VOLUNTARY LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT

VOLUNTARY LIFE ANDACCIDENTAL
DEATH & DISMEMBERMENT

While Shiloh provides employees a competitive company paid Life and AD&D Insurance policy, sometimes individuals and families need additional protection to accomplish their goals. Shiloh is pleased to offer additional Voluntary Life and AD&D Insurance to all eligible employees through New York Life (formerly Cigna). This is a voluntary program.

Voluntary Life and AD&D insurance is paid by the employee.
There are no medical questions for coverage to be issued under the guarantee issue amount when you are first eligible.
Guarantee Issue coverage is available for employees, spouses and children.

Employee Options:

In multiples up to 4 times your base pay. Guarantee issue is $500,000 or 3x your base pay at time of new hire. At subsequent Open Enrollments, you can enroll or increase your Voluntary Life & AD&D insurance in increments of 1 times your base pay up to 3x.. Amounts that exceed guarantee issue require medical underwriting.

Please note: Benefits are reduced by 50% at age 70.

Spouse Options:

$10,000 or $20,000 options.

Child Options:

$5,000 or $10,000 options. Available for children from birth to age 26.

Rates

	Schedule A	Schedule B
Step Ages	Non-Tobacco Rates	Tobacco Rates
29 & Under	$0.077	$0.108
30-34	0.081	0.136
35-39	0.102	0.179
40-44	0.145	0.268
45-49	0.223	0.417
50-54	0.349	0.650
55-59	0.537	1.131
60-64	0.749	1.471
65-69	1.182	2.618
70 & over	2.151	4.412

Use actual annual base wage as of January 1st (for new hire – base wage as of date of hire) times the amount of coverage requested (i.e.; 2x, 3x, 4x).Example: if annual base salary is $31,500 and electing 3 times coverage, times $31,500 x 3.
Round product of Step 1 up to the nearest $1,000 and drop the zeros. Example: $31,500 x 3 = $94,500. Round this up to $95,000; then drop the zeros so you have 95.
Find appropriate age category as of January 1 (for new hires – find appropriate age as of date of hire).
Select factor for Non-Tobacco or Tobacco. (Non-Tobacco criteria is employee must be tobacco free for 12 months.)
Multiple factor from Step 4 by product of Step 2.
Multiple product of Step 5 by 12; then divide by 52 (if paid weekly) or by 26 (if paid bi-weekly). This is your supplemental life insurance premium per paycheck.