Basic Term Life/AD&D 2 9 Covered Lives
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- Mervyn Byrd
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1 Benefits Description Group Life Insurance Basic Term Life/AD&D 2 9 Covered Lives MetLife is the industry leader in group life insurance, with over 2.4 trillion dollars of coverage in force. 1 Group life insurance from MetLife means competitive rates with superior administrative support, from communications to enrollment and claims processing. What s Available MetLife 2 9 Basic Term Life is only available when sold with MetLife 2 9 Dental. 2 Insurance Schedules Flat amount of coverage: $20,000, $30,000 or $50,000 Multiple of Salary: 1x Annual Earnings up to $50,000 or 1x Annual Earnings up to $100,000 Definition of Earnings Annual earnings means gross annual rate of pay as determined by the employer, excluding overtime and other extra pay. Annual earnings for salespeople may include commissions and/or bonuses which may be averaged for twenty-four months, or from the date of employment if the person has been employed for less than twenty-four months. The average will be multiplied by twelve to determine annual earnings. Features Continuation of Life Insurance While Totally Disabled Continuation of Life Insurance is provided for eligible employees who become totally disabled before the age of 60. Total disability means the employee is unable to perform the duties of his/her job and is unable to perform any other job for which he/she is qualified by education, training or experience. The total disability must continue for at least nine consecutive months, during which time premiums are required to be paid. When MetLife has approved the claim for total disability, subsequent premiums will be waived. MetLife may periodically request that the employee send proof that he/she continues to be totally disabled. This benefit terminates on the earliest of the following: the date the employee dies; the date total disability ends; the date the employee refuses to be examined by our physician as required; the date the employee reaches 65; or the date we do not receive required proof of total disability. Dependents are not eligible for this benefit. (Refer to the Cost & Benefit Summary or consult with your MetLife sales representative for details about your plan.) Accelerated Benefits Option (ABO) 3 ABO is available for Life Insurance amounts of $20,000 or more (certain states may have restrictions). Benefits are payable if an employee or employee s legal
2 representative requests payment of the ABO while the employee s life benefits are in effect, and his/her life expectancy is certified by a physician to be six months or less. The amount of accelerated benefits is up to 50% of the covered amount to a maximum of $250,000. Conversion Privilege The conversion privilege allows a covered person whose life insurance coverage ends to obtain an individual policy at his/her own expense, without providing evidence of insurability. The premiums will be based on the amount of coverage and the covered person s age and class of risk at the time of conversion. (Subject to state requirements.) Refer to the certificate of insurance for more information regarding conversion. Total Control Account (TCA) The TCA Settlement Option is the automatic settlement option for all life and AD&D benefits of $5,000 or more. The TCA helps to provide the employee s beneficiaries with immediate access to, and control of, their insurance proceeds. These benefits are paid through an interest-bearing account with the principal and interest guaranteed by the financial strength and claims-paying abilities of the Metropolitan Life Insurance Company. The TCA provides free check writing privileges. All or some of the funds held in a TCA can be transferred into other available settlement options, such as a guaranteed interest certificate which locks in competitive interest rates for periods of six months up to seven years. Annuity and monthly income plan settlement options are also available. List Billing Services The employer will receive a monthly premium statement showing the amount of premium due and providing a list of insured employees and premium by coverage. Accidental Death or Dismemberment (AD&D) AD&D coverage provides 24-hour-a-day, 365-day-ayear protection in addition to basic life insurance coverage. Coverage is provided for the covered losses shown below, if they are caused solely and directly by a covered accident that occurs on or off the job, and occurs within 90 days of the covered accident. No more than the Full Amount will be paid for all covered losses caused by injuries which an employee sustains in one covered accident. The Full Amount is equal to the life benefit payable for loss of life. Covered Loss Benefit Amount Life Full Amount A hand A foot An arm severed at or above the 75% of the Full Amount elbow A leg severed at or above the 75% of the Full Amount knee Sight of an eye 50% of the Full amount Any combination of a hand, a Full Amount foot, and/or sight of an eye Thumb and Index finger of 25% of the Full Amount same hand Speech and hearing in both ears Full Amount Speech Hearing in both ears Paralysis of both arms and both Full Amount legs Paralysis of both legs Paralysis of the arm and leg on either side of the body Brain Damage Full Amount Coma 1% of the Full Amount monthly to a maximum of 60 months Seat Belt Benefit If an Accidental Death and Dismemberment benefit is paid, an additional 10% of the AD&D benefit (minimum of $1,000 and maximum of $10,000) is payable if the employee dies as a result of injuries sustained in a covered accident while driving or riding in a private passenger car and wearing a properly fastened seat belt. Air Bag Benefit This benefit provides an additional 5% of the AD&D benefit (minimum of $100 and maximum of $10,000). The benefit is payable if the seat belt is properly fastened, the air bag deploys and the covered person dies as a result of the injuries sustained in the covered accident. The combined Air Bag and Seat Belt benefit maximum is 15% of AD&D benefit to a maximum of $20,000. Basic Term Life Insurance/AD&D Benefits Description Page 2 of 5
3 Common Carrier Benefit This benefit provides an additional 100% of the Full Amount of the AD&D benefit if a covered person dies as a result of a covered accidental injury while traveling in a Common Carrier. Common Carrier means a government regulated entity that is in the business of transporting fare-paying passengers and does not include chartered or other privately arranged transportation, taxis or limousines. Eligibility Full-Time Employees Only active full-time employees who work at least 30 hours per week are eligible for coverage. Actively at Work Requirement An employee must be actively at work with the employer in order for benefits to become effective. If the employee is not actively at work with the employer on the date benefits would otherwise become effective, the employee s benefits will become effective on the date the employee returns to active work with the employer. Retirees Retirees are not eligible for coverage. Evidence of insurability is required for: Groups with 2 4 employees all employees; Groups with 5 9 employees employees with amounts in excess of the $20,000 non-medical maximum; Employees who were eligible under the prior plan, but did not elect coverage; and Late enrollees (those employees in contributory plans who do not enroll within 31 days of their eligibility date). Minimum Participation Requirements Contributory Plans The employer s contribution must equal at least 25% of the cost of the insurance; employee participation requirements are listed in the participation table (top right). Employee Coverage Number Eligible Minimum Number Insured Non-contributory Plans The employer s contribution must equal 100% of the cost of the insurance and 100% of all eligible employees must enroll. Life insurance and AD&D Benefits are both reduced by 35% at age 65 and to 50% of the amount in effect immediately prior to age 65 at age 70 for active employees; however, all benefits terminate at retirement. Exclusions Accelerated Benefits will end on the earliest of the date: The employee or his/her legal representative has assigned all ABO Eligible Life Insurance; ABO Eligible Life Insurance ends; or All ABO Eligible Life Insurance benefits have been accelerated. For AD&D coverage only, no benefit will be paid for any loss resulting from or caused or contributed to by: Physical or mental illness or infirmity or the diagnosis or treatment of such illness or infirmity; An infection, other than infection occurring in an external accidental wound; Suicide or attempted suicide; Intentionally self-inflicted injury; War, whether declared or undeclared; or act of war, insurrection, rebellion, or riot; Committing or trying to commit a felony; Basic Term Life Insurance/AD&D Benefits Description Page 3 of 5
4 The voluntary intake or use by any means of: Any drug, medication or sedative, unless it is taken or used as prescribed by a physician, or an over the counter drug, medication or sedative taken as directed; Alcohol in combination with any drug, medication, or sedative; or Poison, gas or fumes. No benefit will be paid for any loss if the injured party is intoxicated at the time of the incident and is the operator of a vehicle or other device involved in the incident. No Seat Belt Benefits will be payable if: The loss occurs in a commercially licensed car or a private car which is being used for commercial purposes; or The seat belt does not meet published federal safety standards, was not installed by the car manufacturer, or has been altered after such installation. Cancellation/Termination Coverage is provided through employer participation in a multiple employer trust (MET), and is subject to the terms and provisions in the MET and Master Group Policy (Form G.2130-S) sitused in the District of Columbia, and certificates of insurance (Form GCERT2000) issued to each insured employee. In any state validly exercising extraterritorial jurisdiction, the plan will be modified to meet applicable laws. When insurance ends for the employee s class; When the employee s contributions cease (if such contributions are required); When the employer s contributions cease; When this plan ends in whole or in part; Upon termination of coverage by the employer, with prior written notice to MetLife; If the group life insurance plan is discontinued by MetLife for non-payment of premium or if participation requirements or minimum lives covered requirements are not met; or If the Policyholder fails to provide information on a timely basis or perform any obligations required by the policy or any applicable law. All benefits terminate at retirement. Note: 1. Policy features are subject to state availability and may vary depending on state requirements. Consult your MetLife sales representative for more details. 2. Like most group insurance policies, MetLife group policies contain certain exclusions, limitations, reduction of benefits and terms for keeping them in-force. Your MetLife sales representative can answer any questions about costs and details of coverage. A full description of the benefits will be provided in the certificate. In the event of any conflict between this summary and the group policy, the group policy shall govern. Coverage terminates: When the employee s full-time employment ceases; Basic Term Life Insurance/AD&D Benefits Description Page 4 of 5
5 1 A.M. Best 2007, based on in-force group life amount. 2 Requirement may not apply to all jurisdictions. 3 The Accelerated Benefits Option is subject to state availability and regulation. The accelerated life insurance benefits offered under the certificate are intended to qualify for favorable federal tax treatment. If the accelerated benefits qualify for favorable tax treatment, the benefits will be excluded from the insured s income and not subject to federal taxation. The information was written as a supplement to the marketing of life insurance products. Tax laws relating to accelerated benefits are complex and limitations may apply. Employees are advised to consult with and rely on an independent tax advisor about their own particular circumstances. Receipt of accelerated benefits may affect eligibility of the employee, his or her spouse or family, for public assistance programs such as medical assistance (Medicaid), Temporary Assistance to Needy Families (TANF), Supplemental Social Security Income (SSI) and drug assistance programs. Employees are advised to consult with social service agencies concerning L [exp0511][xMD,NY,SD] 2011 METLIFE, INC. PEANUTS United Feature Syndicate, Inc. Metropolitan Life Insurance Company 200 Park Avenue New York, NY Long Term Disability Insurance Benefits Description Page 5 of 5
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