $0.121
Guarantee Issue Amount: $30,000 35 – 39 $0.146 $0.146
Maximum Amount: 50% of the Employee amount up to $250,000 40 – 44 $0.233 $0.233
CHILD(REN)** 45 – 49 $0.313 $0.313
$0.561
50 – 54
$0.561
Coverage Option: $5,000, $10,000, $15,000 or $20,000 55 – 59 $1.043 $1.043
Guarantee Issue Amount: $20,000 60 – 64 $1.503 $1.503
Maximum Amount: $20,000 65 – 69 $2.435 $2.435
70 - 99 $4.281 $4.281
*There is an age reduction schedule that reduces the benefit at age 65+.
**No coverage available from live birth to 14 days. After 14 days, full elect-
ed coverage goes into effect. VOLUNTARY LIFE/AD&D PREMIUM
CHOOSING A BENEFICIARY EXAMPLE:

Kate Somerville requires all eligible employees to designate Employee age 35 who wants $50,000 of Voluntary Life/
at least one primary beneficiary online in Paylocity. You AD&D Coverage:
many name anyone as your beneficiary to receive your Life
and AD&D benefits in case of your death. Once you have ($50,000/$1,000) x $0.146 = $7.30 per month
named your beneficiary, your designation will remain un-
changed until you change it. You may change your benefi-
ciary as often as you wish. Coverage Amount Rate

NOTE: 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). If you are no longer in your initial eligibility period, you may enroll anytime during the year as long as you provide proof of good health.
You will be asked to complete a health questionnaire and are subject to insurance carrier approval. If you are already enrolled in the Voluntary Life you are eligible
to elect up to an additional $20,000 each year at open enrollment without health questions.

16 KATE SOMERVILLE EMPLOYEE BENEFITS