ECEd. 10.2015-18795 EXP.03.2017 Purchase coverage for 1.0 to 10.0 times your covered annnual earnings to a maximum of $2,000,000.
New Hires: Get the lesser of 1.0 times your covered annual earnings not to exceed $500,000 - no medical questions asked - when enrolling when first eligible in Optional Group Term Life.
Optional
Term Life Insurance
- 100%
Partner
Paid
Current Participants: Your current coverage amount will be continued. During annual enrollment periods, you may increase your current coverage amount by 1 times your covered annual earnings, up to a total coverage amount of $500,000, without evidence of insurability to Prudential. Outside of annual enrollment periods, evidence of insurability is required for all increases in coverage amounts.
Plan Summary
Optional Term Life, Spouse Dependent Term Life, Child Dependent Term Life, Optional
Accidental Death & Dismemberment, Long Term Disability and Short Term Disability
Full Time Active Salaried Partners
All coverages are issued by the Prudential Insurance Company of America.
Current Partners who were denied coverage in the past, Current Partners who waived coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts.
Coverage will be reduced as you age - by 50% at age 70.
If terminally ill, you can get a partial payment of your group term life insurance benefit. You can use this payment as you see fit. In the event of your death, your beneficiary will receive a benefit payout which has been reduced by the amount you received.
Upon termination of employment, you may continue at a certain level of your coverage, without having to provide evidence of good health.
Spouse / Domestic Partner
Optional
Dependent Term Life Insurance
- 100%
Partner
Paid
Purchase coverage for your spouse in increments of $10,000 up to a maximum of $100,000, not to exceed 100% of your Optional Term LIfe coverage amount.
New Hires: Get up to $20,000 for your spouse - no medical questions asked - when enrolling when first eligible in Optional Term Life coverage amount.
Current Participants: Your current coverage amount will be continued. During annual enrollment periods, you may increase your current coverage amount by 1 times your covered annual earnings, up to a total coverage amount of $500,000, without evidence of insurability to Prudential. Outside of annual enrollment periods, evidence of insurability is required for all increases in coverage amounts.
Current Partners who were denied coverage in the past, Current Partners who waived coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts.
Coverage will be reduced as you age - by 50% at age 70.
Upon termination of employment, your spouse (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts for you and your spouse will be subject to a maximum of five times your annual earnings or $1 million, whichever is less.
Child Optional Term
Optional
Dependent Term Life Insurance
- 100%
Partner
Paid
Purchase coverage for $5,000 or $10,000, not to exceed 100% of your Optional Teamount. There are no health requirements for this coverage.
Coverage begins from 14 days, and continues to age 26.
Upon termination of employment, you (if eligible to port) may choose to continue a depenent child coverage amount equal to or lower than your current benefit amount.
Employee Optional Accidental Death & Dismemberment
Insurance
- 100%
Partner
Paid
Purchase coverage for 1.0 to 10.0 times your covered annual earnings to a maximum of $2,000,000. Coverage will be reduced as you age - by 50% at age 70.Spouse / Domestic Partner Optional Accidental Death & Dismemberment
Insurance
- 100%
Partner
Paid
Purchase coverage for your spouse in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional AD&D coverage amount.Coverage will be reduced as you age - by 50% at age 70.
Child
Optional Accidental Death & Dismemberment
Insurance
- 100%
Partner
Paid
Purchase coverage for $5,000 or $10,000, not to exceed 100% of your Optional AD&D coverage amount.Option 1: Your monthly Long Term Disability benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $5,000, less deductible sources of income. No medical questions asked - if enrolling when first eligible. The minimum monthly benefit is the greater of $100 or 10% of your gross monthly benefit. Deductible sources of income may include benefits from statutory plans, Social Security to you and your dependents, workers compensation, unemployment income and other income.
If you meet the definition of disability, your benefits will begin 90 days following an accidental injury or sickness. The benefit duration is up to your normal retirement age under the Social Security Act. However, if you become disabled at or after age 65 benefits are payable according to an age-based schedule. Refer to theBooklet-Certificate for details.
Longer Term Disability Insurance
- 100%
Partner
Paid
You are considered disabled when, because of injury or sickness, you are under the regular care of a doctor, you are unable to perform the material and substantial duties of your regular occupation and your disability results in a loss of income of at least 20%. After receiving benefits for 24 months, you are considered disabled when, due to the same sickness or injury, you are unable to perform the material and substantial duties of any gainful occupation for which you are reasonably fitted by education, training or experience, and disability results in a loss of income of a specified percentage determined by your plan.
Disabilities due to mental illness are limited to 24 months of benefits during your lifetime. Examples of mental illness include schizophrenia, depression, manic depressive or bipolar illness, anxiety, somatization, substance related disorders (including drug and alcohol abuse), and/or adjustment disorders. Disabilities which are primarily based on self-reported symptoms are limited to 24 months of benefits during your lifetime. Examples of self-reported symptoms include headache, pain, fatigue, stiffness, soreness, ringing in the ears, dizziness, numbness and loss of energy. Disabilities due to mental illness and disabilities which are primarily based on self-reported symptoms have a combined limited pay period during your lifetime.
During the first 12 months of part-time work while disabled, you can receive full benefits as long as your combined income and disability benefits do not exceed your monthly pre-disability earnings.
LTD benefits will not be paid for a disability that begins during the first 12 months of coverage and due to a pre-existing condition. A pre-existing condition is an injury or sickness for which you received medical treatment, consultation, diagnostic measures,
prescribed drugs or medicines, or for which you followed treatment recommendations during the 12 months prior to your effective date of coverage.
If you die while collecting disability benefits, a lump sum payment may be paid to your eligible survivors.
You are not covered for a disability caused by war or any act of war, declared or undeclared, an intentionally self-inflicted injury, active participation in a riot, and commission of a crime for which you have been convicted. Benefits are not payable for any period of incarceration as a result of a conviction..
Option 2: Your monthly Long Term Disability benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $10,000, less deductible sources of income. No medical questions asked - if enrolling when first eligible. The minimum monthly benefit is the greater of $100 or 10% of your gross monthly benefit. Deductible sources of income may include benefits from statutory plans, Social Security to you and your dependents, workers compensation, unemployment income and other income.
Benefits, exclusions and provisions may vary by state. Refer to the plan booklet for details.
For your coverage to become effective, you must be actively at work on the effective date of the plan. If you apply for an
amount that requires satisfactory evidence of insurability to The Prudential Insurance Company of America, you must be
actively at work on the date of approval for the amount requiring satisfactory evidence of insurability.
All benefit features may not be available in all states.
Group Term Life is issued by The Prudential Insurance Company of America, a New Jersey Company, 751 Broad
Street, Newark, NJ 07102. Life Claims: 1-800-524-0542. This brochure is intended to be a summary of your benefits
and does not include all plan provisions, exclusions and limitations. Please refer to the Booklet-Certificate, which is
made a part of the Group Contract, for all plan details, including any exclusions, limitations and restrictions which may
apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The
Prudential Insurance Company of America, the terms of the Group Contract will govern. Contract provisions may vary
by state. Contract Series: 83500. California COA #1179 NAIC # 6824.
©2015 Prudential Financial, Inc. and its related entities.
Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide.
+ This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services.
IMPORTANT NOTICE - THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS.
++ This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services.
**Accelerated Death Benefit option is a feature that is made available to group life insurance participants. It is not health, nursing home, or long-term care insurance benefit and is not designed to eliminate the need for those types of insurance coverage. The death benefit is reduced by the amount of the accelerated death benefit paid. There is no administrative fee to accelerate benefits. Receipt of accelerated death benefits may affect eligibility for public assistance and may be taxable. The federal income tax treatment of payments made under this rider depends upon whether the insured is the recipient of the benefits and is considered "terminally ill" or "chronically ill." You may wish to seek professional tax advice before exercising this option.
Rate Sheet
Full Time Active Salaried Partners
All coverages are issued by the Prudential Insurance Company of America.
Effective Date: 01/01/2016
CINTAS CORPORATION
Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds.
“How much does life insurance cost?”
The following steps will show you how to calculate your bi-weekly cost of insurance.
Partner
Step 1
Enter the amount of Employee coverage you wish to purchase.
$
Step 2
Divide the coverage amounts by 1,000.
$
Step 3
Multiply the dollar amounts in Step 2 by the cost of coverage per $1,000 of
coverage, according to your age, that you’ll find in the chart that follows. This
gives you the monthly cost of insurance.
$
Step 4
To calculate your paycheck deduction, multiply the monthly cost in Step 3 by 12
to get the annual cost and then divide the annual cost by 26 to get your bi-weekly
cost.
$
TOTAL COST FOR PARTNER
$
The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here.
Cost of Optional Term Life Insurance for You
Coverage is available for 1.0 to 10.0 times your covered annual earnings, not to exceed $2,000,000. Refer to the Optional Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule.
Partner's Age Partner Non Smoker Rate Partner Smoker Rate
< 25 $0.034 $0.041
25 - 29 $0.040 $0.047
30 - 34 $0.053 $0.062
35 - 39 $0.060 $0.076
40 - 44 $0.067 $0.083
45 - 49 $0.101 $0.125
50 - 54 $0.155 $0.196
55 - 59 $0.290 $0.366
60 - 64 $0.445 $0.562
65 - 69 $0.855 $1.082
70 - 74 $1.388 $1.756
75+ $1.388 $1.756
A 35 year-old employee elects
Example
$60,000 of Optional Term Life for themselves Employee Monthly Cost $3.60 ($60,000 / 1,000 x $0.060)
Spouse / Domestic Partner - Optional Dependent Term Life
Bi-Weekly Non-Smoker Cost per Coverage Amount
Coverage is available in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional Term Life coverage amount. Refer to the Optional Dependent Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the
following age schedule.
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
Age
< 25 $0.16 $0.31 $0.47 $0.63 $0.78 $0.94 $1.10 $1.26 $1.41 $1.57
25-29 $0.18 $0.37 $0.55 $0.74 $0.92 $1.11 $1.29 $1.48 $1.66 $1.85
30-34 $0.24 $0.49 $0.73 $0.98 $1.22 $1.47 $1.71 $1.96 $2.20 $2.45
35-39 $0.28 $0.55 $0.83 $1.11 $1.38 $1.66 $1.94 $2.22 $2.49 $2.77
40-44 $0.31 $0.62 $0.93 $1.24 $1.55 $1.86 $2.16 $2.47 $2.78 $3.09
45-49 $0.47 $0.93 $1.40 $1.86 $2.33 $2.80 $3.26 $3.73 $4.20 $4.66
50-54 $0.72 $1.43 $2.15 $2.86 $3.58 $4.29 $5.01 $5.72 $6.44 $7.15
55-59 $1.34 $2.68 $4.02 $5.35 $6.69 $8.03 $9.37 $10.71 $12.05 $13.38
60-64 $2.05 $4.11 $6.16 $8.22 $10.27 $12.32 $14.38 $16.43 $18.48 $20.54
65-69 $3.95 $7.89 $11.84 $15.78 $19.73 $23.68 $27.62 $31.57 $35.52 $39.46
70-74 $6.41 $12.81 $19.22 $25.62 $32.03 $38.44 $44.84 $51.25 $57.66 $64.06
75+ $6.41 $12.81 $19.22 $25.62 $32.03 $38.44 $44.84 $51.25 $57.66 $64.06
Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds.
Spouse / Domestic Partner - Optional Dependent Term Life
Bi-Weekly Smoker Cost per Coverage Amount
Coverage is available in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional Term Life coverage amount. Refer to the Optional Dependent Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the
following age schedule.
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
Age
< 25 $0.19 $0.38 $0.57 $0.76 $0.95 $1.14 $1.32 $1.51 $1.70 $1.89
25-29 $0.22 $0.43 $0.65 $0.87 $1.08 $1.30 $1.52 $1.74 $1.95 $2.17
30-34 $0.29 $0.57 $0.86 $1.14 $1.43 $1.72 $2.00 $2.29 $2.58 $2.86
35-39 $0.35 $0.70 $1.05 $1.40 $1.75 $2.10 $2.46 $2.81 $3.16 $3.51
40-44 $0.38 $0.77 $1.15 $1.53 $1.92 $2.30 $2.68 $3.06 $3.45 $3.83
45-49 $0.58 $1.15 $1.73 $2.31 $2.88 $3.46 $4.04 $4.62 $5.19 $5.77
50-54 $0.90 $1.81 $2.71 $3.62 $4.52 $5.43 $6.33 $7.24 $8.14 $9.05
55-59 $1.69 $3.38 $5.07 $6.76 $8.45 $10.14 $11.82 $13.51 $15.20 $16.89
60-64 $2.59 $5.19 $7.78 $10.38 $12.97 $15.56 $18.16 $20.75 $23.34 $25.94
65-69 $4.99 $9.99 $14.98 $19.98 $24.97 $29.96 $34.96 $39.95 $44.94 $49.94
70-74 $8.10 $16.21 $24.31 $32.42 $40.52 $48.63 $56.73 $64.84 $72.94 $81.05
75+ $8.10 $16.21 $24.31 $32.42 $40.52 $48.63 $56.73 $64.84 $72.94 $81.05
Children - Optional Dependent Term Life Bi-Weekly Cost per Coverage Amount
One premium rate covers all eligible children
$5,000 $10,000
$0.18 $0.36
Rates may change if plan experience requires a change for all insureds.
"How much does this Optional AD&D insurance cost?"
Optional AD&D*
Insured Monthly Cost of Insurance (rates per $1,000 of Coverage)
Partner $0.025
* This is optional coverage and the entire cost of coverage is partner paid.
Worksheet for Optional AD&D (Partner)
Follow this worksheet to determine the cost of insurance for you.
1. Select the desired amount of coverage $__________
2. Locate the monthly rate The monthly rate per $1,000 is $__________ 3. Divide the selected amount of coverage by $1,000.
Then multiply the result by the monthly rate to get the monthly cost of insurance.
$__________ divided by $1,000 is $__________ __________ multiplied by $__________ = $__________ Total Monthly Cost of Insurance = $__________ 4. Multiply the monthly cost of insurance by 12 and
divide by 26 to get your bi-weekly cost.
__________ multiplied by 12 = $__________ $__________ divided by (26) = $__________
Spouse/Domestic Partner - Optional Accidental Death & Dismemberment Bi-Weekly Cost per Coverage
Amount
Coverage is available in increments of $10,000 to a maximum of $100,000. Refer to the Optional AD&D section for evidence of insurability details.
$10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
$0.12 $0.23 $0.35 $0.46 $0.58 $0.69 $0.81 $0.92 $1.04 $1.15
Children - Optional Accidental Death & Dismemberment Bi-Weekly Cost per Coverage Amount
One premium rate covers all eligible children Coverage is available for $5,000 or $10,000.
$5,000 $10,000
$0.06 $0.12
"How much does this Long Term Disability Insurance cost?"
The following steps will show you how to calculate your cost of insurance.
Cost of Long Term Disability Option 1
Partner's Age Partner's Rate
0 - 29 $0.197
30 - 39 $0.391
40 - 44 $0.743
45 - 49 $1.073
50 - 54 $1.390
55 - 59 $1.592
60 - 64 $1.323
65 - 99 $0.970
Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a
change for all insureds.
Cost of Long Term Disability Option 2
Partner's Age Partner's Rate
0 - 29 $0.258
30 - 39 $0.512
40 - 44 $0.979
45 - 49 $1.414
50 - 54 $1.830
55 - 59 $2.092
60 - 64 $1.740
65 - 99 $1.140
Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a
change for all insureds.
Partner
Step 1
Indicate your monthly earnings.
$
Step 2
If the amount in Step 1 is greater than $16,667, indicate $16,667. Otherwise, indicate the
amount from Step 1.
$
Step 3
Multiply the amount in Step 2 by the rate for your age and divide by 100 to obtain your total
LTD monthly cost.
$
Step 4
Multiply the amount in Step 3 by 12 and divide by 26 to get your bi-weekly cost.
$
The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here.
This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services.
This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York Department of Financial Services.
IMPORTANT NOTICE – THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS
North Carolina Residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare,review the Guide to Health
Insurance for People with Medicare, which is available from the company.
Optional Term Life, Dependent Term Life, Long Term Disability, Short Term Disability, Accidental Death & Dismemberment Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, 751 Broad Street, Newark, NJ 07102. The Booklet‐ Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. Contract Series: 83500
© 2015 Prudential Financial, Inc. and its related entities.
Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide.
