Optional Accidental Death & Dismemberment Policy: Excluded Staff
Excluded Staff Optional Accidental Death & Dismemberment
The plan provides an opportunity to purchase optional Accidental Death and Dismemberment protection. This plan does not require evidence of insurability. There is no cash value upon termination, however, conversion privileges are available. If converting to an individual plan, conversion must be applied for and in place within 30 days of termination of the group coverage.
a) A continuing Excluded Staff member.
b) Eligible employee's spouse and dependents.
Amount of Coverage Available
The insurance is available in units of $10,000 (1 unit) to a maximum of $200,000 (20 units). Employee may elect single or family coverage outlined below:
a) Employee Plan (Single coverage).
Employee may elect units up to a maximum of 20 ($200,000 in 20 $10,000 units).
b) Family Plan (Family coverage).
Employee may elect units up to a maximum of 20 ($200,000) and their family will automatically be insured for one of the following:
- Spouse Only - If the employee does not have dependent children, the spouse will be insured for 50% of the benefit.
- Spouse and Dependent Children - If the employee has both spouse and children, the spouse will be insured for 40% of the benefit, and each dependent child will be insured for 5% of the benefit.
- Dependent Children Only - If the employee does not have a spouse, each dependent child will be insured for 10% of the benefit.
a) Single Coverage - $0.26 per month for each $1,000 of coverage (units of $10,000).
b) Family Coverage - $0.43 per month for each $1,000 of coverage (units of $10,000).
Monthly premiums on $100,000 of coverage would be:
a) Single Coverage - $2.60
b) Family Coverage - $4.30
Effective Date of Coverage
Coverage will be effective the first day of the month following the date the application is received in Human Resources.
Payment of Premiums
Premiums will be deducted monthly from the first pay of each month.
How to Apply
Contact your HR Advisor or HR Assistant. See the HR Advisors section of this website for your HR Advisor's or HR Assistant's name and contact info.
Termination of Coverage
The coverage will cease on the earliest of the following events:
a) the date your employment ends
b) the last day of the month in which a premium has been paid
c) the last day of the month in which you reach age 65
Any persons(s) or organization (charity, church, university etc.) can be named as beneficiary. If appointing a beneficiary under the age of majority, a declaration appointing a trustee must also be completed.