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:

Units of $10,000 to a maximum of 5-times your base annual pay or $1,000,000 (whichever is less). Guarantee issue is 3-times your base pay at time of new hire or $500,000 (whichever is less). At subsequent Open Enrollments, you can enroll or increase your Voluntary Life & AD&D insurance in units of $10,000 up to 5 units. Amounts applied for after your initial eligibility period or exceeding the guarantee issue require medical underwriting.

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

Spouse Options:

Units of $10,000 to a maximum of $250,000 or 100% of the Employee’s approved voluntary life (whichever is less), inclusive of the company-paid Basic Life/AD&D. Guarantee issue is $30,000. At subsequent Open Enrollments, you can enroll or increase your Spouse Voluntary Life & AD&D insurance in units of $10,000 up to 2 units. Amounts applied for after your initial eligibility period or exceeding the guarantee issue require medical underwriting.

Child Options:

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

Rates

	Schedule A	Schedule B
Step Rates by Age	Non-Tobacco Rates	Tobacco Rates
29 & Under	$0.209	$0.240
30-34	0.213	0.268
35-39	0.234	0.311
40-44	0.277	0.400
45-49	0.355	0.549
50-54	0.481	0.782
55-59	0.669	1.263
60-64	0.881	1.603
65-69	1.134	2.750
70 & over	2.283	4.544

Choose your desired coverage in increments of $10,000. Example: ten (10) increments = $100,000.
Divide the figure from Step 1 by $1,000. Example: $100,000 / $1,000 = 100
Find appropriate table age band 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 figure from Step 2 by the factor in Step 4.
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.