Supplemental Term Life/AD&D Covered Lives

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1 Benefits Description Group Life Insurance Supplemental Term Life/AD&D Covered Lives Features Continuation of Life Insurance While Totally Disabled Continuation of Life Insurance is provided for eligible employees who become totally disabled before the age of 60. Total disability means the employee is unable to perform the duties of his/her job and is unable to perform any other job for which he/she is qualified by education, training or experience. The total disability must continue for at least nine consecutive months during which time premiums are required to be paid. When MetLife has approved the claim for total disability, subsequent premiums will be waived. We may periodically request that the employee send us proof that he/she continues to be totally disabled. This benefit terminates on the earliest of the following: the date total disability ends; the date he/she refuses to be examined by our physician as required; the date the employee reaches age 65 or age 70; or the date we do not receive required proof of a total disability, as required. Retirees are not eligible for this benefit. (Refer to your Cost & Benefit Summary or consult with your MetLife sales representative for details about your plan.) Accelerated Benefits Option (ABO) 1 The ABO is available for employees who have Supplemental Term Life Insurance amounts of $20,000 or more. Benefits are payable if an employee or employee s legal representative requests payment of the ABO while the employee s life benefits are in effect, and his/her life expectancy is certified by a physician to be 12 months or less. The amount of accelerated benefits is up to 80% of the covered amount to a maximum of $500,000. Conversion Privilege The conversion privilege allows a covered person whose life insurance coverage ends to obtain an individual policy at his or her expense, without providing evidence of insurability. A covered person may convert all or part of the group coverage. The premiums will be based on the amount of coverage and the covered person s age and class of risk at the time of conversion. (Subject to state requirements.) The certificate of insurance provides more information regarding conversion. Total Control Account (TCA) The TCA Money Market Option is the automatic settlement option for all life and AD&D benefits of $5,000 or more. The TCA provides an employee s beneficiaries with immediate access to, and control of, their insurance proceeds. These benefits are paid through an interest-bearing account with the principal and interest guaranteed by the financial strength and claims-paying ability of Metropolitan Life Insurance Company. The TCA provides free check writing privileges. All or some of the funds held in a TCA can

2 be transferred into other available settlement options, such as a guaranteed interest certificate which locks in competitive interest rates for periods of six months up to seven years. Annuity and monthly income plan settlement options are also available. Billing Options Self-administration of premium is preferred for groups of 200 or more enrolled employees. Groups with fewer than 200 enrolled employees may receive a monthly premium statement showing the amount of premium due and listing the insured employees and premium by coverage. Portability This feature allows a covered employee, whose Supplemental Term Life coverage ceases, the right to continue all or a portion of his or her Supplemental Term Life benefit (subject to state availability). The Supplemental Term Life benefits will be continued under a portability pool established under Group Policy No G. Coverage under the policy will automatically include an Accelerated Benefits Option but it will not include a provision for Continued Death Benefits for Total Disability. A covered employee may make a written request to continue his or her benefits during the Request Period, which is 31 days. This period begins immediately after the earliest of the following events: Supplemental Term Life benefits end because an employee is no longer employed, or An employee is no longer in a class eligible for Supplemental Term Life benefits (subject to applicable state law requirements). Insurance will take effect the day after the Request Period ends. The amount of the life benefit is the amount specified on a new certificate of insurance to be issued to the employee. The minimum amount that the employee may elect is $20,000. The maximum amount that the employee may elect is the lesser of: The amount of Supplemental Term Life benefits in effect on the date Supplemental Term Life benefits would otherwise end because an employee s employment ends or because an employee is no longer in an eligible class; or $1,000,000. Supplemental Accidental Death and Dismemberment (AD&D) Supplemental AD&D coverage provides 24-hour protection in addition to Supplemental Term Life insurance coverage. Coverage is provided for the covered losses shown below, if they are caused solely by a covered accident (which can occur on or off the job) and the loss occurs within 365 days of the covered accident. No more than the Full Amount will be paid for all covered losses caused by injuries which an employee sustains in one covered accident. The Full Amount is equal to the life benefit payable for loss of life. Covered Loss Benefit Amount Life Full Amount A hand A foot An arm severed at or above the 75% of the Full Amount elbow A leg severed at or above the 75% of the Full Amount knee Sight of an eye Any combination of a hand, a Full Amount foot, and/or sight of an eye Thumb and Index finger of 25% of the Full Amount same hand Speech and hearing in both ears Full Amount Speech Hearing in both ears Paralysis of both arms and both Full Amount legs Paralysis of both legs Paralysis of the arm and leg on either side of the body Brain Damage Coma Full Amount 1% of the Full Amount monthly to a maximum of 60 months Seat Belt Benefit If an Accidental Death and Dismemberment benefit is paid, an additional 10% of the AD&D benefit (minimum of $1,000 and maximum of $25,000) is payable if the employee dies as a result of injuries sustained in a covered accident while driving or riding Supplemental Term Life Insurance/AD&D Benefits Description Page 2 of 5

3 in a private passenger car and wearing a properly fastened seat belt. Air Bag Benefit This benefit provides an additional 5% of the AD&D benefit (minimum of $100 and maximum of $10,000). The benefit is payable if the seat belt is properly fastened, the air bag deploys and the covered person dies as a result of the injuries sustained in a covered accident. The combined Air Bag and Seat Belt benefit maximum is 15% to a maximum of $35,000. Common Carrier Benefit This benefit provides an additional 100% of the Full Amount if a covered person dies as a result of covered accidental injury while traveling in a Common Carrier. Common Carrier means a government regulated entity that is in the business of transporting fare-paying passengers and does not include chartered or other privately arranged transportation, taxis or limousines. Travel Assistance and Identity Theft Solution Services 2 Travel Assistance Services are offered to individuals and eligible dependents if an employer elects to add the service to the MetLife Supplemental AD&D plan. Travel Assistance Services include emergency travel and/or medical assistance if a participant becomes sick or is injured when traveling domestically (100 miles or more from home) or internationally. Identity Theft Services: An additional benefit packaged with Travel Assistance Services, Identity Theft Services provide educational and personal guidance to covered participants while at home or away. Rates Initial Rate Guarantee The initial rates are guaranteed for the stated number of years from the effective date of coverage, provided that: The plan of benefits and eligibility remain unchanged; There are no additions or deletions of subsidiaries or affiliates; The census does not change by more than 10%; The volume does not change by more than 25%; and There is no significant change in the geographic distribution. Final rates will be based on actual enrollment. Eligibility Full-time Employees Only active full-time employees who work at least 30 hours per week are eligible for coverage. Actively at Work Requirement An employee must be actively at work with the employer in order for benefits to become effective. If the employee is not actively at work with the employer on the date benefits would otherwise become effective, the employee s benefits will become effective on the date the employee returns to active work with the employer. Evidence of Insurability is required for: Enrollees who apply for amounts in excess of the non-medical maximum; Increases in coverage when the new amount exceeds the non-medical maximum; Employees who were eligible under the prior plan, but did not elect coverage; and Late enrollees. In addition, employees who are hospitalized within 90 days preceding the date he/she enrolls or request an increase in coverage must provide evidence of insurability. Retirees are not eligible for MetLife s Supplemental Term Life coverage or Supplemental AD&D. Minimum Participation Requirements Contributory Plans Supplemental Term Life coverage is provided on a contributory basis and requires: 1. at least 25% participation, and 2. at least 10 covered lives. Supplemental Term Life Insurance/AD&D Benefits Description Page 3 of 5

4 Limitations The maximum MetLife Supplemental Term Life coverage is the lesser of 5x basic annual earnings or $500,000. Exclusions For Supplemental Life coverage only, no benefit will be paid for loss caused or contributed to by: Suicide committed within two years from the effective date of coverage, subject to state variations, beneficiary will receive return of premium if exclusion applies. For Supplemental AD&D coverage only, no benefit will be paid for loss caused or contributed to by: Physical or mental illness or infirmity or the diagnosis or treatment of such illness or infirmity; An infection, other than infection occurring in an external accidental wound; Suicide or attempted suicide; Intentionally self-inflicted injury; War, whether declared or undeclared; or act of war, insurrection, rebellion, riot; Committing or attempting to commit a felony; Services in the armed forces of any country or international authority, except the United States National Guard; Any incident related to: travel in an aircraft as a pilot, crew member or flight student or while acting in any capacity other than as a passenger; parachuting or other descent from an aircraft, except for self-preservation; or travel in an aircraft or device used: for testing or experimental purposes; by or for any military authority; or for travel or designed for travel beyond the earth s atmosphere; The voluntary intake or use by any means of: Any drug, medication or sedative, unless it is: taken or used as prescribed by a physician, or an over-the-counter drug, medication or sedative taken as directed; Alcohol in combination with any drug, medication, or sedative; or Poison, gas or fumes. No benefit will be paid for any loss if the injured party is intoxicated at the time of the incident and is the operator of a vehicle or other device involved in the incident. Accelerated Benefits will not be payable if: The employee or his/her legal representative has assigned all ABO Eligible Life Insurance; ABO Eligible Life Insurance ends; or All ABO Eligible Life Insurance benefits have been accelerated. No Seat Belt Benefits will be payable if: The loss occurs in a commercially licensed car or any private passenger car which is being used for commercial purposes, or if the covered person was driving while under the influence of alcohol or drugs; or The seat belt does not meet published federal safety standards, was not installed by the car manufacturer, or has been altered after such installation. Travel Assistance Services are subject to the following exclusions: Participant is no longer in traveling status (e.g., trips exceeding 120 days); Service for mild lesions, simple injuries such as sprains, simple fractures, or mild sickness that can be treated by local doctors and do not prevent the participant from continuing his or her trip or returning home, infections under treatment and not yet healed; When travel is undertaken for the specific purpose of securing medical treatment; or Injuries that result from attempt at suicide, suicide, participation in acts of war or civil upheavals, riots or physical fights initiated by the participant, Supplemental Term Life Insurance/AD&D Benefits Description Page 4 of 5

5 commission of an unlawful act, use of drugs unless prescribed by a physician, treatment for drug or alcohol addiction, or treatment for mental or nervous disorders, participation in a professional sport or activity of any sport that could be life-threatening, or work-related illness or its consequences. Treatment must be authorized and arranged by AXA Assistance designated personnel to be eligible for benefits under this program. Non-medical services such as hotel, restaurant, taxi expenses or baggage loss while traveling are not covered. For a complete description of the terms and conditions please see the AXA Assistance Travel Assistance Services Service Agreement. AXA Assistance, and not Metropolitan Life Insurance Company, is solely responsible for furnishing the Travel Assistance Services. Cancellation/Termination Coverage terminates: When the employee s full-time employment ceases; When insurance ends for the employee s class; When the employee s contributions cease (if such contributions are required); Upon expiration of grace period following nonpayment of premium; When this plan ends in whole or in part; If the group life insurance plan is discontinued by MetLife for non-payment of premium or if participation requirements or minimum lives covered requirements are not met; or If the Policyholder fails to provide information on a timely basis or perform any obligations required by the policy or any applicable law. Note: 1. This benefit description is a summary of the contractual provisions contained in the Group Policy (Form GPNP99) with certificates of insurance (Form GCERT2000) issued to each insured employee. 2. Like most group insurance policies, MetLife group policies contain certain exclusions, limitations, reduction of benefits and terms for keeping them in force. Policy provisions vary depending on state requirements and variations. Your local MetLife sales representative can answer any questions about costs and details of coverage. Additionally, a full description of the benefits will be provided in the certificate. In the event of any conflict between the provisions of this summary and the group policy or certificate, the policy or certificate shall govern. 1 The Accelerated Benefits Option is subject to state availability and regulation. The accelerated life insurance benefits offered under the certificate are intended to qualify for favorable federal tax treatment. If the accelerated benefits qualify for favorable tax treatment, the benefits will be excluded from the insured s income and not subject to federal taxation. This information was written as a supplement to the marketing of life insurance products. Tax laws relating to accelerated benefits are complex and limitations may apply. Employees are advised to consult with and rely on an independent tax advisor about their own particular circumstances. Receipt of accelerated benefits may effect eligibility of the employee, his or her spouse or family, for public assistance programs such as medical assistance (Medicaid), Temporary Assistance to Needy Families (TANF), Supplementary Social Security Income (SSI) and drug assistance programs. Employees are advised to consult with social service agencies concerning the effect the receipt of accelerated benefits will have on public assistance eligibility for the employee, his or her spouse or family. 2 Travel Assistance Services are administered by AXA Assistance USA, Inc. Certain benefits provided under the Travel Assistance program are underwritten by ACE American Insurance Company. AXA Assistance and ACE American are not affiliated with MetLife, and the Travel Assistance & Identity Theft Services they provide are separate and apart from the insurance provided by MetLife L (exp1210)(All States x FL) 2009 METLIFE, INC. PEANUTS United Feature Syndicate, Inc. Metropolitan Life Insurance Company 200 Park Avenue New York, NY Supplemental Term Life Insurance/AD&D Benefits Description Page 5 of 5

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