Accidental Death & Dismemberment Supplemental Personal Accident Insurance

Accidental Death & Dismemberment Personal Accident Insurance

PROGRAM BASICS:

This Accidental Death & Dismemberment Personal Accident Insurance Coverage is 100% contributory.
This coverage pays additional benefits to you for an accident resulting in the loss of limbs, sight, or life. If you elect this coverage, the amount is available in $25,000 increments up to $300,000 not to exceed 10 times your annual salary.
The benefit reduces by 65% of the original amount on the date you become age 65.
Coverage will terminate at retirement.
Education Benefit included.
This program is underwritten by ReliaStar Life Insurance Company

BENEFITS:

Provides protection 24 hours a day. Insured employees or their beneficiaries receive the benefits listed in Schedule of Benefits for accidental death or dismemberment. Payment will be made if the covered loss is sustained within 180 days of the date of the accident. The Schedule of Benefits is available from the Human Resources Department (805) 882-4739.
Accidental Death & Dismemberment (AD&D) Insurance Outline of Coverage

PLAN SPECIFICS:

Coverage

Amount of Insurance

Employee only Coverage:

$0.04 per $1,000 of coverage

$25,000 to a maximum of $300,000, not to exceed 10 times basic annual earnings.

Family Coverage:

$0.056 per $1,000 of coverage

Employee: $25,000 to a maximum of $300,000, not to exceed 10 times basic annual earnings.
Spouse: 50% of employee amount
Child(ren): 10% of employee amount

This is a summary of benefits only. A complete description of benefits and limitations will be provided in the certificate of coverage.

Underwritten by ReliaStar Life Insurance Company
October 25, 2005