Basic and Supplemental Life and AD&D Insurance

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1 Basic and AD&D Insurance Benefit Highlights State of Arizona What is Basic and AD&D Insurance? The State of Arizona provides, at no cost to you, Basic Life Insurance in an amount of $15,000. Supplemental Life Insurance, which you pay for, is coverage in addition to the Basic Life Insurance that your employer provides to you. Life Insurance pays your beneficiary (please see below) a benefit if you die while you are covered by the policy. Accidental Death and Dismemberment Insurance (AD&D) pays your beneficiary (please see below) a death benefit if you die due to a covered accident while you are insured. It also pays you a benefit for certain accidental injuries. AD&D covers losses that occur away from work or at work. Benefits are paid in addition to any Worker s Compensation benefits you collect. Why do I need Life and AD&D Insurance? What is the difference between Life and AD&D insurance Am I eligible? When can I enroll? When is it effective? This highlight sheet is an overview of your Basic, AD&D Insurance. A Certificate of Insurance is available at benefitoptions.az.gov to explain your coverage in detail. Life and AD&D Insurance is designed to help secure your family s future in the event you no longer can. Your employer provides you Basic Life and AD&D Insurance and you have the opportunity to purchase AD&D Insurance to provide financial resources to your family for: Medical Expenses Funeral Costs Mortgage or Rent Credit Cards College Tuition Child Care AD&D is Insurance that pays an additional benefit if you are seriously injured or die due to a covered accident. Basic and Supplemental Life Insurance pays a benefit if you die for any reason except those excluded in the certificate of insurance. You are eligible if you are an active employee or officer who is benefit eligible as defined by the Arizona Administrative Code Title 2, Chapter 6. The benefit eligible employee has the opportunity to enroll for AD&D during the open enrollment period, within your initial new hire eligibility period, or within 31 days of a qualifying life event. If you have not already done so, you must designate a beneficiary as described below. Coverage goes into effect subject to the terms and conditions of the policy. You must be actively at work with your employer on the day your coverage takes effect. The Hartford is The Hartford Financial Services Group, Inc. and its subsidiaries including issuing companies Hartford Life Insurance Company, Hartford Life and Accident Insurance Company and Hartford Fire Insurance Company. Home Office is Hartford, CT. Page 1 of 5

2 Can I purchase AD&D separately? Income How much Protection AD&D Insurance can I purchase? What does AD&D cover? No, AD&D are offered together. A benefit eligible employee can purchase AD&D Insurance each in increments of $5,000 up to 3 times your base pay or $500,000, whichever is less. The amount of Supplemental Accidental Death and Dismemberment Insurance is equal to the amount of Supplemental Life Insurance elected and approved. You or your beneficiaries may receive benefits due to certain injuries or death from an accident. The covered injuries or death can occur up to 365 days after that accident. The insurance pays: 100% of the amount of your coverage in the event of the following: accidental loss of life, two limbs, the sight of both eyes, one limb and the sight of one eye, or speech and hearing in both ears or quadriplegia. One-half (50%) of the amount of your coverage in the event of the following: paraplegia, accidental loss of one limb, sight of one eye, or speech or hearing in both ears or hemiplegia. One-quarter (25%) of the amount of your coverage in the event of the following: accidental loss of thumb and index finger of the same hand. Your total benefit for all losses due to the same accident will not be more than 100% of the amount of coverage you purchase. Am I guaranteed coverage? What is a beneficiary? Are any resources available for beneficiaries? The certificate of insurance includes definitions, a complete list of covered losses and other enhancements and benefits. Newly benefit eligible employees can elect AD&D coverage valued at up to $500,000 or 3 times your Base Pay, whichever is less - no medical information is required. At annual enrollment or a qualifying life event (as defined in the policy), a benefit eligible employee will be limited to increasing coverage in increments of $5,000 up to $20,000, not to exceed the lesser of 3 times your annual Base Pay or $500,000. Your beneficiary is the person (or persons) or legal entity (entities) who receives a benefit payment if you die while you are covered by the policy. You must select your beneficiary when you complete your enrollment application; your selection is legally binding. Please refer to Important Details below for additional beneficiary information. Beneficiary Assist provides grief, legal and financial counseling to beneficiaries. The Hartford offers this program at no cost to beneficiaries of any of its group life or accident policies. Services include: unlimited phone contact, assessment and action planning, up to five face-to face sessions, referrals and more. You will receive more details about Beneficiary Assist once your enrollment for AD&D Insurance is approved. Page 2 of 5

3 AD&D coverage for your dependents You may choose to purchase AD&D Insurance coverage for your dependents in amounts of $2,000, $4,000, $6,000, $10,000, $12,000, $15,000, or $50,000. Coverage cannot exceed 100% of the amount of combined Basic and Supplemental Life that you have for yourself. You may not elect coverage for any dependent that is an active member of the armed forces of any country or international authority. If your dependent(s) is confined in a hospital or elsewhere because of disability on the date his or her insurance would normally have become effective, coverage (or an increase in coverage) will be deferred until that dependent is no longer confined and has performed all the normal activities of a healthy person of the same age for at least 15 consecutive days. Your dependents are guaranteed coverage of up to $50,000. Children are covered from Live birth to 26 years old. Children age 19 or older may be covered if they were disabled prior to attaining age 19. Does my coverage reduce as I get older? Can I keep my life coverage if I leave my employer? No. All coverage cancels at retirement. Yes, subject to the contract, you have the option of: Converting your group life coverage to your own individual policy (policies). Portability is an option that allows you to continue your Life Insurance coverage. To be eligible, you must terminate your employment prior to Social Security Normal Retirement Age. This option allows you to continue all or a portion of your Life Insurance coverage under a separate Portability term policy. Portability is subject to a minimum of $5,000 and a maximum of $500,000 and does include coverage for your Spouse and Child(ren). To elect Portability, you must apply and pay the premium within 31 days of the termination of your Life Insurance. Evidence of Insurability will not be required. Dependent Spouse Portability is subject to a maximum of $50,000. What is the living benefits option? Do I still pay my life insurance premiums if I become disabled? Dependent Child Portability is subject to a maximum of $10,000. If you are diagnosed as terminally ill with up to a 12-month life expectancy, you may be eligible to receive payment of a portion of your Life Insurance. (This option is also available to your dependents) The remaining amount of your Life Insurance would be paid to your beneficiary when you die. This option does not apply to AD&D Insurance. If you become totally disabled before age 65 and your disability lasts for at least 6 months, your Supplemental Life Insurance premium may be waived. This option does not apply to AD&D Insurance. If you are enrolled in the Hartford Long Term Disability (LTD) plan, no additional Waiver of Premium claim filing is required. If you are not enrolled in the Hartford Long Term Disability (LTD) plan as an Arizona State Retirement System Participants, and you expect to be out for longer than 90 days from the date of illness or injury, call The Hartford at This is necessary to initiate review for Waiver of Premium. The Hartford will determine if you meet the definition of Disabled to qualify for Waiver of Premium for your Life insurance. Page 3 of 5

4 Important Details This document is an overview of your Life and AD&D Insurance. The group policy as issued to your employer is available to explain your coverage in detail. You can download a PDF copy of the policy from the following website: Beneficiary Designation Beneficiary designation is an important matter. It is your responsibility, as the employee, to ensure that your beneficiary designation is correct and up to date. You, as the employee, should consult an attorney to be sure the designation correctly reflects your marital situation. 1. You, as the employee, are automatically the beneficiary for any dependent life coverage (spouse or children) and for Accidental Death and Dismemberment (AD&D) benefits, if payable. 2. If you do not designate a beneficiary or if the designated beneficiary does not survive you and there is no contingent beneficiary named, policy provisions state the following: If no beneficiary is named, or if no named beneficiary survives You, We may, at Our option, pay: 1. the executors or administrators of Your estate; or 2. all to Your surviving Spouse; or 3. if Your Spouse Does not survive You, in equal shares to Your surviving Children; or 4. if no child survives You, in equal shares to Your surviving parents. 3. In the event of your death; Arizona law provides that a divorce, annulment, or similar event will, in most cases, invalidate a beneficiary designation that names your former spouse. If you, the beneficiary or your former spouse reside in a state other than Arizona or the divorce occurred in another state then those states laws may apply. Also, specific language within the divorce decree and/or property settlement agreement may overrule such revocation. It is important that employees who are divorced or who are getting divorced are aware of this. They should review the beneficiary designation on their group coverage with their own attorney so that it is correct and compliant with the law and the divorce documents. To designate a new beneficiary, or to maintain your former spouse as the beneficiary, you will most likely need to submit a new designation. 4. Under Arizona state statutes spouses do not automatically have a community property share in the policy proceeds when the spouse is not the named beneficiary. When an employee names a child, grandchild, parent, brother or sister (of their own or of their spouse) as beneficiary then the surviving spouse will have effectively waived any community property rights they may have. The employee (with their spouse) should discuss this with their own attorney as part of their estate planning to be sure that what they want to happen will happen and to understand how benefits may be dispersed under Arizona community property law. Again, if you, the beneficiary or a former spouse reside in another state, those states law may apply. Life Insurance Waiver of Premium The Hartford provides a Waiver of Premium provision under the Life Insurance provided to eligible State of Arizona employees. Waiver of Premium is a provision which allows covered employees to continue the employee s and the employee s dependent s Life Insurance coverage without paying premium. Allows employees covered under Group Life Insurance from The Hartford: who become disabled (as defined in the Life Insurance Policy) prior to age 65 and provide proof within one year, and whose disability lasts for at least 6 consecutive months (elimination period). Page 4 of 5

5 To continue coverage without premium payment once they are approved. (Premium is required during the elimination period.) Coverage continues while the employee remains disabled: for the duration specified in the contract even if the Group Life Policy terminates. Limitations and Exclusions As is standard with most term life insurance, this insurance coverage includes certain limitations and exclusions: Death by suicide (two years). (Applies to Supplemental only) AD&D insurance does not cover losses caused by or contributed by: sickness; disease; or any treatment for either; any infection, except certain ones caused by an accidental cut or wound; intentionally self-inflicted injury, suicide or suicide attempt; war or act of war, whether declared or not; injury sustained while in the armed forces of any country or international authority; taking prescription or illegal drugs unless prescribed for or administered by a licensed physician; injury sustained while committing or attempting to commit a felony; the injured person s intoxication. Other exclusions may apply depending upon your coverage. Once a group policy is issued to your employer, a certificate of insurance will be available to explain your coverage in detail. This benefit highlights sheet is an overview of the insurance being offered and is provided for illustrative purposes only and is not a contract. It in no way changes or affects the policy as actually issued. Only the insurance policy issued to the policyholder (your employer) can fully describe all of the provisions, terms, conditions, limitations and exclusions of your insurance coverage. In the event of any difference between the benefit highlights sheet and the insurance policy, the terms of the insurance policy apply. Page 5 of 5