PROTECT YOUR FAMILY AND YOUR WAY OF LIFE

Individual and Family Group Term Life Insurance PROTECT YOUR FAMILY AND YOUR WAY OF LIFE Board of Regents of the University of Wisconsin System Underwritten by Minnesota Life Insurance Company Policy number 32871-G m

ENROLL FOR INDIVIDUAL AND FAMILY GROUP TERM LIFE How?. 1. Read this brochure to familiarize yourself with the plan. 2. Complete the application form or enroll through e-benefits if available. You can obtain an application from your institution s benefits office or at www.uwsa.edu/ohrwd/benefits/life/if/app.pdf. 3. You must enroll through e-benefits or deliver the application to your institution s benefits office within 30 days of your eligibility begin date. 4. The certificate of insurance that represents the plan provisions is available at: www.uwsa.edu/ohrwd/benefits/life/if/cert.pdf. If you are unable to access the certificate online, contact your benefits office for a paper copy. Please review the certificate and retain it in a safe place. When can I enroll? New employees may enroll within 30 days of their initial employment begin date, or Wisconsin Retirement System (WRS) coverage begin date. If you are married, in a domestic partnership or have an eligible dependent child(ren) when you initially enroll in coverage, you may enroll your family members when you first enroll in coverage as an employee. Coverage will be effective the first day of the calendar month on or after your benefits office receives your application. Coverage amounts you elect within these 30 days are guaranteed, regardless of your medical history. Graduate Assistants, Employees-in-Training, Short-Term Academic Staff and other employees covered by the Graduate Assistant benefits package who did not elect coverage when initially eligible under the Graduate Assistant benefits package have another opportunity to elect coverage if/when the employee later becomes benefits eligible in a position covered by the Wisconsin Retirement System (WRS). The employee must elect coverage within 30 days of the WRS coverage begin date. A UW employee who is either married to another UW employee or who has established a domestic partnership for benefits purposes with another UW employee cannot be insured as both an employee and a spouse/domestic partner on another UW employee s plan. Child coverage can also only be covered under one parent s plan. You may add a spouse to your coverage within 30 days of marriage. You may add a domestic partner to your coverage within 30 days of first establishing a domestic partnership with your domestic partner for employee benefit purposes. You may add child coverage within 30 days of having an eligible child to cover for the first time. Please note that if you get married or establish a domestic partnership and your new spouse/ domestic partner has children, these children are considered eligible children under the plan and you may add child coverage within 30 days of the marriage/domestic partnership begin date provided you do not have any children eligible for coverage prior to the marriage/domestic partnership. If you already have child coverage in place, any eligible children of your spouse/ domestic partner are automatically covered. Employees who are enrolled in coverage at the beginning of the annual increase option period may elect additional coverage for themselves and insured family members without providing proof of good health. At any time you may apply for coverage or increase your coverage level beyond the amounts that are guaranteed (as identified above), by providing proof of good health. This applies to yourself and your family members. You can obtain a Medical Evidence of Insurability form from your benefits office or at www.uwsa.edu/ohrwd/benefits/life/if/eoi.pdf. Acceptance and enrollment is not guaranteed when you apply for coverage through Medical Evidence of Insurability so it is recommended that you enroll in coverage during your regular enrollment periods. 2

GROUP TERM LIFE INSURANCE Why Group Term Life? You may elect coverage under the Individual and Family Group Term Life insurance plan for yourself, your spouse or domestic partner and your dependent children under age 25. Term life insurance is a great way to provide a foundation of financial protection for your family. Your Group Term Life insurance program from the Board of Regents of the University of Wisconsin System has the following features: Flexible amounts of insurance coverage give you the ability to choose your level of protection. Guaranteed coverage amounts for new employees, as well as guaranteed annual increase options for employees already enrolled in the plan. Convenient payroll deductions of premiums. Tax-free death benefit paid to the beneficiary(s). Conversion of your coverage. If you leave the University of Wisconsin System, you can continue your coverage by converting to an individual policy without providing proof of good health. Premiums may be higher than for those paid by active employees. Eligibility Employees of the University of Wisconsin System who are eligible for participation in the State of Wisconsin group health insurance program may elect coverage under this plan. If an employee is covered as a spouse/domestic partner under another UW employee s plan, the employee may enroll in coverage as an employee or be covered as a spouse/domestic partner under the spouse s or domestic partner s plan an employee cannot have coverage under more than one person s plan. Likewise, if an employee is covered as a child under a parent s plan, the employee may enroll in employee coverage but is ineligible for coverage as a child under the parent s plan. Wisconsin Retirement System retirees are not eligible to participate. Effective date of insurance You have 30 days from your employment begin date or Wisconsin Retirement System (WRS) start date to enroll. Coverage is effective on the first of the month on or following the receipt of your application by your institution s benefits office. You will have an annual opportunity to increase your coverage level. This increased coverage will be effective on January 1 following the annual increase option period. If you apply for coverage through Evidence of Insurability, coverage will be effective the first of the month following the approval of your application. How much coverage can I apply for? You (employee) may purchase insurance for When you are hired Yourself $5,000, $10,000, $15,000 or $20,000 Additional coverage available during Annual Increase period $5,000, $10,000, $15,000 or $20,000 (up to $300,000 maximum) Enrollment and coverage level increases applied for through Evidence of Insurability $5,000 increments (up to $300,000 maximum) Your Spouse/Domestic Partner $5,000 or $10,000 $5,000 or $10,000 (up to $150,000 maximum or employee coverage amount, whichever is less) $5,000 increments (up to $150,000 maximum or employee coverage amount, whichever is less) Your children $2,500 or $5,000 $2,500 (up to $25,000 maximum or employee coverage amount, whichever is less) $2,500 increments (up to $25,000 maximum or employee coverage amount, whichever is less) 3

How much does life insurance cost? Your monthly insurance premium and your spouse or domestic partner premiums are based upon your age and amount of coverage you elect. Premiums for children are based only on the insurance amount and are not based on age. All of your children will be insured for the same amount of insurance and all will be insured for just one monthly premium. Below is a chart outlining the per $1,000 of coverage premium rates for employee and spouse/ domestic partner coverage. The premiums for the levels of child coverage are calculated for you. Pre calculated premiums for coverage levels available to new employees are available on the following page. Determining your age for premium purposes Your age is based on your age as of January 1st of the coverage year. For example, your premium in 2014 is based on your age as of January 1, 2014. Monthly Individual and Family Group Life insurance premiums (Spouse/domestic partner premium based on employee s age) Employee s age Employee coverage (per $1,000 of coverage) Spouse/Domestic Partner coverage (per $1,000 of coverage) Child coverage ($0.070 per $1,000 of coverage) Total premium listed below Under 28 $0.023 $0.036 $2,500 $0.18 28-30 0.025 0.040 $5,000 $0.35 31-33 0.032 0.050 $7,500 $0.53 34-36 0.037 0.059 $10,000 $0.70 37-39 0.045 0.072 $12,500 $0.88 40-42 0.068 0.108 $15,000 $1.05 43-45 0.108 0.171 $17,500 $1.23 46-48 0.130 0.207 $20,000 $1.40 49-51 0.181 0.288 $22,500 $1.58 52-54 0.232 0.369 $25,000 $1.75 55-57 0.323 0.513 58-60 0.403 0.621 61-63 0.556 0.774 64-66 0.799 1.080 67-69 1.117 1.503 70-72 1.724 2.331 73 and over 2.466 3.330 Employee and spouse/domestic partner rates increase with age and all rates are subject to change. Example for coverage effective in 2014 A new employee elects $20,000 of life insurance for herself, $10,000 for her domestic partner and $5,000 for her child. Employee s date of birth is August 1, 1969. Coverage is effective July 1, 2014. Employee s age on January 1, 2014: Age 44 Her insurance premium is based on the 43-45 age band. 1. To determine the premium for $20,000 of employee coverage, multiply the premium listed in the Employee Coverage 43-45 age band by 20. 2. To determine the premium for $10,000 of domestic partner coverage, multiply the premium listed in the Spouse/ Domestic Partner Coverage 43-45 age band by 10 (premium is based on the employees age). 3. To determine the premium for $5,000 of child coverage, refer to the appropriate coverage and premium level in the child coverage premium chart above. $0.108 x 20 = $2.16 $0.171 x 10 = $1.71 $0.35 Total Monthly Premium $4.22 4

Pre-calculated monthly premiums for coverage levels available to new employees (Spouse/domestic partner premium based on employee s age) Employee s Age Employee Coverage Spouse/Domestic Partner coverage $20,000 $15,000 $10,000 $5,000 $10,000 $5,000 Under 28 $0.46 $0.35 $0.23 $0.12 $0.36 $0.18 28-30 0.50 0.38 0.25 0.13 0.40 0.20 31-33 0.64 0.48 0.32 0.16 0.50 0.25 34-36 0.74 0.56 0.37 0.19 0.59 0.30 37-39 0.90 0.68 0.45 0.23 0.72 0.36 40-42 1.36 1.02 0.68 0.34 1.08 0.54 43-45 2.16 1.62 1.08 0.54 1.71 0.86 46-48 2.60 1.95 1.30 0.65 2.07 1.04 49-51 3.62 2.72 1.81 0.91 2.88 1.44 52-54 4.64 3.48 2.32 1.16 3.69 1.85 55-57 6.46 4.85 3.23 1.62 5.13 2.57 58-60 8.06 6.05 4.03 2.02 6.21 3.11 61-63 11.12 8.34 5.56 2.78 7.74 3.87 64-66 15.98 11.99 7.99 4.00 10.80 5.40 67-69 22.34 16.76 11.17 5.59 15.03 7.52 70-72 34.48 25.86 17.24 8.62 23.31 11.66 73 and over 49.32 36.99 24.66 12.33 33.30 16.65 Child Coverage ($0.070 per $1,000 of coverage) Total Premium Listed Below $2,500 $0.18 $5,000 0.35 Employee and spouse/domestic partner rates increase with age and all rates are subject to change. For New Employees Calculating your premium You can use the chart above to determine your total monthly premium. 1. Enter the year that coverage will be effective: 2. Enter your age as of January 1 of the year in which coverage will be effective: (Your premium will be based on your age as of January 1 of each year) For the next section, please refer to the coverage tables above 3. Find Selected Employee Coverage Level Enter premium: 4. Find Selected Spouse/Domestic Partner Coverage Level Enter premium: 5. Find Selected Child Coverage Level Enter premium: Add All Premiums to Determine Total Monthly Premium Total Premium: 5

How much life insurance do I need? When choosing the amount of coverage that s right for you and your family, it is important to think about the amount of money your family would need to maintain their lifestyle during your working career if your income were not included. How much would your family need to live comfortably without depleting existing assets and compromising short- and long-term plans? When answering the following questions, keep in mind how many years it will be until your children are financially independent, as well as when you plan to retire. You may also visit Minnesota Life s online insurance needs calculator to help determine how much life insurance you may beed at lifebenefits.com/insuranceneeds. Insurance Needs Calculator A. For how many years do you plan to provide financial support to your family? years (Think about the number of years your children or elderly parents will depend on you for financial support.) B. Multiply your answer by 12 to get the number of months you wish to provide for your family. months C. Enter the number from B in the white boxes below. Calculation 1. How much a month would your family need for mortgage or rent? $ x = $ OR You can substitute estimated total amount for above. $ 2. How much a month would your family need to pay for all other debt car payment, credit cards or personal loan payments? $ x = $ OR You can substitute estimated total amount for above. $ 3. How much a month would your family need to meet ongoing expenses food, utilities, day care, elder care, etc. $ x = $ OR You can substitute estimated total amount for above. $ 4. Estimate the total cost of your children s education ($10,000 for public, $20,000 for private per-year cost). $ 5. Add lines 1-4 together and write total here. $ 6. Estimate the amount of personal savings, life insurance or other assets you already have in place, plus any Social Security benefit you anticipate leaving to your family. $ Subtract line 6 total from line 5 total and put that number here. Based on the information you provided, this is the recommended amount of life insurance. Use this amount when setting up your life insurance plan or to obtain a quote for life insurance. $ Remember, your individual financial situation may require more or less insurance. 6

How will I pay for this coverage? Your premiums will be collected through convenient payroll deduction by the University of Wisconsin System. If you are on some type of unpaid leave such as a personal/medical leave of absence or a seasonal work break, you may continue your insurance by submitting the monthly premium to your benefits office before the first of each month during your leave. Employees who have academic year appointments who are expected to return to work the following semester will have additional premium deductions taken from paychecks through summer prepays coverage active over the summer months. What happens if I do not pay my premium while on a leave of absence or during a seasonal or academic year work break? If you do not continue to pay your premium during your leave or work break, your coverage will end. You will have the opportunity to reapply for the same level of coverage that you carried prior to your leave or work break by submitting an application within 30 days of your return to work. If you are going on military leave, consult your benefits office. How do I choose a beneficiary? Designating a beneficiary for your life insurance lets you determine who receives the death benefit. You may choose any beneficiary and may change the designation at any time by filing a signed beneficiary change form. The entire death benefit received by your beneficiary is income tax-free. If you do not choose a beneficiary, benefits will be paid according to the following plan default: 1. The insured s spouse or domestic partner, if living; otherwise; 2. The insured s surviving children equally, otherwise; 3. The insured s surviving grandchildren equally, otherwise; 4. The insured s surviving parents equally, otherwise; 5. The insured s surviving siblings equally, otherwise; 6. The insured s estate. Death benefits payable under spouse/domestic partner or child coverage are payable to the insured employee or the employee s estate. A beneficiary form is available at your institution s benefits office or at www.uwsa.edu/ohrwd/ benefits/life/if/. Additional benefits for no extra cost Accelerated death benefit gives you access to your life insurance benefit when you need it. If you are diagnosed as terminally ill and are expected to live 12 or fewer months, you may elect to receive up to 100 percent of your life insurance during your lifetime. If you elect to accelerate the benefit, the benefit paid upon your death will be reduced accordingly. Your insured spouse/domestic partner or insured dependent children are eligible for the accelerated benefit. IMPORTANT: If employee coverage is fully accelerated, spouse/domestic partner and dependent child coverage ends. No premiums to pay in the event of disability. If you become totally disabled (for more than six months) before age 60, your premiums will be waived until you are no longer disabled or until you reach age 65. You will not be able to increase your coverage until you have returned to work. Convert coverage if you become ineligible for coverage or terminate employment. You can continue the life insurance protection on yourself, your spouse/domestic partner and your eligible dependent children, by converting the group term plan to an individual life insurance policy. If you die, the coverage for your spouse or domestic partner and eligible child(ren) may be converted to an individual policy. A conversion application and the first premium for coverage must be submitted within 31 days after the group coverage ends. In addition, your dependent children may convert up to five times their coverage amount at age 25, provided you remain eligible for coverage under this plan. Premiums may be higher than for those paid by active employees. For more information on conversion, see your certificate. You can obtain a conversion brochure from your institution s benefits office or at www.uwsa.edu/ohrwd/benefits/life/if/. 7

What if I have a claim? Minnesota Life is committed to providing superior service to you and your family. Our goal is to process all claims promptly, fairly and courteously. Most claims are processed in five to ten business days of receipt of the necessary claim information. If you or your family wishes to present a claim, please contact your institution s benefits office for specific instructions. You may also call Minnesota Life concerning the status of a claim. About Minnesota Life Minnesota Life is one of the country s largest group life insurers. We understand the important role we play in the financial well-being of the five million employees we insure nationwide, and we will remain financially strong so we can be there when you need us most. We are considered among the highest rated group life insurance companies by the independent rating agencies that analyze the financial soundness and claims-paying ability of insurance companies. For more information about the rating agencies and to see where our ratings rank compared to other companies ratings, please visit www.securian.com/ratings. Based on insurance in force, A.M. Best Group Life Statistical Study, 2007-2011. Information in this brochure is intended as a general guide to the insurance coverage. If there are any differences between this brochure and the policy or certificate, the policy or certificate will govern. Coverage offered under policy form number 03-30540. The University of Wisconsin System does not discriminate on the basis of disability in the provision of programs, services or employment. If you need this printed material interpreted or in another form, or if you need assistance using this service, please contact us at (608) 263-4375. m Minnesota Life Insurance Company A Securian Company Group Insurance Madison Office P.O. Box 259708, Madison, WI 53725-9708 1-866-295-8690 608-277-8665 Fax www.lifebenefits.com 2013 Securian Financial Group, Inc. All rights reserved. F59114 Rev 9-2013 UWS1302 A03249-0913