Life Insurance

Group term life insurance and optional supplemental life insurance are offered through Prudential.

Eligibility:

Benefit-eligible employees are enrolled in group term life insurance equal to 100% of their annual base salary.

This coverage amount will decrease to 50% of the annual base salary when the employee reaches age 70. From age 75-79 coverage amount will decrease to 30% of the annual base salary and at age 80 and over, coverage amount decreases to 20%.

Benefit-eligible employees are eligible to purchase supplemental life insurance the first of the month following date of hire.

Late enrollment allowed, proof of good health through evidence of insurability is required, coverage may be declined.

Cost: (Supplemental insurance only)

*Premiums deducted through payroll on a pre-tax basis.

• Rate will double if enrolling for employee + spouse coverage
• Dependent/child rate is $.073 per $1000 of coverage, $10,000 coverage maximum

Life Insurance Information:

Life Insurance Certificate Booklet & Summary Plan Description

Prudential Life Insurance website

This website provides additional forms for proof of insurability and claims. You may also access tools such as a calculator to assist you with determining how much life insurance you need.

Forms:

Supplemental Life Insurance Enrollment Application

Beneficiary Change Form - for Group Term Life Insurance

This summary is not intended to be a complete description of your benefits.  Please consult your summary plan description and/or insurance certificate for additional details including plan limitations and exclusions. The master plan documents will prevail.