Standard Insurance Company
Group Optional Life Insurance
Group Optional Life Insurance and
Voluntary Accidental Death and
Dismemberment Insurance
For University of Alaska Employees
About This Booklet
This booklet is designed to answer some common questions about the group Optional Life coverage being offered by your employer to eligible employees.
This booklet also includes information about Voluntary Accidental Death and Dismemberment (AD&D) Insurance. You may choose to elect Optional Life insurance and/or Voluntary AD&D insurance.
This booklet is not intended to provide a detailed description of either coverage.
If coverage becomes effective and you become insured, for either one or both coverages you will receive a group insurance certifi cate containing a detailed description of the insurance coverage including the defi nitions, exclusions, limitations, reductions and terminating events. The controlling provisions will be in the group policy issued by Standard Insurance Company. Neither the certifi cate nor the information presented in this booklet modifi es the group policy or the insurance coverage in any way. If you have questions, please contact your human resources representative.
Please note that defi ned terms and provisions from the group policy are italicized in this booklet. Features of the group Optional Life coverage and Voluntary AD&D coverage may vary by state.
Group Optional Life Insurance
It’s not easy to think about, but what if you suddenly died? Your family could be faced with house payments, unpaid bills, childcare and other expenses just to maintain their current lifestyle. Could your family live without your income? Would your family be able to cover the medical expenses associated with a terminal illness or with burial and funeral expenses?
You make a great investment in your family. You spend time with them.
You care for them. You work for them. And if you’re not there for them, you want them protected. The University of Alaska provides you with a basic amount ($50,000) of Group Life insurance to help protect your loved ones in the event of your death. Since every employee’s needs are different, the University also provides you with the opportunity to apply for Optional Life and AD&D insurance from The Standard.
The advantages to you and your loved ones include:
Choice – You decide how much coverage you need from the range of amounts available.
Flexibility – If your needs change, you can request to change the amount of coverage. Increases in coverage require evidence of insurability.
Convenience – With premiums deducted directly from your paycheck, you don’t have to worry about mailing monthly payments.
Peace of Mind – You can take comfort and satisfaction in knowing that you have done something positive for your family’s future.
Commonly Asked Questions
The following information provides details to give you a better understanding of group Optional Life insurance available from The Standard.
Am I eligible for this coverage?
To be eligible for this plan:
• You must be insured for basic Group Life coverage with The Standard.
• You must be an active employee of University of Alaska, excluding temporary and seasonal employees, full-time members of the armed forces, leased employees and independent contractors.
• You must be regularly working at least 40 hours each week for full-time employees or at least 20 hours a week for part-time employees.
What is the effective date of the Optional Life coverage?
The effective date of the Optional Life coverage is dependent upon a minimum number of eligible employees in your company applying and qualifying for it. Your employer and The Standard have agreed upon this required level of participation. If it is not met, the Optional Life coverage will not become effective.
When does my insurance go into effect?
If the minimum participation requirement is met and the Optional Life coverage goes into effect, then the effective date of your coverage depends on when you become an eligible member, when you apply and whether you are required to provide evidence of insurability.
If you are not required to provide evidence of insurability, if you apply and agree to pay premiums, your Optional Life coverage becomes effective on:
• The date you become eligible if you apply on or before that date; or
• The date you apply if you apply within 30 days after you become eligible.
If you are required to provide evidence of insurability, if you apply and agree to pay premiums, your Optional Life coverage becomes effective on the date The Standard approves your evidence of insurability.
In every case, you must meet the active work requirement before your insurance becomes effective.
What is the active work requirement?
Active work means performing with reasonable continuity, the material duties of your own occupation at your employer’s usual place of business. You must be capable of active work on the day before the scheduled effective date of your insurance or your insurance will not become effective as scheduled. If you are not actively at work on the day before the scheduled effective date of insurance, your insurance will not become effective until the day after you complete 1 day of active work as an eligible employee.
How much coverage may I get for myself?
The amount of your basic Group Life coverage is $50,000 and is paid for by your employer.
Eligible employees may elect Optional Life coverage in units of $25,000, to a maximum of $400,000.
If you want to become insured for an amount of Optional Life in excess of the guarantee issue amount of $200,000, the excess will be subject to medical underwriting approval. All late applications and requests for coverage increases are also subject to medical underwriting approval.
Is Accidental Death and Dismemberment (AD&D) coverage
also available?
You may also elect AD&D insurance from The Standard. With AD&D insurance, you or your benefi ciaries may be eligible to receive an amount in the event of death or dismemberment as a result of an accident.
To be eligible for the Voluntary AD&D plan you must be an active employee of University of Alaska and regularly working at least 40 hours each week for full-time employees or at least 20 hours a week for part-time employees. An eligible employee does not include a full-time member of the armed forces, a temporary, leased, or seasonal employee, or independent contractor.
The amount of this AD&D insurance benefi t for loss of life1 is $100,000.
The amount of this AD&D insurance benefi t for other covered losses is a percentage of the amount payable for AD&D insurance coverage on the date of the accident, as shown below:
Loss: Percentage Payable:
One hand or one foot . . . 50 %
Sight in one eye, speech or hearing in both ears . . . 50 %
Two or more of the losses listed above . . . 100 %
Thumb and index fi nger on the same hand2. . . 25 %
Quadriplegia . . . 100 %
Hemiplegia . . . 50 %
Paraplegia . . . 50 %
Coma. . . 1% per month of the remainder of the AD&D Insurance Benefi t payable for Loss of life after reduction by any AD&D Insurance Benefi t paid for any other Loss as a result of the same accident.
Payments for coma will not exceed a maximum of 11 months.
At no time will more than 100 percent of the available AD&D insurance benefi t be paid for all losses resulting from one accident.
The loss must occur due to an accident and independently of all other causes, within 365 days after the accident. Loss of life must be evidenced by a certifi ed copy of the death certifi cate. All other losses must be certifi ed by a physician in the appropriate specialty as determined by us.
How much coverage may I get for my spouse and children?
Dependents insurance from Standard Insurance Company is also available with this plan.
Eligible employees may elect Optional AD&D coverage for a spouse and child. The amount of AD&D insurance for your spouse and child is equal to a percentage of your AD&D insurance, as follows:
Spouse only: 50%
Children only: 15% for each Child Spouse and Children: 40% for your Spouse
10% for each Child
1 Loss of life includes disappearance and accidental exposure to adverse weather conditions. Disappearance must be caused directly by an accident that could have reasonably resulted in death and must occur independently of all other causes continuing for a period of 365 days after the date of the accident despite reasonable search efforts.
2 This benefi t is not payable if an AD&D insurance benefi t is payable for the loss of the entire hand.
How much coverage do I need?
It can be diffi cult to determine the amount of insurance you need. Each family has its own unique set of circumstances, combined with needs that may arise with the unexpected loss of life. Use the worksheet below in calculating the amount of life insurance coverage you may need. The fi nal total is the amount of Optional Life insurance you might want to consider applying for to meet your obligations. Once you determine how much coverage you need, complete the Enrollment Form within your enrollment packet and submit it to your human resources department.
Immediate Needs
YouMedical and hospital expenses $ ______________
Funeral/burial expenses ______________
Loans/debts requiring payment upon death ______________
Taxes
Federal and state income taxes ______________
Property taxes ______________
Federal and state estate taxes ______________
Long Term Needs
Mortgage $ ______________
Debts (credit cards, car and student loans, etc.) ______________
Educational/vocational fund ______________
Childcare expenses ______________
Emergency fund for unforeseen expenses ______________
Income Replacement
Consider the income needed to support your family
and the number of years that support is needed. $ ______________
Total Income Needs
Add all of the above. $ ______________
Available Resources
Existing life insurance coverage $ ______________
Other assets such as 401(k), stocks, bonds, etc. ______________
Total Optional Life Insurance Needed
Subtract the amount of your total available resources
from your total income needs. $ ______________
Life Insurance Worksheet
How much will Optional Life coverage cost me?
Employee Optional Life Insurance Premiums - 26 pays
Coverage Amount Employee Age on July 1
<30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
$25,000 0.46 0.69 0.81 1.15 1.73 3.00 5.19 7.04 16.73 $50,000 0.92 1.38 1.62 2.31 3.46 6.00 10.38 14.08 - $75,000 1.38 2.08 2.42 3.46 5.19 9.00 15.58 21.12 - $100,000 1.85 2.77 3.23 4.62 6.92 12.00 20.77 28.15 - $125,000 2.31 3.46 4.04 5.77 8.65 15.00 25.96 35.19 - $150,000 2.77 4.15 4.85 6.92 10.38 18.00 31.15 42.23 - $175,000 3.23 4.85 5.65 8.08 12.12 21.00 36.35 49.27 - $200,000 3.69 5.54 6.46 9.23 13.85 24.00 41.54 56.31 - $225,000 4.15 6.23 7.27 10.38 15.58 27.00 46.73 63.35 - $250,000 4.62 6.92 8.08 11.54 17.31 30.00 51.92 70.38 - $275,000 5.08 7.62 8.88 12.69 19.04 33.00 57.12 77.42 - $300,000 5.54 8.31 9.69 13.85 20.77 36.00 62.31 84.46 - $325,000 6.00 9.00 10.50 15.00 22.50 39.00 67.50 91.50 - $350,000 6.46 9.69 11.31 16.15 24.23 42.00 72.69 98.54 - $375,000 6.92 10.38 12.12 17.31 25.96 45.00 77.88 105.58 - $400,000 7.38 11.08 12.92 18.46 27.69 48.00 83.08 112.62 -
How much will AD&D coverage cost?
Employee Optional Life Insurance Premiums - 19 pays
Coverage Amount Employee Age on July 1
<30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
$25,000 0.63 0.95 1.11 1.58 2.37 4.11 7.11 9.63 20.53 $50,000 1.26 1.89 2.21 3.16 4.74 8.21 14.21 19.26 - $75,000 1.89 2.84 3.32 4.74 7.11 12.32 21.32 28.89 - $100,000 2.53 3.79 4.42 6.32 9.47 16.42 28.42 38.53 - $125,000 3.16 4.74 5.53 7.89 11.84 20.53 35.53 48.16 - $150,000 3.79 5.68 6.63 9.47 14.21 24.63 42.63 57.79 - $175,000 4.42 6.63 7.74 11.05 16.58 28.74 49.74 67.42 - $200,000 5.05 7.58 8.84 12.63 18.95 32.84 56.84 77.05 - $225,000 5.68 8.53 9.95 14.21 21.32 36.95 63.95 86.68 - $250,000 6.32 9.47 11.05 15.79 23.68 41.05 71.05 96.32 - $275,000 6.95 10.42 12.16 17.37 26.05 45.16 78.16 105.95 - $300,000 7.58 11.37 13.26 18.95 28.42 49.26 85.26 115.58 - $325,000 8.21 12.32 14.37 20.53 30.79 53.37 92.37 125.21 - $350,000 8.84 13.26 15.47 22.11 33.16 57.47 99.47 134.84 - $375,000 9.47 14.21 16.58 23.68 35.53 61.58 106.58 144.47 - $400,000 10.11 15.16 17.68 25.26 37.89 65.68 113.68 154.11 -
Coverage Amount 26 Pays 19 Pays Annually
Member $100,000 0.88 1.20 22.80
Family $100,000 1.75 2.40 45.60
Voluntary AD&D Premiums See the back of this booklet for more information pertaining to premium calculation.
See the back of this booklet for more information pertaining to premium calculation.
Will I have to provide information regarding my
medical history?
If you apply for Optional Life insurance within 30 days of becoming eligible to apply and meet the active work requirement, you will automatically qualify for up to a set amount of insurance coverage called the guarantee issue amount. The guarantee issue amount under this policy is $200,000.
This means that you will not have to answer medical questions to purchase coverage up to this amount.
If you want to apply more than 30 days after becoming eligible to apply you must wait until the annual enrollment period in order to elect or increase your current coverage amounts. During the annual enrollment period you may elect up to the guarantee issue amount without having to answer any medical questions.
If you determine that you need more insurance than the guarantee issue amount, satisfactory evidence of insurability is required. You will need to complete and submit a Medical History Statement. In some cases, we may request additional medical information or a physical exam.
Evidence of insurability is not required for Voluntary AD&D insurance.
Evidence of insurability is also required for reinstatement of terminated coverage and for members eligible but not insured under prior life insurance plans.
How do I apply for Optional Life and Voluntary AD&D
insurance coverage?
To apply for both coverages, complete the Enrollment Form in your enrollment packet, place it in a confi dential envelope and submit it to your human resources department.
How are benefi ts paid?
Benefi ts will be paid by check to the benefi ciary you name and sent directly to the benefi ciary.
Will insurance benefi ts be reduced as I grow older?
Under this plan, your Optional Life coverage reduces to $25,000 when you reach the age of 65. Your AD&D Insurance does not reduce due to age under this plan.
What happens if I become totally disabled and can’t work?
The Standard will continue your Optional Life insurance without premium payments if you:
• Become totally disabled while insured under the group policy
• Are under the age of 60
• Complete the waiting period of 180 days
• Provide The Standard with satisfactory proof of total disability The Waiver of Premium provision does not apply to AD&D insurance.
What happens if I become terminally ill?
Under the Accelerated Benefi t provision, you may be eligible to receive up to 75 percent, or a maximum of $450,000, of your Optional Life insurance coverage if you become terminally ill, have a life expectancy of less than 12 months and meet other eligibility requirements.
This benefi t allows you to use the proceeds as you desire — whether to cover medical expenses or to maintain your quality of life. The amount of Optional Life insurance payable upon your death is reduced by the Accelerated Benefi t paid and an interest charge. However, to help protect your benefi ciaries, The Standard will pay at least 10 percent of the original Optional Life coverage amount at that time even if interest charges on the accelerated amount would have exhausted the remaining benefi ts over time.
Are there any other benefi ts with Optional Life coverage
from The Standard?
The Standard pays an additional benefi t, the Repatriation Benefi t, if you die more than 200 miles from your primary place of residence. The Standard will pay for expenses, up to a benefi t maximum, incurred to transport your body to a mortuary near your primary place of residence.1
1 This benefi t is not available in Maryland.
2 Provided through an agreement with MEDEX® Assistance Corporation.
The Standard includes a travel assistance program that provides a full range of 24-hour medical, legal and travel assistance services to you and your dependents when you travel more than 100 miles from home or in a foreign country.2
What are some of the features of Voluntary AD&D Insurance?
The AD&D coverage includes the following additional benefi ts when an AD&D insurance benefi t is payable:
• Seat Belt Benefi t. The Seat Belt Benefi t provision provides an additional benefi t in the event you die as a result of an automobile accident and you were properly wearing and using a seat belt system.
• Air Bag Benefi t. The Air Bag Benefi t provides an additional benefi t in the event you die as a result of an automobile accident for which a Seat Belt Benefi t is payable and the automobile is equipped with an air bag system which deployed as evidenced by a police accident report and you were seated in the driver’s or passenger’s seat intended to be protected by the air bag system.
• Family Benefi ts Package. The Family Benefi ts Package includes the Child Care Benefi t, Higher Education Benefi t and Career Adjustment Benefi t. It provides your eligible family members with additional fi nancial help for childcare, college or career training.
• Paralysis Benefi t. This benefi t provides a portion of your AD&D benefi t if you suffer an accident that results in quadriplegia, hemiplegia, or
paraplegia. This benefi t is also available to your dependents.
• Repatriation Benefi t. This benefi t provides a reimbursement for expenses associated with transporting your body back to a mortuary near your home in case your death occurs away from your primary place of residence.
What are the exclusions?
Optional Life includes an exclusion for death resulting from suicide or other intentionally self-infl icted injury while sane or insane.3 The amount payable will exclude amounts that have not been continuously in effect for at least two years on the date of death.
AD&D insurance benefi ts are not payable for death or dismemberment caused or contributed to by:
• War or act of war, declared or undeclared, whether civil or international, and any substantial armed confl ict between organized forces of a military nature
• Suicide or other intentionally self-infl icted injury while sane or insane3
• Committing or attempting to commit an assault or felony, or actively participating in a violent disorder or riot
• Voluntary use or consumption of any poison, chemical compound, alcohol or drug, unless used or consumed according to the directions of a physician
• Sickness or pregnancy existing at the time of the accident
• Heart attack or stroke
• Medical or surgical treatment for any of the above
3 For Missouri and New Jersey residents, “insane” is not applicable.
When does coverage end?
Optional Life coverage ends automatically on the earliest of the following:
• The date the last period ends for which a premium was paid for your Optional Life insurance (except if premiums are waived while totally disabled, if applicable)
• The date your employment terminates
• The date your Group Life insurance ends
• The date the group policy terminates
• The date Optional Life insurance terminates under the group policy
• The date you cease to be a member; however, insurance may continue for limited periods under certain circumstances
• If applicable, the date your employer ceases to participate under the group policy
AD&D insurance for you and your spouse will automatically end on the earliest of the following:
• The date your employment terminates
• The date the group policy terminates
• The date your Waiver of Premium begins
• The date the AD&D insurance terminates under the group policy
• The date the last period ends for which a premium was paid for your AD&D insurance
• For your dependents, the date your Dependents AD&D insurance ends
• The date your employment terminates
If my Optional Life insurance ends or is reduced, may I
convert to an individual policy?
If your Optional Life insurance from The Standard ends or is reduced for any reason other than failure to pay premiums, you may be able to convert the terminated coverage to certain types of individual life insurance policies without providing evidence of insurability. You must apply for conversion and pay the required premium within 31 days after group coverage ends or is reduced. AD&D coverage may not be converted under this provision.
May I buy group life coverage after I leave my employer?
If your insurance ends because your employment terminates, you may be eligible to buy group life insurance from The Standard through the Portability provision, assuming you meet the eligibility requirements. Please see your human resources representative for additional information. This option is not available in all states and is subject to state variations.
What if I have additional questions?
If you have any additional questions, please contact your human resources representative.
How are Optional Life Insurance rates calculated?
Use the following rates to determine the monthly premium for your Optional Life coverage:
Employee age on July 1 Rate per $1,000 of total coverage
Age 29 and under $0.040
Age 30 to 34 $0.060
Age 35 to 39 $0.070
Age 40 to 44 $0.100
Age 45 to 49 $0.150
Age 50 to 54 $0.260
Age 55 to 59 $0.450
Age 60 to 64 $0.610
Age 65 or above $1.300
To calculate your monthly premium:
$___________ ÷ $1,000 = ___________ x $___________ = $___________
Amount of Premium Rate Your monthly cost
Optional Life from above chart
The amount shown on above is your estimated monthly cost. To calculate your 26 pays payroll deduction, multiply your monthly cost by 12 and divide it by 26. To calculate your 19 pays payroll deduction, multiply your monthly cost by 12 and divide it by 19.
How are Voluntary AD&D Insurance rates calculated?
To calculate the Employee Only Voluntary AD&D premium:
$___________ ÷ $1,000 = ___________ x $___________ = $___________
Your Amount Elected Premium Rate Your monthly cost
To calculate the monthly premium for Dependents AD&D insurance:
$___________ ÷ $1,000 = ___________ x $___________ = $___________
Amount of Premium Rate Your monthly cost
Optional Life elected for Dependents
*Please see the amounts available to Dependents on page 5.
The amount shown on above is your estimated monthly cost. To calculate your 26 pays payroll deduction, multiply your monthly cost by 12 and divide it by 26. To calculate your 19 pays payroll deduction, multiply your monthly cost by 12 and divide it by 19.
$0.019
$0.038
GP190-LIFE, GP399-LIFE/TRUST
GP494-ADD/S99, Group Voluntary AD&D Insurance Standard Insurance Company
1100 SW Sixth Avenue Portland OR 97204 www.standard.com
Standard Insurance Company has earned a solid reputation for its quality products, expert resources, superior service, steady growth, innovation and strong fi nancial performance. Founded in 1906, The Standard is a leader in the group disability and life insurance market, while also offering individual disability, group dental and retirement plans for groups and individuals.
