EMPLOYEE BENEFITS

Employee

Spouse

Child(ren)

Accidental Death and Dismemberment

• You may select a minimum benefit of $10,000 to a maximum benefit amount of $500,000, in increments of $25,000, not to exceed 10 times your annual base salary.

• Employee must select coverage to select any Dependent coverage.

• The Spouse benefit is equal to 50% of the amount elected by the Employee. The Child benefit is equal to 10% of the amount elected by the Employee.

Designating a Beneficiary

A beneficiary is the person or entity you designate to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary and you can change beneficiaries at any time. If you name more than one beneficiary, you must identify the share for each.

Supplemental Employee Life Coverage

You may select a minimum of $15,000 to a maximum of $75,000 in increments of $15,000, not to exceed 7 times your annual base salary. If you decline Supplemental Employee life insurance when first eligible or if you elect coverage and wish to increase your benefit amount at a later date, Evidence of Insurability (EOI) – proof of good health – may be required before coverage is approved.

Supplemental Dependent Life Coverage

• Increments of $10,00 up to $500,000, not to exceed 7 times your annual salary

• Guaranteed Issue $200,000

• Increments of $10,000 up to 100% of employee amount

• Guaranteed Issue $50,000

• Birth to six months - $1,000

• Six months to age 26 - $10,000

Option 1:

• Life Amount Spouse $5,000

• Child: Live Birth to under 6 months $250

• 6 months to under 26 years $1,000 Option 2:

• Life Amount Spouse $10,000

• Child: Live Birth to under 6 months $250

• 6 months to under 26 years $2,000