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your ground crew. take care of Canada Board Insurance Products Exclusively for ALPA Members Plan Year 2016 ALPA Canada s Optional Life Insurance Plans

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take care of

your ground crew.

Plan Year 2016

ALPA Canada’s Optional Life Insurance Plans

Underwritten by

The Co-operators Life Insurance Company

Insurance Products

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Air Line Pilots Association Insurance Plan—

Benefits Summary

Eligibility

ƒ Available to members under age 65 who hold a valid Cat. 1 medical certificate (or with medical underwriting) and are residents of Canada.

ƒ Aircrew Officers Association (AOA) members: Class 1 Medical or CAT 1 required to enroll.

Basic Life Insurance

ƒ Compulsory coverage of $20,000 for each ALPA(C) Active, Executive Active, and Executive Inactive member.

ƒ Premium derived from dues or assessment.

ƒ Coverage terminates at age 70 for active members.

Optional Group Life Insurance

ƒ Available to Active, Executive Active, Executive Inactive, and Inactive Participant members.

ƒ Available to both you and your spouse.

ƒ Can be purchased in units of $50,000 to a maximum amount of $500,000.

ƒ Premiums for optional life insurance are based on the gender, age, and smoker status of the person applying, and on the amount of insurance.

ƒ Coverage is available to age 65.

Dependent Life Insurance (includes Prenatal benefit*) — mandatory for members with dependents

ƒ Covers your spouse and your dependent children for $5,000 each in the event of death.

ƒ Coverage for dependent children begins at birth.

ƒ Prenatal coverage begins at 20 weeks gestation.

* This benefit reimburses the cost of a funeral for a stillborn infant. The maximum benefit is the lesser of the actual cost of the funeral or the amount of the life insurance benefit for dependent children.

Accidental Death, Disease, & Dismemberment Insurance (includes Critical Illness)

ƒ Available to members only (spouse excluded).

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by his/her employer to a maximum benefit of $75,000.

ƒ Pays an amount equal to the sum insured in the event of an accidental death.

ƒ Pays a portion of the death benefit for

dismemberment, loss of use, or paralysis due to an accident.

ƒ Optional life must be elected prior to having AD&D coverage.

ƒ Coverage is available to age 65.

Can my spouse apply for additional coverage? ƒ Yes, additional coverage is available for your

spouse (optional life insurance only). Your spouse may apply for coverage at any time; however, the application for coverage is medically underwritten and must be approved by medical underwriting prior to being in effect (see attached application). If the application is approved, premiums will be due the 1st of the month following approval.

ƒ For spouse coverages, the beneficiary will automatically be the pilot member.

Who qualifies for Dependent Life Insurance coverage? ƒ The member’s legal spouse, common-law spouse,

or former spouse. The same person must be insured for all spousal benefits, and only one spouse can be insured at a time.

ƒ A 12-month co-habitation rule applies to the common-law spouse.

ƒ Insurable children are unmarried dependent children (from birth to age 21, or age 25 for students), whether natural, adopted, or step-children of the member or spouse.

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while attending a training program are not considered students.

Why do I need additional coverage?

ƒ Statistics indicate that Canadian families require insurance coverage at a level of at least four to six times the annual household income. One of the most valuable assets that we as individuals possess is the ability to earn an income. Loss of income through untimely death can have a devastating effect on a family’s lifestyle and dreams unless provisions are made for the replacement of lost income.

Is a medical exam required?

ƒ No medical is required if the applicant holds a valid and current CAT. 1 medical certificate or equivalent Class 1 medical (members without a CAT. 1 or Class 1 are subject to medical underwriting).

When does my coverage reduce or terminate?

ƒ Your coverage amount will reduce by 50% at age 60 to a maximum benefit amount of $150,000. Coverage terminates at age 65.

Can we convert our coverage?

ƒ If coverage under this group plan terminates on or before your 65th birthday, you may convert your and/or your spouse’s life insurance to an individual insurance plan without providing evidence of insurability. Conversion beyond your or your spouse’s 65th birthday is not available.

Is the Optional Plan portable?

ƒ Yes, if you leave the employment of an ALPA airline you can continue your enrollment with your Optional Plan if you’re classified as an Inactive Participant member of ALPA and continue your premium payments.

How do I apply?

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Air Line Pilots Association, Int’l

535 Herndon Parkway, P.O. Box 1169 Herndon, VA 20172-1169

ATTN: Member Insurance

The preceding summary is intended to provide a brief description of the benefits available under the Air Line Pilots Association Insurance Plan. Note that life and accidental death & dismemberment insurance reduce by 50% at age 60 to a maximum benefit of $150,000. This material does not create or confer any rights. The exact terms and conditions of your benefits are outlined in the applicable group benefits policy.

Member Plan Benefits for:

Group Name: Air Line Pilots Association

Insurance Plan

Questions and Inquiries

http://memberinsurance.alpa.org

1-800-746-ALPA (2572)

24-Hour Emergency Claims Service, please call: 1-888-724-1444

How much does the plan cost?

Optional Life Insurance

ƒ Units of $50,000 to maximum of $500,000

ƒ Monthly rates per $1,000 of insurance

Smoker *Nonsmoker Age Male Female Male Female

under 35 0.131 0.106 0.080 0.066 35–39 0.176 0.152 0.090 0.077 40–44 0.267 0.182 0.119 0.077 45–49 0.381 0.260 0.169 0.111 50–54 0.493 0.325 0.249 0.157 55–59 0.789 0.484 0.378 0.240 60–64 1.160 0.732 0.636 0.450

Maximum coverage available between ages 60 to 64 is $150,000.

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Accidental Death, Disease, & Dismemberment ($0.050 per $1,000) ƒ Members only. ƒ The amount of ADD&D must be equal to the amount of life coverage selected.

Dependent Life Insurance (includes Prenatal benefit)

ƒ Coverage is mandatory for members with dependents. Select “Family” on the Enrollment and

Change form. See Benefits Summary.

ƒ Provides $5,000 of life insurance per eligible dependent.

ƒ Monthly rate of $1.91 per family.

Underwritten by:

References

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