1 Voluntary Life Insurance with Accidental Death and Dismemberment (AD&D) SUMMARY OF BENEFITS Sponsored by: Quantum 3D, Inc. Effective date: January 1, 2010 Life Benefit Employee Spouse Dependent Amount Choice of $10,000 increments. Not to exceed five times your annual salary. Employees age 70 and older, maximum benefit is $50,000. Choice of $5,000 increments Employee must elect coverage for spouse to be eligible. Not to exceed 50% of employee elected amount. Minimum Amount $10,000 $5,000 $10,000 Maximum Amount $500,000 $250,000 $10,000 Guarantee Issue The Lesser of $80,000 or 300% of salary under age 70 $20,000 age No Guarantee Issue age 75 and older $10,000 if employee is under age 60 No Guarantee Issue if employee is age 60 and older $10,000 AD&D Benefit Employee Spouse Amount Benefit Reduction Employee Benefits will reduce: Additional Benefits See Definition: See Definition: See Definition: The benefit amount is equal to the life amount elected by you. Cost included in the schedule. 35% at age 65 An additional 25% of original amount at age 70 An additional 15% of original amount at age 75 Benefits terminate at age 80 or retirement, whichever is first Accelerated Death Benefit Portability Conversion Same as employee Spouse 35% at employee age 65 Benefits terminate at employee age 70 or retirement, whichever occurs first Eligibility Employee Spouse and Dependents All full-time active employees working 30 or more hours per week in an eligible class are eligible for coverage on the policy effective date. A delayed effective date will apply if the employee is not actively at work. $250 Child: 14 days to six months $10,000 Child: Six months to age 19 (to age 25 if full-time student) Newborn children to age 14 days are not eligible for a benefit. Cannot be in a period of limited activity on the day coverage takes effect.
6 Definitions Accelerated Death Benefit AD&D Conversion Guarantee Issue Limited Activity Portability Accident Plus Term Life Accelerated Death Benefit provides an option to withdraw a percentage of your life insurance coverage when diagnosed as terminally ill (as defined in the policy). The death benefit will be reduced by the amount withdrawn. To qualify, you have satisfied the Active Work rule and have been covered under this policy for the required amount of time as defined by the policy. Check with your tax advisor or attorney before exercising this option. Accidental Death and Dismemberment (AD&D) insurance provides specified benefits for a covered accidental bodily injury that directly causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from a covered accident, both the life and the AD&D benefit would be payable. If you terminate your employment or become ineligible for this coverage, you have the option to convert all or part of the amount of coverage in force to an individual life policy on the date of termination without Evidence of Insurability. Conversion election must be made within 31 days of your date of termination. For timely entrants enrolled within 31 days of becoming eligible, the Guarantee Issue amount is available without any Evidence of Insurability requirement. Evidence of Insurability will be required for any amounts above this, for late enrollees or increase in insurance, and it will be provided at your own expense. A period when a spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex. If coverage has been in force for at least 12 months, you may continue coverage for a specified period of time after your employment by paying the required premium. Portability is available if you cease employment for a reason other than total disability. A written application must be made within 31 days of your termination. If loss occurs due to an accident, you may also receive the following Accident Plus benefits: Coma: Pays 5% of your principal sum up to a maximum of $5,000 if you are in a coma as a result of an accident covered under the policy and remain in a coma for 31 continuous days. Plegia: Pays 100% of your principal sum for quadriplegia and 50% of your principal sum for paraplegia and hemiplegia. Plegia must be caused by a covered accident. Benefits are doubled if accident is caused by a common carrier. Repatriation: Pays up to $5,000 for preparation and transportation of your body when the accident occurs more than 150 miles away from home. Death must be the result of a covered accident. Education: As a result of your death, this benefit pays 5% of the principal sum up to a maximum of $5,000 for your eligible dependent s post-secondary education. The benefit is paid for up to four years. Spouse Training: As a result of your death, this benefit pays 5% of your principal sum up to a maximum of $5,000 for your spouse and covers the cost of classes taken to retrain or refresh skills needed for employment. Benefits will be paid for one year and enrollment must occur within 365 days of the covered accident. Child Care: As a result of your death, this benefit pays 5% of your principal sum up to a maximum of $5,000 for expenses paid to a licensed childcare facility for an eligible dependent attending on a regular basis. The benefit will be paid for up to four consecutive years, or until your child s 13th birthday, whichever comes first. Coverage provided to the designated beneficiary upon the death of the insured. Coverage is provided for the time period that you are eligible and premium is paid. There is no cash value associated with this product. This insurance is optional and can be purchased by you and your spouse.
7 Exclusion: Suicide Additional Benefits BeneficiaryConnect SM TravelConnect SM Benefits will not be paid if the death results from suicide within two years after coverage is effective. May apply if employee contributes toward the premium. Support services for beneficiaries who have experienced a loss. Travel assistance services for employees and eligible dependents traveling more than 100 miles from home. For assistance or additional information Contact Lincoln Financial Group at (800) or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations.
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