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Term Life Insurance Eligibility
You may be eligible for Term Life Insurance coverage as a member of the Public Employees Federation (PEF). You may also be eligible for Dependent Life Insurance and/or Survivor Income Protection Coverage if you are covered for Life Insurance under this plan and meet the other requirements described in this brochure.
Select one of the following options:
Option A - $20,000 Option 1 - One times Basic Annual Earnings Option 2 - Two times Basic Annual Earnings Option 3 - Three times Basic Annual Earnings Option 4 - Four times Basic Annual Earnings Option 5 - Five times Basic Annual Earnings
Earnings are rounded to the next higher $1,000 based on current earnings. Maximum: $500,000. Hourly or Per Diem employees may only select Option A. Premium is based on the member's current age and is a bi-weekly rate. Rates are adjusted as you enter a new age bracket.
Effective 4/01/05 a 5% premium discount will be applied to member's coverage.
For example: a member age 43 interested in $20,000 of coverage would pay: $.09 x 20 = $1.80 bi-weekly minus the 5% discount = $1.71 bi-weekly or $44.46 annually
If you have chosen a salary based option and your annual earnings change for any reason, including promotions to a PEF represented position, your insurance will automatically be adjusted annually on a date determined by the program.
Optional Extension Benefit
If you have elected Life Insurance coverage for yourself, you may also elect the Optional Extension Benefit for an additional cost.
If you become totally disabled before age 60 and before you retire and your disability lasts for at least 9 months, your insurance may be extended during the disability without further cost to you. You must provide proof of your condition within one year of your last day of work. Once Hartford Life approves your claim, this provision allows your coverage to continue as long as you remain totally disabled, and premiums are paid. This benefit does not apply to AD&D Benefits or Dependent Life Insurance.
Optional Extension Benefit coverage is not available to members age 60 and over.
For example: a member age 43 interested in $20,000 of coverage with Optional Extension Benefit would pay:
$ .10 x 20 = $2.00 minus the 5% discount = $1.90 bi-weekly or $49.40 annually
Mortgage Protection
If you purchase a home, you may increase your benefit by one level without proof of good health. The amount of increase may not exceed the mortgage amount. You must make such election within 120 days of the closing on the home and provide evidence of the purchase.
AD&D Benefit
If you have elected Life Insurance coverage for yourself, you are automatically covered for Accidental Death and Dismemberment (AD&D) coverage. The AD&D Principal Sum is equal to the amount of your Life Insurance coverage.
Accidental Death Coverage
Accidental Death coverage, an additional benefit equal to the amount of your Life Insurance coverage (Principal Sum), will be payable if your death occurs as a direct result of an accidental bodily injury sustained while insured, provided death occurs within 90 days of the accident.
Accidental Dismemberment Coverage
This plan pays a benefit if while insured you suffer a bodily injury caused by an accident and if within 90 days after the accident you lose, as a direct result of the injury, a hand, foot or eye. The amount payable for any one loss will be equal to one-half the amount of your life insurance coverage. You may also be eligible for one-quarter of the principal sum for other accidental losses. However, no more than an amount equal to your full life insurance coverage is payable for all losses resulting from one accident. See your booklet-certificate for a complete AD&D benefit schedule. Exceptions The Accidental Death and Dismemberment coverage provides benefits for losses caused by accidents only. No benefits are payable for a loss caused or contributed to by bodily or mental infirmity; disease ptomaines or bacterial infections; medical or surgical treatment; suicide or intentionally self-inflicted injury; or war or any act of war.
Enhancements to AD&D
If you are eligible for a payment under the AD&D coverage, you may be eligible for one or more of the following enhancements.
Day Care Benefit
If you die, then a Day Care Benefit is payable in addition to the Principal Sum. The Day Care Benefit is payable for each dependent if such dependent is less than age 7 at the time of your death; and proof of such dependent's enrollment in a day care program is provided. The day care benefit payable is the lesser of $10,000 or 5% of your Principal Sum. One Day Care Benefit is payable each year for each dependent who qualifies for Day Care Benefits. No more than two day care benefits will be payable for each dependent. Payment will be made to the person who has primary responsibility for such dependent's expenses.
Education Benefit
If you die, then an Education Benefit will be paid in addition to the Principal Sum. This benefit is payable to each of your dependents who qualifies as a student. Please refer to your booklet-certificate to see if your dependents qualify as a student.
The education benefit payable is the lesser of $5,000; 5% of the Principal Sum; or the actual tuition expense for any one school year. No more than one Education Benefit will be payable per student during any one school year. If the student is a minor, payment will be made to the student's legal representative. If no dependent qualifies as a student, then a $1,000 payment will be made in accordance with your beneficiary designation.
Seat Belt Benefit
If you die from injuries sustained in a motor vehicle, a Seat Belt Benefit will be paid in addition to the Principal Sum. The seat belt benefit payable is 25% of the Principal Sum rounded to the next higher $1,000. This benefit is payable provided that:
a) the injury occurs while the individual is a passenger riding in or the licensed operator of a duly registered motor vehicle: and
b) the individual is wearing a Seat Belt at the time of the accident, as verified in the police accident report.
Felonious Assault Benefit
If you are injured as the result of a Felonious Assault, and such injury is either fatal or results in a dismemberment (as described in the Description of Loss schedule under the AD&D benefits in your Booklet-Certificate), then a Felonious Assault benefit is payable in addition to either the Principal Sum or a portion of the Principal Sum. The Felonious Assault Benefit payable is the lesser of one times your annual rate of basic earnings rounded to the next higher $1,000; $25,000; or an amount equal to the Principal Sum or the portion payable thereof. For purposes of this policy, a Felonious Assault is defined as a violent or criminal act directed at you during the course of a robbery, hold-up or kidnapping involving employer funds.
New Enhancements to Dependent Life Insurance
Eligibility If you are covered for Life Insurance under this plan you may also apply for Dependent coverage. We have added several options for coverage of your spouse and dependent children. You can now elect spouse coverage from $20,000 up to $100,000 and $4,000 for your eligible children. Under this coverage a benefit is payable if your dependent dies from any cause while insured. Your dependent child(ren) may be eligible if they are between 15 days and 19 years of age or age 25 if they are attending school on a full-time basis. Dependent life insurance for your fully handicapped child can be continued past the age of 19; call PEF Membership Benefits for clarification.
Exception: Dependent Life insurance coverage is not available to a dependent in the military service
Please note: Your dependent life insurance selection must represent your family status: Option D1 for married members/domestic partners. Option D2 for unmarried members. Option D1 - Dependent Life for married members/domestic partners Choose Spousal/Domestic Partner coverage of $20,000, $50,000, $75,000 or $100,000 and $4,000 for each eligible dependent child.
Premium is based on the member's current age and is a flat bi-weekly rate.
In no event can the spouses/domestic partner amount be more than 100% of the members amount. Only $20,000 option is available in the 120 day new employee open enrollment. Domestic Partner Coverage The term "domestic partner" means an individual with whom the member executes a Domestic Partner Affidavit to establish eligibility. We will use the same criteria currently used by the State of New York to qualify a domestic partner for health insurance benefits. This includes proof that you have been residing together for at least 6 months and documentation of financial interdependence such as a joint bank account, credit card, joint ownership of residence, joint obligation on a loan or mutually granted durable power of attorney.
Option D2 - Dependent Life for Unmarried members.
Total cost is $.26 bi-weekly regardless of age or number of children.
Survivor Income Protection
$200 monthly benefit available
Eligibility
If you are insured for life insurance under this plan, you may increase your coverage by applying for Survivor Income Protection for an additional premium. This option pays a monthly benefit of $200 if you die from any cause while insured under this plan and if an eligible survivor of yours is living on the first day of the calendar month following your death.
Eligible Survivors
These include your spouse, but not if you and your spouse are legally separated or if you and your spouse have lived apart for more than the year immediately preceding your death; your unmarried children under 19 years of age; and any unmarried child over 19 years of age who is dependent upon you for support due to mental retardation or physical handicap which began before the child reached the age of 19 and while you were covered under this plan. There are exceptions with respect to marriage of less than 12 months duration. Call your Membership Benefits Program for details.
Continuous Benefit
The first monthly benefit is payable on the first day of the calendar month following your death. This benefit will continue to be paid until any one of the following occurs:
Option E - $200 per month
Survivor Income Protection Total Cost
* Premium is based on the member's current age and is a flat bi-weekly rate.
Term Life Important Features
Conversion Privilege
The insurance you purchase under this program need not end along with your other group coverages, thanks to Hartford Life's conversion privilege. If your membership with PEF terminates or you are no longer in an eligible class, you may convert up to the face amount of your group policy to an individual policy from Hartford Life. Your dependents may also convert if your coverage ends as described above or if they no longer meet the definition of dependent. Conversion must be requested and the premium paid within 31 days following the end of Life Insurance coverage. Proof of good health will not be required. If your coverage ends, you will receive information about this option.
Living Benefits Option
Should you or your spouse become diagnosed as terminally ill with a 24 month or less life expectancy, this benefit allows an accelerated payment of a portion of the terminally ill person's life insurance proceeds. The Living Benefits Option is available to individuals from Hartford Life. Your request cannot exceed 80% of the in force Amount of Life Insurance, and is subject to a minimum of the least of:
1. 25% of the in force Amount of Life Insurance; or 2. $50,000;or 3. the Accelerated Death Benefit percentage originally selected, multiplied by the amount of Life Insurance that would have been in force for you, including any age reductions, at your expected time of death, and a maximum of $175,000. Should you or your spouse, if they are covered under this plan, become terminally ill, the funds are paid directly to you, with no policy restrictions on how they may be used. The remaining benefit is then payable to the beneficiary.
Terminally Ill or Terminal Illness means that if an individual or their spouse:
a. suffers from an incurable, progressive and medically recognized disease or condition; and
b. to a reasonable medical probability and based on generally accepted prognostic protocol, will not survive more than 24 months beyond the request for the Accelerated Death Benefit.
Retiree Coverage
PEF members enrolled in the plan prior to retirement may maintain their life coverage as a member of the PEF Retirees. Optional Extension Benefit and AD&D coverage terminate upon retirement. Retirees are eligible to maintain Survivor Income Protection and dependent coverage, and are subject to coverage reductions defined under “Coverage Reductions.”
General Information
Effective Dates
The effective date of your coverage depends on the date you enroll and whether proof of good health is required. If you:
However, if you're absent from work due to injury or illness on the date coverage would normally begin, your coverage will be deferred until you return to active full-time work.
Your coverage will continue for as long as the group policy stays in effect, your premiums are paid, and you remain an eligible member.
If you choose to increase your amount of coverage, you'll be required to provide proof of good health, that must be approved by Hartford Life before the increase can take effect. If you are absent from work on the date an increase in coverage would ordinarily begin, the increase will be deferred as described above.
Coverage Reductions
Benefits reduce to 60% of the amount in force on the first of the month following the month in which an active member attains age 70. If at age 70 you have participated in the plan for at least the 5 continuous years preceding the attainment of age 70 and you are not an active member, your life insurance will be reduced to $10,000 or you may elect a further reduction in benefit to $5,000. If you have not been in the plan for 5 continuous years, your coverage will terminate.
How to Enroll
Complete the Life Insurance Request Card and return it to PEF Membership Benefits. If you have been in the PS&T Unit for longer than 120 days, or if you are a new employee requesting coverage in excess of 3x earnings or $20,000 dependent coverage you will have to complete a Personal Health Statement. Application forms can be obtained by calling Membership Benefits at 800-342-4306. ext. 243 or emailing a request to mbrequests@pef.org
This brochure explains the general purposes of the insurance described, but in no way changes or affects the policy as actually issued. In the event of any discrepancy between this brochure and the policy, the terms of the policy apply. Complete details are in the certificate of insurance issued to each insured individual.
Underwritten by. Hartford Life Insurance Company Hartford Plaza Hartford, CT 06115
Hartford Life |
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