Life Insurance Guide Basic Life and AD&D Insurance: Company paid Choose between these coverage amounts during your enrollment 1.5 X base salary 50,000 Why the choice in Basic coverage? The value of group life insurance over 50,000 in total coverage is taxable to you (including Basic and Additional coverage.) This value is determined from IRS tables (not from the actual premium paid) and is required by federal tax law. The taxable amount is added to your income and you must pay the taxes on this additional amount. A Life Insurance Tax Calculator is available on appvion.com to determine the amount that will be added to your income to be taxed. Double payment for death due to accident AD&D means Accidental Death and Dismemberment. If you were to elect total coverage of 100,000 and you were to die of natural causes or illness, the insurance company would pay your designated beneficiary 100,000 income tax free. This is your life insurance benefit. However, if your death were the result of an accident, then the insurance company would also pay your beneficiary an accidental death benefit income tax free. 100,000 (for life insurance) 100,000 (for accidental death insurance) 200,000 Total Income-Tax-Free Benefit Travel Accident Life Insurance: Company paid 2 X base salary in coverage for work-related travel This benefit is provided automatically by the company, there s no need to enroll. For frequent travelers, such as executives and field sales and tech reps, this benefit is paid if death or dismemberment occurs due to a travel accident regardless of the nature of the trip. The benefit would pay to your beneficiary in addition to the Basic coverage described above. Additional, Spouse and Child Life Insurance: Employee paid Supplemental Accidental Death & Dismemberment: Employee paid For options available to you, please reference the attached flyers.
Enrollment at a glance A guide to your plan basics Appvion, Inc. All Salaried Employees Take advantage of insurance offered at your workplace. It s convenient and affordable. Life Insurance provides basic protection for your loved ones if something happens to you. While many U.S. households have life insurance, the average amount of coverage is often inadequate to meet family needs or pay off debt. Taking advantage of life insurance coverage offered by Appvion, Inc. can be an important part of your financial security. Appvion, Inc. provides you with Basic Life Insurance coverage in the amount of 1.5 times your annual salary to a maximum of 500,000, and Accidental Death and Dismemberment Insurance in the amount of 1.5 times your annual salary to a maximum of 500,000. Coverage is rounded to the next higher 1,000. Eligible employees may apply for more coverage in the Additional Group Term Life Insurance program. Additional Term Life Insurance Your Life Insurance Benefit Includes Convenient Payroll Deductions Take it With You Accelerated Benefit (Applicable for Additional Life Only) Since deductions are taken directly from your paycheck, you never have to worry about late payments or lapse notices. The portability option allows for continued coverage that can help protect your family even when your current employment ends. You may collect a portion of your death benefit (typically 75%) while you are living, if you are diagnosed with a terminal condition with a limited life expectancy of no more than twelve months (may vary by state). Refer to the information on the following pages to learn more about Additional Group Term Life Insurance options and determine your coverage cost.
Eligibility Coverage Options Guaranteed Issue Offer* Additional Term Life Insurance Coverage Options For You For Your Spouse For Your Child(ren) All active employees working 40+ hours per week. 1, 2, 3, or 4 times your annual salary. The amount chosen cannot exceed 500,000. Coverage is rounded to the next higher 1,000. This election includes an equal AD&D amount to your approved Employee Additional Life Insurance. Late Enrollee Not applicable. You must provide evidence of insurability for any coverage elected during the enrollment period. If you are covered for Employee Basic Life Insurance, you may elect coverage even if you do not elect Additional Life coverage on yourself. 10,000 or 25,000 up to 200,000 in 25,000 increments. Coverage is limited to 50% of the total combined amount of Employee Basic and Additional Life Insurance coverage. Late Enrollee Not applicable. Your spouse must provide evidence of insurability for any coverage elected during the annual enrollment period. If you are covered for Employee Basic Life Insurance, you may elect coverage even if you do not elect Additional Life coverage on yourself. 5,000, 10,000 or 25,000 on your children age 14 days but less than 19 years and student dependents less than 25 years. Late Enrollee You can elect coverage during the open enrollment period without Supplemental Accidental Death & Dismemberment (AD&D) Insurance You can elect to increase your current coverage amount by 1 increment during the open enrollment period without providing evidence of insurability. Coverage is limited to 500,000. New Hire You can elect up to 500,000 or 2 times your annual salary, whichever is less, of coverage during the initial eligibility period without insurability. You may elect single or family coverage. Supplemental option: 50,000 up to 250,000 in 50,000 increments. You can elect to increase your amount up to 1 increment during the open enrollment period. Coverage is limited to 50% of the total Employee Life Insurance amount. New Hire You can elect up to 10,000 of coverage during the initial eligibility period without insurability on your spouse. Supplemental Family option: Spouse- 50% of Employee Spouse + Children- Spouse: 40% of Employee Children: 10% of Employee Contact your employer if you have questions about the definition of "child" for your plan. You can elect to increase your current coverage amount up to a total amount of 25, 000 during the enrollment period without New Hire You can elect coverage during the initial eligibility period without Supplemental Family option: Child(ren)- 15% of Employee Spouse + Children- Spouse: 40% of Employee Children: 10% of Employee Accidental Death & Dismemberment coverage has exclusions that are described in the certificate of insurance or riders.
*Evidence of insurability is required if you elect Additional Life Insurance coverage in amounts in excess of the limits described above, you elect coverage outside of the open enrollment period, or you submit an application for coverage more than 31 days after the date you become eligible. Evidence of insurability is subject to approval by the insurance company. Insurance Rate Information and Premium Calculator The cost is calculated based on the age of the employee at the start of the plan s current policy year. The rates shown are guaranteed until 06/30/2018. Employee Additional Life and AD&D Insurance Rates Supplemental Accidental Death and Dismemberment (AD&D) Insurance Rates Age Monthly Cost per 1,000 of Coverage Under 25 0.088 25-29 0.088 30-34 0.088 35-39 0.116 40-44 0.15 45-49 0.20 50-54 0.34 55-59 0.53 60-64 0.80 65-69 1.446 70 + 1.446 Monthly Cost Coverage type per 1,000 of Coverage Single Supplemental AD&D 0.03 Family Supplemental AD&D 0.04 Children Life Insurance Rates Coverage Levels Monthly Cost Per 1,000 0.17 Spouse Additional Life Insurance Rates Age Monthly Cost per 1,000 of Coverage Under 25 0.058 25-29 0.058 30-34 0.058 35-39 0.086 40-44 0.120 45-49 0.170 50-54 0.310 55-59 0.500 60-64 0.770 65-69 1.416 70 + 1.416
Follow the steps below to calculate the premium based on the amount of insurance you plan to elect. Additional Life Insurance For You For Your Spouse For Your Children Step 1: Select the amount of insurance you want Step 2: Divide this number by 1,000 Step 3: Enter the rate from the table(s) above Step 4: Multiply Step #2 by Step #3 Step 5: Add (A), (B), and (C) for the Total Monthly Premium (A) (B) (C) Supplemental AD&D Insurance For You For Your Family Step 6: Select the amount of insurance you want Step 7: Divide this number by 1,000 Step 8: Enter the rate from the table(s) above Step 9: Multiply Step #7 by Step #8 Step 10: Add (A) and (B) Step 11: Add Step 5 and Step 10 for the Total Monthly Premium (A) (B) Total Bi-Weekly Premium - Multiply the Total Monthly Premium by 12, and divide by 26. This is a summary of benefits only. A complete description of benefits, limitations, exclusions and termination of coverage will be provided in the certificate of coverage. All coverage is subject to the terms and conditions of the group policy. To keep coverage in force, premiums are payable up to the date of coverage termination. Insurance products and services are provided by ReliaStar Life Insurance Company, a member of the Voya family of companies. Policy form LP00GP (may vary by state). LG12171 Group #68881-9, Acct # 20, 05/04/2015