MARYLAND ASSOCIATION OF BOARDS OF EDUCATION. Basic Term Life. Basic Accidental Death & Dismemberment

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Summary of Beefits MARYLAND ASSOCIATION OF BOARDS OF EDUCATION All Somerset Couty Employees Basic Term Life, Basic Accidetal Death & Dismembermet, Optioal Term Life ad Depedet Term Life Issued by The

1 Summary of Beefits MARYLAND ASSOCIATION OF BOARDS OF EDUCATION All Somerset Couty Employees Basic Term Life, Basic Accidetal Death & Dismembermet, Optioal Term Life ad Depedet Term Life Issued by The Prudetial Isurace Compay of America Effective: 09/01/2014 Basic Term Life 100% Employer Paid Basic Term Life: You are automatically erolled for 1.0 times your covered aual earigs to $1,000,000. If you are termially ill, you ca get a partial paymet of your group life isurace beefit. You ca use this paymet as you see fit. The paymet to your beeficiary will be reduced by the amout you receive with the Accelerated Beefit Optio. Refer to the pla booklet for details. Paymet of premium ca be waived if you are totally disabled for 9 moths, you are less tha 60 years old whe the disability begis, ad you cotiue to be totally disabled. This waiver termiates at age 65. This provisio may vary by state. The amout of isurace reduces to 75% at age 70 ad 66 2/3% at age 75. Coverage will ed o your termiatio of employmet or as specified i the pla booklet. You may covert your isurace to a idividual life isurace policy issued by the Prudetial Isurace Compay of America. Basic Accidetal Death & Dismembermet 100% Employer Paid Basic AD&D pays you ad your beeficiary a beefit for the loss of life or other ijuries resultig from a covered accidet % for loss of life ad a lesser percetage for other ijuries. Ijuries covered may iclude loss of sight or speech, paralysis, ad dismembermet of hads or feet. Basic AD&D beefits are paid regardless of other coverages you may have. Basic AD&D: You are automatically erolled for a amout equal to your Basic Term Life coverage amout.

2 Optioal Term Life 100% Employee Paid Purchase coverage i icremets of $10,000 to $200,000. New Hires: Get up to $200,000 - o medical questios asked - whe erollig whe first eligible i Optioal Group Term Life. Curret Participats: Your curret coverage amout will be cotiued. Durig aual erollmet periods, you may icrease your curret coverage amout by $10,000, up to a total coverage amout of the pla maximum - without providig evidece of isurability to Prudetial. Outside of aual erollmet periods, evidece of isurability satisfactory to The Prudetial Isurace Compay of America is required for all icreases i coverage amouts. Curret Employees who were deied coverage i the past, Curret Employees who waived coverage i the past or Late Etrats (did ot eroll whe first eligible): Evidece of isurability satisfactory to The Prudetial Isurace Compay of America is required for all coverage amouts. If termially ill, you ca get a partial paymet of your group term life isurace beefit. You ca use this paymet as you see fit. I the evet of your death, your beeficiary will receive a beefit payout which has bee reduced by the amout you receive. Paymet of premium ca be waived if you are totally disabled for 9 moths, you are less tha 60 years old whe the disability begis, ad you cotiue to be totally disabled. This waiver termiates at age 75. This provisio may vary by state. Refer to the pla booklet for details. Coverage will be reduced as you age - to 75% at age 70 ad 66 2/3% at age 75. Upo termiatio of employmet, you may cotiue at a certai level of your coverage, without havig to provide evidece of good health. Depedet Term Life 100% Employee Paid Purchase coverage for your spouse for $25,000 ad for each of your childre for $10,000. Erollmet i Depedet Term Life Coverage does ot require erollmet i Optioal Employee Term Life however the amout of isurace o a Depedet will ot exceed 100% of the amout for which you are isured uder Basic ad Optioal Employee Term Life Coverages combied. New Hires: Get up to $25,000 for your spouse- o medical questios asked - whe erollig whe first eligible i Optioal Depedet Group Term Life. Curret Spouse Participats: Your spouse's curret coverage amout will be cotiued. Curret Employees whose spouse has bee deied coverage i the past, Curret Employees who waived spouse coverage i the past or Late Etrats (did ot eroll whe first eligible): Evidece of isurability satisfactory to The Prudetial Isurace Compay of America is required for all coverage amouts. Evidece of isurability is ot required whe electig Depedet Term Life for your childre. The death beefit for babies from 14 days to 6 moths old is $1,000. Coverage begis from 14 days, ad cotiues to age 19, if umarried. If umarried, depedet o you ad a full-time studet, coverage cotiues to age 25. Beefits, exclusios ad provisios may vary by state. Refer to the pla booklet for details. For your coverage to become effective, you must be actively at work o the effective date of the pla. If you apply for a amout that requires satisfactory evidece of isurability to The Prudetial Isurace Compay of America, you must be actively at work o the date of approval for the amout requirig satisfactory evidece of isurability.

3 All beefit features may ot be available i all states. Group Term Life ad Disability coverages are issued by The Prudetial Isurace Compay of America, a New Jersey Compay, 751 Broad Street, Newark, NJ Life Claims: ad Disability Support: This brochure is iteded to be a summary of your beefits ad does ot iclude all pla provisios, exclusios ad limitatios. Please refer to the Booklet-Certificate, which is made a part of the Group Cotract, for all pla details, icludig ay exclusios, limitatios ad restrictios which may apply. If there is a discrepacy betwee this documet ad the Booklet-Certificate/Group Cotract issued by The Prudetial Isurace Compay of America, the terms of the Group Cotract will gover. Cotract provisios may vary by state. Cotract Series: Califoria COA #1179 NAIC # Prudetial Fiacial, Ic., ad its related etities. Prudetial, the Prudetial logo, ad the Rock symbol are service marks of Prudetial Fiacial, Ic. ad its related etities, registered i may jurisdictios worldwide.

How much it will cost MARYLAND ASSOCIATION OF BOARDS OF EDUCATION All Somerset Couty Employees Issued by The Prudetial Isurace Compay of America Effective: 09/01/2014 Employee - Optioal Term Life Per

4 How much it will cost MARYLAND ASSOCIATION OF BOARDS OF EDUCATION All Somerset Couty Employees Issued by The Prudetial Isurace Compay of America Effective: 09/01/2014 Employee - Optioal Term Life Per Pay Period Cost per Coverage Amout Coverage is available i icremets of $10,000 to a maximum of $200,000. Refer to the Optioal Term Life sectio for evidece of isurability details. Iitial rates based o age as of effective date of your coverage. Rates will chage based o the followig age schedule. Age $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100, $0.19 $0.37 $0.56 $0.74 $0.93 $1.12 $1.30 $1.49 $1.67 $ $0.19 $0.37 $0.56 $0.74 $0.93 $1.12 $1.30 $1.49 $1.67 $ $0.25 $0.49 $0.74 $0.98 $1.23 $1.48 $1.72 $1.97 $2.21 $ $0.37 $0.74 $1.12 $1.49 $1.86 $2.23 $2.60 $2.98 $3.35 $ $0.62 $1.24 $1.85 $2.47 $3.09 $3.71 $4.33 $4.94 $5.56 $ $1.11 $2.22 $3.33 $4.44 $5.55 $6.66 $7.77 $8.88 $9.99 $ $1.67 $3.34 $5.00 $6.67 $8.34 $10.01 $11.68 $13.34 $15.01 $ $2.41 $4.81 $7.22 $9.62 $12.03 $14.44 $16.84 $19.25 $21.65 $ $3.64 $7.28 $10.93 $14.57 $18.21 $21.85 $25.49 $29.14 $32.78 $ $5.87 $11.74 $17.60 $23.47 $29.34 $35.21 $41.08 $46.94 $52.81 $ $19.13 $38.26 $57.38 $76.51 $95.64 $ $ $ $ $ $19.13 $38.26 $57.38 $76.51 $95.64 $ $ $ $ $ Implemetatio of the isurace pla(s) will deped o havig a specific percetage of all eligible employees erollig i the pla(s). If this percetage of erollmet level is ot met, these coverage(s) may ot be effective

5 Employee - Optioal Term Life Per Pay Period Cost per Coverage Amout Coverage is available i icremets of $10,000 to a maximum of $200,000. Refer to the Optioal Term Life sectio for evidece of isurability details. Iitial rates based o age as of effective date of your coverage. Rates will chage based o the followig age schedule. Age $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200, $2.05 $2.23 $2.42 $2.60 $2.79 $2.98 $3.16 $3.35 $3.53 $ $2.05 $2.23 $2.42 $2.60 $2.79 $2.98 $3.16 $3.35 $3.53 $ $2.71 $2.95 $3.20 $3.44 $3.69 $3.94 $4.18 $4.43 $4.67 $ $4.09 $4.46 $4.84 $5.21 $5.58 $5.95 $6.32 $6.70 $7.07 $ $6.80 $7.42 $8.03 $8.65 $9.27 $9.89 $10.51 $11.12 $11.74 $ $12.21 $13.32 $14.43 $15.54 $16.65 $17.76 $18.87 $19.98 $21.09 $ $18.35 $20.02 $21.68 $23.35 $25.02 $26.69 $28.36 $30.02 $31.69 $ $26.47 $28.87 $31.28 $33.68 $36.09 $38.50 $40.90 $43.31 $45.71 $ $40.06 $43.70 $47.35 $50.99 $54.63 $58.27 $61.91 $65.56 $69.20 $ $64.55 $70.42 $76.28 $82.15 $88.02 $93.89 $99.76 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ Rates may chage as the isured eters a higher age category. Also, rates may chage if pla experiece requires a chage for all isureds. Per Pay Period Cost of Depedet Term Life Spouse: $25,000/Childre: $10,000 $2.82 Rates may chage if pla experiece requires a chage for all isureds. Group Isurace coverages are issued by The Prudetial Isurace Compay of America, 751 Broad Street, Newark, NJ This policy provides ACCIDENT isurace oly. It does NOT provide basic hospital, basic medical or major medical isurace as defied by the New York State Isurace Departmet. IMPORTANT NOTICE - THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS. Implemetatio of the isurace pla(s) will deped o havig a specific percetage of all eligible employees erollig i the pla(s). If this percetage of erollmet level is ot met, these coverage(s) may ot be effective Prudetial Fiacial, Ic. ad its related etities. Prudetial, the Prudetial logo, ad the Rock symbol are service marks of Prudetial Fiacial, Ic. ad its related etities, registered i may jurisdictios worldwide

Summary of Benefits RRD

Summary of Benefits RRD Summary of Beefits RRD All Eligible Employees Basic Term Life, Optioal Term Life, Optioal Depedet Term Life ad Optioal Accidetal Death & Dismembermet Issued by The Prudetial Isurace Compay of America Effective: