Optional Accidental Death and Dismemberment Insurance
Amount of Insurance
In order to be insured under this benefit, you must also be insured under the basic group life insurance program.
This plan provides additional accidental death and dismemberment insurance for you, your spouse and dependent children, if desired, on an employee-pay-all basis. You are covered 24 hours a day, 365 days a year, on or off the job, while traveling or at home.
You may select coverage for yourself or yourself and your family by choosing one of the following plans:
- Employee Only Plan
You may purchase, in units of $10,000, any amount of coverage between $10,000 and $300,000. - Family Plan
You may elect to insure your family under the following plan:Your spouse is insured for 40% of the benefit which you have selected and each dependent child is insured for 5% of the selected amount.
Where there are no dependent children, the spouse is automatically insured for 50% of the benefit selected. Where there is no spouse, each dependent child will be covered for 10% of your benefit. (Refer to the Benefit Summary for definition of eligible dependents.)
Benefits are payable for injuries or death sustained in an accident occurring while the policy is in force, which results in a loss within 365 days of the accident. Benefits are payable as a percentage of the principal sum in accordance with the schedule applicable to the basic accidental death and dismemberment insurance plan.
Beneficiary Designation
Your loss of life benefit will be paid to the beneficiary(ies) you have named on your Group Enrollment Card. All other benefits for you, your spouse and dependent children will be paid to you.
Waiver of Premium
While insured under the plan, should you become disabled from engaging in any occupation for which you are, or may become qualified, by education, training or experience, your optional accidental death and dismemberment insurance may be continued in force following six months of continuous disability for the duration of such disability without further premium payment up to your attainment of age 65, recovery or death.
Termination of Coverage
Your optional accidental death and dismemberment insurance coverage terminates on the earlier of termination of employment or on your attainment of age 75. Coverage may be continued during early retirement but not beyond your 65th birthday.
Conversion Privilege
If your insurance reduces and/or terminates on or prior to age 65, you may be entitled to convert up to $100,000 of optional accidental death and dismemberment insurance to an individual policy of the type then being offered by the insurer to conversion applicants. Application for conversion must be made within 31 days of the termination or reduction date and no medical evidence of insurability would be required. The premium rate would be based on your age and class of risk at that time. For further information, please contact your Administrator.
Additional Benefits
The following benefits are covered in addition to the benefits provided under the basic accidental death and dismemberment policy.
Common Disaster Benefit
In the event that you and your insured spouse both suffer loss of life due to injury sustained in the same accident, the principal sum applicable to your insured spouse will be increased to equal the principal sum applicable to you. Both deaths must occur within 90 days of the date of the accident.
Extended Family Benefit
If an insured employee suffers loss of life for which benefits are payable under the schedule of benefits in this policy, the insurance which is in force for the insured spouse and dependents will be continued for a period of six months without payment of premium.
Escalation Benefit
An increase in the Employee's Principal sum of 3% per year with maximum of 15% will be applied on each and every anniversary date of the policy, up to a maximum of five years, provided the policy remains in effect. The amount of such increase shall not form part of the employee's principal sum for the purpose of calculating subsequent increases under this provision.
Exclusions
The exclusions applicable to the basic accidental death and dismemberment insurance plan also apply to the optional plan.
Applying for Coverage
You may elect coverage for yourself, or yourself and your family by indicating on your Group Enrollment Card the plan selected and the amount of coverage you want. Your coverage becomes effective on the date the application is received by your employer but in no event prior to the commencement of active, regular employment.
Open Enrollment Period
If an Employee chooses not to take advantage of this benefit provision within 31 days of the date of eligibility, an opportunity to enroll or increase present coverage in this plan is provided once every two years during an open enrollment period. The date of the open enrollment period is selected by the policyholder and agreed upon by the company.
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