Your Retiree Supplemental Group Term Life Insurance Handbook...

Size: px
Start display at page:

Download "Your Retiree Supplemental Group Term Life Insurance Handbook..."

Transcription

1 Your Retiree Supplemental Group Term Life Insurance Handbook... SUPPLEMENTAL GROUP TERM LIFE INSURANCE Just as the name implies, Supplemental Group Term Life (SGTL) coverage supplements other life insurance you may have You pay the entire cost for coverage; your former employer does not contribute You take advantage of group rates To qualify, you must be at least 55 years old and have 10 years of eligible credit You must also apply for coverage before you retire Coverage is also available for your spouse and eligible dependent children Make sure your beneficiary designations are always up to date (the form is at NAME: FIRST MIDDLE INITIAL LAST BENEFICIARY DESIGNATION, continued from Section D, designate a trust as a beneficiary or list additional beneficiaries DESERET MUTUAL ID NO.: BIRTH DATE (MM/DD/YYYY): Full Given Name of Beneficiary Relationship Birth Date Contact Phone # PRIMARY TELEPHONE: ALTERNATE TELEPHONE: Benefit MARITAL STATUS: MARRIED WIDOWED SINGLE (NEVER MARRIED) SEPARATED DIVORCED B. PARTICIPANT AUTHORIZATION PRIMARY Participant s Signature: Date: C. SPOUSAL CONSENT WAIVER (IF APPLICABLE) See the back page for more information! If you re married and you choose a primary beneficiary other than, or in addition Notary Stamp to, your spouse including a trust, your spouse must give his/her consent, ALTERNATE according to federal regulations.* Your signature must be witnessed by a notary public or an authorized Deseret Mutual representative. Spouse s Signature Date 150 Social Hall Avenue, Suite 170 P.O. Box 45530, Salt Lake City, Utah Telephone Toll free Fax Website: A. PARTICIPANT INFORMATION Name of Trust Date of Trust Notary Public or Deseret Mutual Representative Signature BENEFICIARY FORM Contact DatePhone # FOR DESERET MUTUAL USE ONLY CONTRACT NUMBER: For the waiver to be valid, spouse s signature date and notary date must be the same. D. BENEFICIARY DESIGNATION E. IMPORTANT INFORMATION TO KNOW If you WHEN want to NAMING designate YOUR different BENEFICIARIES beneficiaries for each plan, you must complete a separate form for each plan. Please include your name, Deseret Mutual identification number, date, and signature. 1. Types of beneficiaries: CHECK BOX FOR ALL PLAN(S) THAT APPLY : a. Primary person to receive benefits LIFE INSURANCE when you die SAVINGS RETIREMENT b. Alternate person to receive the primary benefits GROUP when TERM you die LIFE if beneficiary THRIFT is deceased 401(k) RETIREE GROUP TERM LIFE* 2. SUPPLEMENTAL GROUP TERM LIFE TAX SHELTERED ANNUITY 403(b) RETIREE SUPPLEMENTAL GROUP TERM LIFE* If you name multiple primary or multiple alternate beneficiaries, benefits will be split equally, unless otherwise noted on the 24-HOUR ACCIDENTAL DEATH & RETIREMENT PLUS MASTER RETIREMENT PLAN (PENSION)* form. If you re allocating the percentage of benefit, please verify that the total for primary beneficiaries equals 100% and DISMEMBERMENT SAVINGS ANNUITY * You cannot preselect your beneficiaries. the total for alternate beneficiaries equals 100%. Available only on or after you apply for retirement 3. If you name minor children as beneficiaries, LIST ALL BENEFICIARIES: we must have Beneficiary legal guardianship payments are papers paid from for each the most child recent, at the valid time beneficiary of your designation. (To name more beneficiaries, use than the 18. back This of could this page.) mean To legal designate expenses a trust for the as a beneficiary, and see delay the back benefit of this page. death if they are unmarried and younger payments. Please consider this when naming ALL PRIMARY your beneficiaries. BENEFICIARIES SHARE EQUALLY ALL ALTERNATE BENEFICIARIES SHARE EQUALLY 4. Spousal Consent Waiver: Full Given Name of Beneficiary Relationship Birth Date Contact Phone # Benefit a. Thrift Plan and Retirement PLUS Plan required if you re married and choose a primary beneficiary other than or in addition to your spouse, including a trust* b. Savings Annuity: i. Term Certain & Life Payment Options (2 ½, 5, 7 ½, 10, 15, or 20 years) required if you re married and choose a primary beneficiary other than or in addition to your spouse, including a trust* ii. Joint & Survivor Payment Options PRIMARY not required. Your beneficiary must be someone other than your spouse c. Master Retirement Plan: i. Term Certain & Life Payment Options (10, 15, or 20 years) required if you re married and choose a primary beneficiary other than or in addition to your spouse, including a trust* ii. Joint & Survivor Payment Option not required. Your beneficiary must be someone other than your spouse d. Life Insurance Plans (Group Term Life, Supplemental Group Term Life, Occupational Accidental Death & Dismemberment, and 24-Hour Accidental Death BENFRM0115 & Dismemberment) PLEASE not required SEE THE BACK FOR INSTRUCTIONS ON COMPLETING YOUR BENEFICIARY DESIGNATIONS 5. When you die, Deseret Mutual will contact your primary beneficiary to request additional information, including a certified death certificate. Benefit *If you re married, the law requires your spouse to be your primary beneficiary. But you may choose a beneficiary other than or in addition to your spouse with your spouse s written, notarized consent. If you don t have a valid beneficiary designation on file when you die, the Qualified Preretirement Survivor Annuity (QPSA) benefit will be in effect. From the QPSA, 50 your benefit or account balance will be paid to your current spouse, and the remaining 50% will be paid to your estate or named beneficiary. A more detailed explanation of the QPSA is available upon request. COMPANY CODE Retiree Supplemental Group Term Life Insurance Table of Contents Enrollment Coverage Spousal Coverage Coverage for Your Surviving Spouse Coverage for Dependent Children Premiums Receiving Insurance Benefits Eligible Dependents Exclusions Filing Claims Definitions Claims Review & Appeal Procedures Notification of Discretionary Authority Notification of Benefit Changes TABLE OF CONTENTS

2 Your Retiree Supplemental Group Term Life Insurance Handbook... No one wants to leave family or loved ones behind without some financial protection. Finding affordable life insurance is vital to establishing a secure financial future. And to help provide this security, Deseret Mutual offers several different life insurance plans to meet your needs. This section of your Benefits Handbook outlines the major provisions of Deseret Mutual s Supplemental Group Term Life insurance plan for retirees as of January 1, This document also serves as your summary plan description, or SPD. Retiree Supplemental Group Term Life Insurance Just as the name implies, Retiree Supplemental Group Term Life insurance is supplemental to all other life insurance coverage you may have. You pay the entire cost for coverage. But you have the advantage of low group rates. Enrollment To enroll in Retiree Supplemental Group Term Life insurance, you apply at the time you retire as part of the Online Retirement Application. is application may also include a health questionnaire to measure whether you meet Deseret Mutual s health standards. If you don t enroll within 30 days of your retirement, you will not be eligible for life insurance in the future. Coverage To qualify for this coverage, you must be at least 55 years old and have 10 years of eligible credit in Deseret Mutual s benefit program. Also, you must apply for this coverage before you retire. After you retire, you cannot enroll or increase your levels of coverage. You can select one of four coverage amounts, depending on your age: $10,000, $15,000, $25,000, or $35,000. If you had Group Term Life (GTL) insurance before you retired, you do not have to meet Deseret Mutual s health standards for $10,000 of SGTL coverage. And if you had both GTL and SGTL coverage before you retired, you do not have to meet Deseret Mutual s health standards for $15,000 of SGTL coverage. e $35,000 coverage amount reduces to $25,000 when you turn 75. Additional coverage requires that you meet health standards. SPOUSAL COvERAGE Your spouse can select $5,000, $10,000, $15,000, or $25,000 of coverage, depending on his or her age. For additional coverage, your spouse must meet Deseret Mutual s health standards for all levels if he or she was not enrolled before you retired. COvERAGE FOR YOUR SURvIvING SPOUSE If your spouse s Retiree Group Term Life or Retiree Supplemental Group Term Life insurance is in force at the time of your death, your spouse does not need to meet health standards to continue at the same level of Retiree Supplemental Group Term Life coverage as a surviving spouse. If your spouse does not have any Retiree Group Term Life in effect at the time of your death, your surviving spouse can apply for $5,000 of Survivor Supplemental Group Term Life coverage. For more information about surviving spouse benefits, please contact Deseret Mutual. COvERAGE FOR DEPENDENT CHILDREN If your dependents were enrolled before you retired, they can continue the same levels of coverage without 2015 PAGE 1

3 meeting Deseret Mutual s health standards. If they weren t previously enrolled, they must enroll within 30 days of your retirement and must meet Deseret Mutual s health standards for all options. You may choose between three insurance options for your eligible dependent children: Birth to 6 months 6 months to 26 years Option 1 $ 1,000 $ 3,000 Option 2 $ 7,500 Option 3 $ 15,000 ese levels of coverage may continue during your retirement. If you acquire a new dependent after you retire, you can enroll him or her within 60 days of the date you acquired the dependent. e dependent must meet Deseret Mutual s health standards for coverage Option 2 or Option 3. Premiums To determine the monthly premium for you and your spouse, see the table on page 4. Find the amounts per thousand opposite your age, or your spouse s age, as of last January 1. en multiply these amounts by the number of thousands of coverage for which you or your spouse is applying. Because this is supplemental coverage, you pay the entire cost of the premium for the coverage you choose. If your monthly retirement check is large enough to cover the premium, your premiums are automatically deducted from your check. Otherwise, you will be billed monthly. PREMIUMS FOR DEPENDENT CHILDREN e following premiums apply to children of active or retired employees as of April 1, e monthly premium covers all of your eligible children, regardless of how many children you have. If you have a child who has less coverage than the others, you pay the higher amount. $0.44 for $3,000 of coverage $0.96 for $7,500 of coverage $1.74 for $15,000 of coverage Receiving Insurance Benefits If one of your insured dependents dies, benefits are paid to you. If you die, the SGTL insurance benefits are paid to your named beneficiary. Please be aware that Deseret Mutual can only release information to your designated primary beneficiary. If you designated multiple beneficiaries and a primary beneficiary dies before you do and you don t designate a new beneficiary, the benefit payment for the predeceased primary beneficiary is equally distributed among the remaining living primary beneficiary(ies). The same applies to predeceased alternate beneficiary(ies) if no primary beneficiaries exist. If you die without naming a beneficiary or if your beneficiary dies before you do and you have not named an alternate beneficiary or you do not have a valid beneficiary benefits are paid to your estate. e court may recognize the personal representative you named in your estate plan. Or a family member may be appointed as your personal representative through the court system. is personal representative files the necessary paperwork with Deseret Mutual, and we release your funds to the personal representative on behalf of your estate. You may change your beneficiary at any time on our website (or in writing). We suggest you always provide an alternate beneficiary and make sure your beneficiaries are current. A named beneficiary may die or you may divorce and remarry. So you need to review your beneficiaries on a regular basis PAGE 2

4 If you have named a trust as your beneficiary, Deseret Mutual will request a full copy of the trust for legal review before benefit payments can be made. If your beneficiary is a minor and a trustee has not been named to receive the minor s share, a guardian must be appointed through a court proceeding, and a certificate of appointment and qualification must be sent to Deseret Mutual. If a guardian is not appointed, Deseret Mutual will hold the funds at simple interest until the minor is of age and requests the payment. Eligible Eligible Dependents Your eligible dependents include your spouse and dependent children. Your spouse is defined as a person of the opposite sex who is your legal husband or wife. Exclusions Retiree Supplemental Group Term Life insurance benefits are not available for loss caused wholly or partly, directly or indirectly, by: suicide (if the coverage was in force for less than two years before the suicide) any falsification, omission, or misstatement regarding information used to determine eligibility for coverage during the application and underwriting process may be grounds to void coverage war or act of war, or service in the military forces of any country at war, declared or undeclared. War includes hostilities made by force or arms by one country against another, or between countries or factions within a country, either with or without a formal declaration of war Filing Filing Claims Claims To receive benefits, you or your beneficiary must: Step 1: Contact Deseret Mutual. Deseret Mutual then sends an information packet to you or your beneficiary. Step 2: Complete the forms in the packet. Step 3: Send the completed forms and a copy of the death certificate to Deseret Mutual. Definitions For definitions of words and terms applicable to the retiree life insurance plans, please refer the Definitions section of your Benefits Handbook. Claims Review & Appeal Procedures If Deseret Mutual denies your claim and you want to appeal because you think it was denied inappropriately, or if you have other claim concerns or complaints, please bring them to our attention. You must submit your appeals within 12 months from the date we send your benefit decision notification. For more information about how to appeal a claim, please refer to the General Information section of your Benefits Handbook. Notification of Discretionary Authority Deseret Mutual has full discretionary authority and the sole right to interpret the plan and to determine eligibility. All Deseret Mutual decisions relating to plan terms or eligibility are binding and conclusive. Notification of Benefit Changes Deseret Mutual is subject to the Employee Retirement Income Security Act (ERISA) and reserves the right to amend or terminate this plan at any time. If benefits change, we will notify you at least 30 days before the effective date of change PAGE 3

5 Age Last January 1 Amount per $1,000 Premiums as of January 1, 2015 Amounts of Coverage $5,000 $10,000 $15,000 $25,000 $35,000 Younger than to to to to to to and older Notes: Enrollment Coverage Spousal Coverage Coverage for Your Surviving Spouse Coverage for Dependent Children Premiums Receiving Insurance Benefits Exclusions Filing Claims Definitions Claims Review & Appeal Procedures Notification of Discretionary Authority Notification of Benefit Changes 2014 PAGE 4

Your Supplemental Group Term Life Insurance Handbook...

Your Supplemental Group Term Life Insurance Handbook... Your Supplemental Group Term Life Insurance Handbook... SUPPLEMENTAL GROUP TERM LIFE INSURANCE Just as the name implies, SGTL coverage supplements other life insurance you may have You pay the entire cost

More information

Your Supplemental Group Term Life Insurance Handbook...

Your Supplemental Group Term Life Insurance Handbook... Your Supplemental Group Term Life Insurance Handbook... No one wants to leave family or loved ones behind without some financial protection. And finding affordable life insurance is vital to establishing

More information

SUPPLEMENTAL GROUP TERM LIFE

SUPPLEMENTAL GROUP TERM LIFE SGTAB1HBA0116 2016 SUPPLEMENTAL GROUP TERM LIFE This section of your benefits handbook outlines the major provisions of Deseret Mutual s Supplemental Group Term Life (SGTL) insurance plan as of January

More information

MASTER RETIREMENT PLAN FREQUENTLY ASKED QUESTIONS

MASTER RETIREMENT PLAN FREQUENTLY ASKED QUESTIONS DESERET MUTUAL BENEFIT ADMINISTRATORS 150 Social Hall Avenue, Suite 170 P.O. Box 45530 Salt Lake City, Utah 84145 Telephone 801-578-5600 Toll free 800-777-3622 Fax 801-578-5904 Website www.dmba.com MASTER

More information

Your Master Retirement Plan Handbook...

Your Master Retirement Plan Handbook... annuity options. Master Retirement Plan Your Master Retirement Plan Handbook... Key points in understanding this generous benefit: Remember, if you re married, you can select any of the payment options.

More information

NOTICE OF QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY (QPSA)

NOTICE OF QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY (QPSA) NOTICE OF QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY (QPSA) Participant Name: Employer: New Form Date Completed: Age: QPSA Waived Replacement Form Date Completed: Age: QPSA Waived FOR DEFINED BENEFIT PLANS

More information

THE JOHNS HOPKINS UNIVERSITY SUPPORT STAFF PENSION PLAN QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY NOTICE

THE JOHNS HOPKINS UNIVERSITY SUPPORT STAFF PENSION PLAN QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY NOTICE THE JOHNS HOPKINS UNIVERSITY SUPPORT STAFF PENSION PLAN QUALIFIED PRE-RETIREMENT SURVIVOR ANNUITY NOTICE If you are married and die before you begin receiving retirement benefits under The Johns Hopkins

More information

YOUR PAYMENT OPTIONS

YOUR PAYMENT OPTIONS A Guide to YOUR PAYMENT OPTIONS Deseret Mutual Benefit Administrators FBB0140715 MASTER RETIREMENT PLAN PAYMENT OPTIONS Several payment options are available to you from your Master Retirement Plan benefit.

More information

G You are totally and permanently disabled. If you have checked this box, complete Sections III, IV and V of this application.

G You are totally and permanently disabled. If you have checked this box, complete Sections III, IV and V of this application. THE NATIONAL ASBESTOS WORKERS SUPPLEMENTAL PENSION PLAN BENEFIT APPLICATION For Distributions Over $5,000 INSTRUCTIONS: Please read this application carefully and completely before answering any questions.

More information

DESIGNATION OF BENEFICIARY For:

DESIGNATION OF BENEFICIARY For: 730 Third Avenue New York NY 10017-3206 DESIGNATION OF BENEFICIARY For: Group Supplemental Retirement Annuities Rollover Individual Retirement Annuities Supplemental Retirement Annuities Classic Individual

More information

DESIGNATION OF BENEFICIARY For:

DESIGNATION OF BENEFICIARY For: P.O. Box 1268 Charlotte NC 28201-1268 DESIGNATION OF BENEFICIARY For: Group Supplemental Retirement Annuities Rollover Individual Retirement Annuities Supplemental Retirement Annuities Classic Individual

More information

DESIGNATION OF BENEFICIARY For:

DESIGNATION OF BENEFICIARY For: DESIGNATION OF BENEFICIARY For: Group Supplemental Retirement Annuities Rollover Individual Retirement Annuities Supplemental Retirement Annuities Classic Individual Retirement Annuities Group Retirement

More information

INSTRUCTIONS FOR BENEFICIARY DESIGNATION FORMS. Congress passed the Retirement Equity Act in 1984, and as a result,

INSTRUCTIONS FOR BENEFICIARY DESIGNATION FORMS. Congress passed the Retirement Equity Act in 1984, and as a result, INSTRUCTIONS FOR BENEFICIARY DESIGNATION FORMS TO: FROM: Congress passed the Retirement Equity Act in 1984, and as a result, - If you are married, your plan benefits are automatically paid to your spouse

More information

Instructions For Choosing Your Beneficiary

Instructions For Choosing Your Beneficiary Prudential 30 Scranton Office Park Scranton, PA 18507-1789 Please print using blue or black ink. Keep a copy for your records and send the original form to the address above or fax it to 1-866- 439-8602.

More information

MASTER RETIREMENT PLAN

MASTER RETIREMENT PLAN MRP0751HBB0116 2016 MASTER RETIREMENT PLAN This section of your benefits handbook outlines the major provisions of the Deseret Mutual Master Retirement Plan as of January 1, 2016. This document also serves

More information

Part-time Employee Retirement Plan Designation of Beneficiary

Part-time Employee Retirement Plan Designation of Beneficiary Part-time Employee Retirement Plan Designation of Human Resources To the Trustee (s) or Custodian (as applicable) of the Austin Community College Money Purchase Plan Printed Name of Participant I hereby

More information

PLEASE PRINT CLEARLY IN BLUE/BLACK INK

PLEASE PRINT CLEARLY IN BLUE/BLACK INK PLEASE PRINT CLEARLY IN BLUE/BLACK INK PENSION OPTION AND BENEFICIARY FORM PENSION OPTION AND BENEFICIARY FORM FORMER 144 HOSPITAL DIVISION BASIC DEFERRED PENSION FORMER 144 HOSPITAL DIVISION BASIC DEFERRED

More information

Pre-Retirement Beneficiary Designation Form

Pre-Retirement Beneficiary Designation Form Pre-Retirement Beneficiary Designation Form INSTRUCTIONS You are eligible under your Plan to have a death benefit paid to a beneficiary if you die before you begin receiving retirement benefits. Your death

More information

UNITED HERITAGE CREDIT UNION DEFINED BENEFIT PLAN INSTRUCTIONS FOR DESIGNATING OR CHANGING BENEFICIARY

UNITED HERITAGE CREDIT UNION DEFINED BENEFIT PLAN INSTRUCTIONS FOR DESIGNATING OR CHANGING BENEFICIARY Beneficiary Form Instructions INSTRUCTIONS FOR DESIGNATING OR CHANGING BENEFICIARY These instructions will assist you in properly completing the DESIGNATION OF BENEFICIARY form. 1. To designate one person,

More information

a prescribed Registered Retirement Income Fund (prrif) from a financial institution as prescribed under The Pension Benefits Act, 1992.

a prescribed Registered Retirement Income Fund (prrif) from a financial institution as prescribed under The Pension Benefits Act, 1992. PEPP Talk... on Annuities From SPAF This issue of PEPP Talk provides members of the Public Employees Pension Plan (PEPP) with information on annuities from the Saskatchewan Pension Annuity Fund (SPAF).

More information

FDIC Basic Life Insurance for Retirees

FDIC Basic Life Insurance for Retirees FDIC Basic Life Insurance for Retirees Summary of Benefits Please Note: The FDIC may terminate the Plan or may modify, amend, or change the provisions, terms, and conditions of the Plan at any time. Revised

More information

Provisions Applicable to Group Term Life, AD&D, and Voluntary AD&D SECTION SIX AT-A-GLANCE

Provisions Applicable to Group Term Life, AD&D, and Voluntary AD&D SECTION SIX AT-A-GLANCE Provisions Applicable to Group Term Life, AD&D, and Voluntary AD&D SECTION SIX AT-A-GLANCE AD&D and Voluntary AD&D Limitations and Exclusions...pg. 50 Beneficiary Designations...pg. 52 Changes in Insurance...pg.

More information

Metropolitan Edison Company Bargaining Unit Retirement Plan

Metropolitan Edison Company Bargaining Unit Retirement Plan Metropolitan Edison Company Bargaining Unit Retirement Plan January 2007 Metropolitan Edison Company Bargaining Unit Retirement Plan This Summary Plan Description is created for the use of eligible participants

More information

Your General Information Handbook...

Your General Information Handbook... Your General Information Handbook... GENERAL INFORMATION Make sure you know how to reach us if you need help Understand the specifics of eligibility and enrollment Review a snapshot of your entire benefits

More information

Supplemental Term Life Insurance Plan

Supplemental Term Life Insurance Plan Supplemental Term Life Insurance Plan JANUARY 1, 2006 Who Is Eligible Service Requirement Eligibility Date Dependent Age Limit Employee-Only Coverage Options Spouse-Only Coverage Options Children-Only

More information

Christian Brothers Employee Retirement Plan

Christian Brothers Employee Retirement Plan 7.1.2014.SummaryPlanDescription.001018 Christian Brothers Employee Retirement Plan July 1, 2014 Christian Brothers Retirement Planning Services 1205 Windham Parkway, Romeoville, IL 60446-1679 800.807.0700

More information

Beneficiary Designation

Beneficiary Designation Beneficiary Designation Defined Benefit Plan For active or deferred members of the Alaska Public Employees Retirement System (PERS) and Teachers Retirement System (TRS) Defined Benefit Plan Welcome to

More information

CHAPTER 11 FEDERAL EMPLOYEES GROUP LIFE INSURANCE (FEGLI) Section I - General. Section II - Types and Costs of Insurance

CHAPTER 11 FEDERAL EMPLOYEES GROUP LIFE INSURANCE (FEGLI) Section I - General. Section II - Types and Costs of Insurance CHAPTER 11 FEDERAL EMPLOYEES GROUP LIFE INSURANCE (FEGLI) Section I - General General. The FEGLI Program offers all indefinite and permanent technicians an opportunity to participate in the plan which

More information

Your Disability Plan Handbook...

Your Disability Plan Handbook... due benefits. End of Definition of Disability Tax Information Insurance Premiums Thrift Plan Flexible Spending Reductions Rehabilitation & Vocational Training Return-to-work Incentives Appeal Process Notification

More information

INSTRUCTIONS FOR COMPLETING THE FOLLOWING FORMS:

INSTRUCTIONS FOR COMPLETING THE FOLLOWING FORMS: INSTRUCTIONS FOR COMPLETING THE FOLLOWING FORMS: BENEFICIARY DESIGNATION FORM: Every Plan Participant must complete a Beneficiary Designation form. This designation does not apply to any insurance policy(ies)

More information

11/2003. You should name Public. and one or. PSERS. You may. also name. benefits are paid

11/2003. You should name Public. and one or. PSERS. You may. also name. benefits are paid Publication 9520 11/2003 BENEFIT and BENEFICIARY When do I nominate a beneficiary? You should name a beneficiary when your employer enrolls you with the Public School Employees Retirement System (PSERS).

More information

Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance

Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance Issued by: Standard Insruance Company For new employees of ENROLLMENT CONDUCTED BY: 1410 Piedmont Drive E. Tallahassee, FL 32308 800.330.6115

More information

~ Death and Survivor Benefits ~ Death and Survivor Benefits

~ Death and Survivor Benefits ~ Death and Survivor Benefits ~ Death and Survivor Benefits ~ Death and Survivor Benefits We re here to help. Contact us: Internet: Phone: Mail: Website: www.trsl.org Email: web.master@trsl.org Your questions will be answered within

More information

CONSUMERS LIFE INSURANCE COMPANY

CONSUMERS LIFE INSURANCE COMPANY CONSUMERS LIFE INSURANCE COMPANY Group Life, Dependent Life, Short-Term Disability & Long-Term Disability Products ADMINISTRATIVE KIT C O N S U M E R S L I F E I N S U R A N C E C O M P A N Y CONSUMERS

More information

GROUP LIFE INSURANCE PROGRAM. Troy University

GROUP LIFE INSURANCE PROGRAM. Troy University GROUP LIFE INSURANCE PROGRAM Troy University RELIANCE STANDARD LIFE INSURANCE COMPANY Home Office: Chicago, Illinois Administrative Office: Philadelphia, Pennsylvania CERTIFICATE OF INSURANCE We certify

More information

ALCATEL-LUCENT RETIREE LUMP-SUM WINDOW PROGRAM PROGRAM ANNOUNCEMENT

ALCATEL-LUCENT RETIREE LUMP-SUM WINDOW PROGRAM PROGRAM ANNOUNCEMENT ALCATEL-LUCENT RETIREE LUMP-SUM WINDOW PROGRAM PROGRAM ANNOUNCEMENT WHAT S INSIDE Program Overview... 1 Program Timing... 2 Getting Ready... 3 Your Choices Under the Program... 4 How to Participate in

More information

Survivor Benefits for Families of Civilian Federal Employees and Retirees

Survivor Benefits for Families of Civilian Federal Employees and Retirees Order Code RS21029 Updated April 17, 2008 Survivor Benefits for Families of Civilian Federal Employees and Retirees Summary Patrick Purcell Specialist in Social Legislation Domestic Social Policy Division

More information

Summary Plan Description

Summary Plan Description Summary Plan Description Glatfelter Retirement Plan Program for Hourly Employees in the Spring Grove Group (Applicable to Employees hired prior to January 17, 2011) Effective January 1, 2012 DMEAST #14404512

More information

LUMP SUM BENEFIT APPLICATION

LUMP SUM BENEFIT APPLICATION NATIONAL ELECTRICAL ANNUITY PLAN NEAP LUMP SUM BENEFIT APPLICATION 2400 Research Boulevard, Suite 500, Rockville, MD 20850-3266 Telephone (301) 556-4300 Rev 01/12 National Electrical Annuity Plan Lump

More information

Survivor Benefit Rules for Defined Contribution Plans

Survivor Benefit Rules for Defined Contribution Plans Important Information Plan Administration and Operation August 1999* Survivor Benefit Rules for Defined Contribution Plans WHO'S AFFECTED Survivor benefit rules apply to all qualified defined contribution

More information

UTAH SMALL EMPLOYER HEALTH INSURANCE APPLICATION

UTAH SMALL EMPLOYER HEALTH INSURANCE APPLICATION UTAH SMALL EMPLOYER HEALTH INSURANCE APPLICATION OFFICE USE ONLY REASON FOR ENROLLMENT (mark all that apply) Policy / Group No. New Group Newborn Loss of Coverage Open Enrollment Court Order Marriage Effective

More information

New Contact for Benefits Administration

New Contact for Benefits Administration New Contact for Benefits Administration Effective July 24, 2014, Pacific Gas and Electric Company (PG&E) is introducing a new partner for benefits administration. The following print version of content

More information

Federal Retirement Benefits Checklist for Employee

Federal Retirement Benefits Checklist for Employee Federal Retirement Benefits Checklist for Employee Five Years before Retirement Attend a pre-retirement seminar at your agency, if available. Request a listing of all your verified civilian and military

More information

GROUP LIFE INSURANCE PROGRAM. Bentley University

GROUP LIFE INSURANCE PROGRAM. Bentley University GROUP LIFE INSURANCE PROGRAM Bentley University RELIANCE STANDARD LIFE INSURANCE COMPANY Home Office: Chicago, Illinois Administrative Office: Philadelphia, Pennsylvania CERTIFICATE OF INSURANCE We certify

More information

UNO-VEN Retirement Plan. Summary Plan Description As in effect January 1, 2012

UNO-VEN Retirement Plan. Summary Plan Description As in effect January 1, 2012 Summary Plan Description As in effect January 1, 2012 In the event of any conflict between this Summary Plan Description (SPD) and the actual text of the UNO-VEN Retirement Plan, the more detailed provisions

More information

Employee Compensation & Benefits Handbook

Employee Compensation & Benefits Handbook GROUP LIFE INSURANCE PLAN S ELIGIBILITY... 2 INTRODUCTION... 2 GROUP LIFE INSURANCE PLANS... 3 Full-time regular employees, Full-time regular employees represented by UWUA Locals 102, 118, 126, 140, 270,,

More information

403(b) Program Highlights

403(b) Program Highlights 403(b) Program Highlights As part of Henry Ford Health System s (HFHS) commitment to helping employees plan for their future financial wellness, HFHS offers a 403(b) program whereby employees can save

More information

Beneficiary is: " " Beneficiary is: " "

Beneficiary is:   Beneficiary is:  DOC010538120 Service address: RiverSource Life Insurance Co. of New York 70500 Ameriprise Financial Center Minneapolis, MN 55474 Life Insurance and Annuity Change of Beneficiary i New York Insurance Regulation

More information

Your Thrift Plan Handbook... THRIFT PLAN. Thrift Plan for Retirees Table of Contents. Keys to having made the most of your savings:

Your Thrift Plan Handbook... THRIFT PLAN. Thrift Plan for Retirees Table of Contents. Keys to having made the most of your savings: Preset Mixes Table Your Thrift Plan Handbook... Keys to having made the most of your savings: THRIFT PLAN Be sure to choose a payment option To make the most of your benefits, meet with a Deseret Mutual

More information

TSA HRAccess -- Survivor Benefits for Employee Death-in-Service

TSA HRAccess -- Survivor Benefits for Employee Death-in-Service The table below provides an overview of the benefits that may be payable or available to beneficiaries when a TSA employee dies. The table is an outline and should be read in conjunction with applicable

More information

Trustee-to-Trustee Transfer Out of the ICMA Retirement Corporation Packet

Trustee-to-Trustee Transfer Out of the ICMA Retirement Corporation Packet I C M A R E T I R E M E N T C O R P O R A T I O N Trustee-to-Trustee Transfer Out of the ICMA Retirement Corporation Packet Included in this packet: Trustee-to-Trustee Transfer Out of the ICMA Retirement

More information

Defined Benefit Retirement Plan. Summary Plan Description

Defined Benefit Retirement Plan. Summary Plan Description Defined Benefit Retirement Plan Summary Plan Description This booklet is not the Plan document, but only a summary of its main provisions and not every limitation or detail of the Plan is included. Every

More information

Retirement Facts 5. Survivor Benefits Under the Civil Service Retirement System

Retirement Facts 5. Survivor Benefits Under the Civil Service Retirement System Retirement Facts 5 Survivor Benefits Under the Civil Service Retirement System This is a non-technical summary of the laws and regulations on the subject. It should not be relied upon as a sole source

More information

Life Insurance Benefits

Life Insurance Benefits Understanding Your Life Insurance Benefits Table of Contents Welcome 1 Eligibility 2 Insurance Types 2 Employee Life Insurance 3 Basic Life Insurance 3 Optional Life Insurance 3 Insurance Benefits - Basic

More information

copyright 2007 employee Benefit Advisors, Inc.

copyright 2007 employee Benefit Advisors, Inc. FEDERAL EMPLOYEES GROUP LIFE INSURANCE-FEGLI Through the FEGLI program, the Federal Government provides you with an opportunity to participate in this group plan, which offers normally competitive rates

More information

Member Handbook. Teacher. MainePERS Benefits for Teachers. October 2014 mainepers.org

Member Handbook. Teacher. MainePERS Benefits for Teachers. October 2014 mainepers.org Teacher Member Handbook MainePERS Benefits for Teachers October 2014 mainepers.org MainePERS Benefits for Teachers A general summary of the benefits available to you as a MainePERS member A publication

More information

Additional Life Coverage Highlights Johnson County Community College

Additional Life Coverage Highlights Johnson County Community College Additional Life and Accidental Death and Dismemberment (AD&D) Insurance Standard Insurance Company has developed this document to provide you with information about the optional coverage you may select

More information

Retirement and Survivor Annuities for Former Spouses of Federal Employees

Retirement and Survivor Annuities for Former Spouses of Federal Employees Order Code RS22856 April 3, 2008 Summary Retirement and Survivor Annuities for Former Spouses of Federal Employees Patrick Purcell Specialist in Income Security Domestic Social Policy Division A former

More information

Applying for a Railroad Retirement Annuity

Applying for a Railroad Retirement Annuity Applying for a Railroad Retirement Annuity Railroad employees who are planning to retire should be aware of what steps to take and what documents are required when applying for an annuity from the Railroad

More information

Federal Employees Group Life Insurance Program

Federal Employees Group Life Insurance Program FEGLI Federal Employees Group Life Insurance Federal Employees Group Life Insurance Program Office of Personnel Management Retirement & Insurance Service RI 76-12 Previous editions are not usable Revised

More information

USE THIS FORM IF YOU ARE TRYING TO...

USE THIS FORM IF YOU ARE TRYING TO... USE THIS FORM IF YOU ARE TRYING TO... LIFE INSURANCE FORMS: If You Are Trying To: Use This Form Enrollments & Waivers For each new permanent and temporary employee, the authorized agent must complete the

More information

QUALIFIED PLAN DISTRIBUTION NOTICE

QUALIFIED PLAN DISTRIBUTION NOTICE QUALIFIED PLAN DISTRIBUTION NOTICE Introduction As a participant in your employer s Qualified Retirement Plan, you have accumulated a vested account balance. You may receive your vested account balance

More information

District of Columbia Teachers Retirement Plan Summary Plan Description 2007

District of Columbia Teachers Retirement Plan Summary Plan Description 2007 District of Columbia Teachers Retirement Plan Summary Plan Description 2007 This booklet is a Summary Plan Description of the benefits provided to you under the District of Columbia Teachers Retirement

More information

Summary Plan Description As In Effect January 1, 2013

Summary Plan Description As In Effect January 1, 2013 Employee And Dependent Life Insurance Provisions Of The CITGO Petroleum Corporation Medical, Dental, Vision, & Life Insurance Program For Hourly Employees Summary Plan Description As In Effect January

More information

New York State Nurses Association. Pension Plan. Summary Plan Description. July 2012. Summary Plan Description

New York State Nurses Association. Pension Plan. Summary Plan Description. July 2012. Summary Plan Description New York State Nurses Association N Y S N A Pension Plan Summary Plan Description July 2012 Summary Plan Description 1 2 NYSNA Pension Plan Summary Plan Description Table of Contents Introduction... 5

More information

GOLD CROSS SERVICES, INC. 401(K) RETIREMENT SAVINGS PLAN SUMMARY PLAN DESCRIPTION

GOLD CROSS SERVICES, INC. 401(K) RETIREMENT SAVINGS PLAN SUMMARY PLAN DESCRIPTION GOLD CROSS SERVICES, INC. 401(K) RETIREMENT SAVINGS PLAN SUMMARY PLAN DESCRIPTION TABLE OF CONTENTS INTRODUCTION TO YOUR PLAN What kind of Plan is this?... 1 What information does this Summary provide?...

More information

2014 CITY OF MILWAUKEE VOLUNTARY AND FAMILY LIFE INSURANCE INFORMATIONAL BROCHURE

2014 CITY OF MILWAUKEE VOLUNTARY AND FAMILY LIFE INSURANCE INFORMATIONAL BROCHURE 2014 2014 CITY OF MILWAUKEE VOLUNTARY AND FAMILY LIFE INSURANCE INFORMATIONAL BROCHURE Group Life Insurance Administrator c/o Employes Retirement System 789 North Water Street Suite 300 Milwaukee, Wisconsin

More information

LIFE INSURANCE SUMMARY

LIFE INSURANCE SUMMARY LIFE INSURANCE SUMMARY Your family can count on your paycheck to meet day-to-day expenses while you are actively at work, but it is important to plan for their financial security in the event of your death.

More information

Electrical. Pension. Trustees. Pension Plan No. 2

Electrical. Pension. Trustees. Pension Plan No. 2 Electrical Pension Trustees Pension Plan No. 2 ABOUT THIS BOOKLET To understand your benefits from the Electrical Contractors Association and Local Union 134, I.B.E.W. Joint Pension Trust of Chicago Pension

More information

LOCAL 282 - WELFARE, PENSION, ANNUITY & JOB TRAINING TRUST FUNDS

LOCAL 282 - WELFARE, PENSION, ANNUITY & JOB TRAINING TRUST FUNDS Participant's Name Participant's Address Social Security No. Telephone # BENEFICIARY DESIGNATION PART I. COMPLETE PART I. IF YOU ARE MARRIED I am married to Full Name of Spouse My spouse's date of birth

More information

Your Survivor Benefits

Your Survivor Benefits Your Survivor Benefits Contents Your Survivor Benefits... 3 About This SPD...3 Changes to the Plans...4 Participating in the Plans... 5 Eligibility...5 Enrolling When First Eligible...7 Changing Your Elections...9

More information

The law, language and calculations. PERA Benefits and Marriage Dissolution

The law, language and calculations. PERA Benefits and Marriage Dissolution The law, language and calculations PERA Benefits and Marriage Dissolution Public Employees Retirement Association of Minnesota September 2010 September 2010 If you have questions about marriage dissolution

More information

APPLICATION FOR SURVIVORS BENEFITS

APPLICATION FOR SURVIVORS BENEFITS APPLICATION FOR SURVIVORS BENEFITS ALL APPLICATIONS FOR SURVIVORS BENEFITS SHOULD BE SENT TO: UMWA Health and Retirement Funds 2121 K Street, NW Suite 350 Washington, DC 20037-1879 1-800-291-1425 Fax:

More information

TSP Annuities. Thrift Savings Plan. March 2006. Federal Retirement Thrift Investment Board

TSP Annuities. Thrift Savings Plan. March 2006. Federal Retirement Thrift Investment Board Announcement Effective April 1, 2006, a new annuity contract was put into place for TSP annuities. Because the annuity and interest adjustment factors have changed, the old tables previously contained

More information

APPLICATION FOR HEALTH BENEFITS

APPLICATION FOR HEALTH BENEFITS APPLICATION FOR HEALTH BENEFITS ALL APPLICATIONS FOR HEALTH BENEFITS SHOULD BE SENT TO: UMWA Health and Retirement Funds 2121 K Street, NW Suite 350 Washington, DC 20037-1879 1-800-291-1425 Fax: 202-521-2353

More information

Certifies that it has issued the group insurance policy shown below and, subject to the terms of that policy you, the Insured, are eligible.

Certifies that it has issued the group insurance policy shown below and, subject to the terms of that policy you, the Insured, are eligible. COMPANION LIFE INSURANCE COMPANY 7909 PARKLANE ROAD, SUITE 200, COLUMBIA, SC 29223-5666 PO Box 100102, Columbia, SC 29202-3102 (803) 735-1251 (Herein called Companion Life) Certifies that it has issued

More information

State of Louisiana All Employees

State of Louisiana All Employees State of Louisiana All Employees Basic Term Life Insurance Basic plus Supplemental Term Life Insurance Accidental Death and Dismemberment Insurance Dependent Term Life Insurance The Prudential Insurance

More information

DEATH BENEFITS. Department of Employee Trust Funds P. O. Box 7931 Madison, WI 53707-7931 etf.wi.gov ET-6101 (REV 5/13)

DEATH BENEFITS. Department of Employee Trust Funds P. O. Box 7931 Madison, WI 53707-7931 etf.wi.gov ET-6101 (REV 5/13) DEATH BENEFITS Department of Employee Trust Funds P. O. Box 7931 Madison, WI 53707-7931 etf.wi.gov ET-6101 (REV 5/13) 4 The Department of Employee Trust Funds (ETF) administers three programs that provide

More information

Anne Arundel County, Maryland Group Life Certificate of Insurance Class 3 Retirees Group Policy Number 646904

Anne Arundel County, Maryland Group Life Certificate of Insurance Class 3 Retirees Group Policy Number 646904 Anne Arundel County, Maryland Group Life Certificate of Insurance Class 3 Retirees Group Policy Number 646904 STANDARD INSURANCE COMPANY A Stock Life Insurance Company 900 SW Fifth Avenue Portland, Oregon

More information

Application Retirement Withdrawals

Application Retirement Withdrawals Dear Participant: Application Retirement Withdrawals Enclosed is an application packet for a Retirement distribution from the Lake County, Illinois Plasterers & Cement Masons Retirement Savings Plan. Please

More information

National Electrical Annuity Plan Lump Sum Benefit Application

National Electrical Annuity Plan Lump Sum Benefit Application National Electrical Annuity Plan Lump Sum Benefit Application To avoid delays in the processing and payment of your benefit, please follow these instructions carefully and completely. 1. Print all information

More information

Benefits Handbook Date July 1, 2009. Basic Life Insurance Plan MMC

Benefits Handbook Date July 1, 2009. Basic Life Insurance Plan MMC Date July 1, 2009 MMC This is a Company-paid group-term life insurance plan that helps you provide for your family s financial security. The Plan pays money to someone you name as your BENEFICIARY if you

More information

CSRS Spouse Benefits - Death of an Employee FERS i Chapter 70

CSRS Spouse Benefits - Death of an Employee FERS i Chapter 70 CSRS Spouse Benefits - Death of an Employee FERS i Table of Contents Subchapter 70A CSRS Part 70A1 General Information Section 70A1.1-1 Overview... 1 A. Introduction... 1 B. Topics Covered... 1 C. Organization

More information

Summary Plan Description NEA Complimentary Life Insurance (DUES-TAB) (Revised September 2008)

Summary Plan Description NEA Complimentary Life Insurance (DUES-TAB) (Revised September 2008) NEA Members Insurance Trust The National Education Association sponsors the NEA Members Insurance Trust Summary Plan Description NEA Complimentary Life Insurance (DUES-TAB) This is to certify that, as

More information

Community College System of New Hampshire Basic Life, Additional Life, Spouse and Child Life, and Accidental Death & Dismemberment

Community College System of New Hampshire Basic Life, Additional Life, Spouse and Child Life, and Accidental Death & Dismemberment Benefits at a Glance for Community College System of New Hampshire Group Policy # 152335 Effective Date January 1, 2011 (Date of last revision: 10/22/13) I. Basic Life and Accidental Death and Dismemberment

More information

Summary of Benefits Checklist Upon the Death of a Federal Employee FEDERAL EMPLOYEES' GROUP LIFE INSURANCE (FEGLI)

Summary of Benefits Checklist Upon the Death of a Federal Employee FEDERAL EMPLOYEES' GROUP LIFE INSURANCE (FEGLI) ATTACHMENT 2 Summary of Benefits Checklist Upon the Death of a Federal Employee The benefits based on the death of a Federal employee applicable to your claim are checked below. Only the items checked

More information

Members Guide to: Survivor Benefits

Members Guide to: Survivor Benefits Members Guide to: Survivor Benefits Whether a police officer or firefighter dies before or after retirement, their survivors may be eligible to receive survivor benefits from OP&F. These benefits are generally

More information

Application for Retirement Allowance Public Employees' Retirement System Teachers' Pension and Annuity Fund

Application for Retirement Allowance Public Employees' Retirement System Teachers' Pension and Annuity Fund Application for Retirement Allowance Public Employees' Retirement System Teachers' Pension and Annuity Fund State of New Jersey Division of Pensions and Benefits PO Box 295 Trenton, New Jersey 08625-0295

More information

Additional Life Coverage Highlights Kent State University

Additional Life Coverage Highlights Kent State University Additional Life Coverage Highlights Additional Life Insurance will provide Basic Life coverage from Standard Insurance Company. If you are enrolled in Basic Life, you may also apply for Additional Life

More information

Philadelphia University Defined Contribution Retirement Plan. Retirement Annuity (RA) Plan. Summary Plan Description

Philadelphia University Defined Contribution Retirement Plan. Retirement Annuity (RA) Plan. Summary Plan Description Philadelphia University Defined Contribution Retirement Plan Retirement Annuity (RA) Plan Summary Plan Description Amended and Restated July 1, 2014 Table of Contents Part I: Information About The Plan.............................................

More information

What you need to know about your CalPERS. State Safety Benefits

What you need to know about your CalPERS. State Safety Benefits YO U R B E N E F I T S YO U R F U T U R E What you need to know about your CalPERS State Safety Benefits C O N T E N T S Introduction............................................. 2 Your Retirement Benefits.................................

More information

GROUP LIFE INSURANCE PROGRAM. District School Board of Collier County, FL

GROUP LIFE INSURANCE PROGRAM. District School Board of Collier County, FL GROUP LIFE INSURANCE PROGRAM District School Board of Collier County, FL RELIANCE STANDARD LIFE INSURANCE COMPANY Home Office: Chicago, Illinois Administrative Office: Philadelphia, Pennsylvania CERTIFICATE

More information

THE UNITED STATES LIFE Insurance Company In the City of New York

THE UNITED STATES LIFE Insurance Company In the City of New York THE UNITED STATES LIFE Insurance Company In the City of New York (Called United States Life) United States Life will pay the benefits of this policy subject to its provisions. This page and the pages that

More information

Employer Instructions for Filing Group Life Insurance Claims. 1. Detach this page and complete the Employer s Statement on the following page.

Employer Instructions for Filing Group Life Insurance Claims. 1. Detach this page and complete the Employer s Statement on the following page. Group Life Claims Employer Instructions for Filing Group Life Insurance Claims 1. Detach this page and complete the Employer s Statement on the following page. 2. Give the beneficiary the remaining pages

More information

Understanding The Benefits

Understanding The Benefits Understanding The Benefits 2015 Contacting Social Security Visit our website At our website, www.socialsecurity.gov, you can: Create a my Social Security account to review your Social Security Statement,

More information

BENEFIT DISTRIBUTION REQUEST FORM (For Distributions due to Termination, Death, Disability, and Retirement) Date: EIN: 16-6184130 TIN: 611256314

BENEFIT DISTRIBUTION REQUEST FORM (For Distributions due to Termination, Death, Disability, and Retirement) Date: EIN: 16-6184130 TIN: 611256314 BENEFIT DISTRIBUTION REQUEST FORM (For Distributions due to Termination, Death, Disability, and Retirement) : EIN: 16-6184130 TIN: 611256314 Plan Name: UFCW LOCAL ONE 401(K) SAVINGS PLAN Participant Data

More information

OPERATING ENGINEERS TRUST FUNDS

OPERATING ENGINEERS TRUST FUNDS OPERATING ENGINEERS TRUST FUNDS 1640 South Loop Road Alameda, CA 94502 P.O. Box 23190 Oakland, CA 94623-0190 Telephone (510) 433-4422 or (510) 271-0222 or Claims Department (800) 251-5013 Pension Department

More information

2014 Retirement Planning Checklists

2014 Retirement Planning Checklists 2014 Retirement Planning Checklists www.feddesk.com FREE Federal & Military Guides Since 2002 2014 Retirement Planning Checklists Published by Feddesk.com FREE Federal and Military Guides Since 2002 www.feddesk.com

More information

New Hanover Regional Medical Center 403(b) and 457(b) Retirement Savings Plans

New Hanover Regional Medical Center 403(b) and 457(b) Retirement Savings Plans New Hanover Regional Medical Center 403(b) and 457(b) Retirement Savings Plans Mutual Fund Safe Harbor Request For Hardship Withdrawal Group ID# 45944003 Group ID# 45944002 1. CLIENT INFORMATION Name:

More information