Plan Summary CINTAS CORPORATION

Transcription

1 CINTAS CORPORATION Plan Summary Optional Term Life, Spouse Dependent Term Life, Child Dependent Term Life, Optional Accidental Death & Dismemberment, Long Term Disability and Short Term Disability Full Time Active Salaried Partners All coverages are issued by the Prudential Insurance Company of America. Optional Term Life Insurance - 100% Partner Paid Purchase coverage for 1.0 to 10.0 times your covered annnual earnings to a maximum of $2,000,000. New Hires: Get the lesser of 1.0 times your covered annual earnings not to exceed $500,000 - no medical questions asked - when enrolling when first eligible in Optional Group Term Life. Current Participants: Your current coverage amount will be continued. During annual enrollment periods, you may increase your current coverage amount by 1 times your covered annual earnings, up to a total coverage amount of $500,000, without evidence of insurability to Prudential. Outside of annual enrollment periods, evidence of insurability is required for all increases in coverage amounts. Current Partners who were denied coverage in the past, Current Partners who waived coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. If terminally ill, you can get a partial payment of your group term life insurance benefit. You can use this payment as you see fit. In the event of your death, your beneficiary will receive a benefit payout which has been reduced by the amount you received. Coverage will be reduced as you age - by 50% at age 70. Upon termination of employment, you may continue at a certain level of your coverage, without having to provide evidence of good health. ECEd EXP

2 Spouse / Domestic Partner Optional Dependent Term Life Insurance - 100% Partner Paid Purchase coverage for your spouse in increments of $10,000 up to a maximum of $100,000, not to exceed 100% of your Optional Term LIfe coverage amount. New Hires: Get up to $20,000 for your spouse - no medical questions asked - when enrolling when first eligible in Optional Term Life coverage amount. Current Participants: Your current coverage amount will be continued. During annual enrollment periods, you may increase your current coverage amount by 1 times your covered annual earnings, up to a total coverage amount of $500,000, without evidence of insurability to Prudential. Outside of annual enrollment periods, evidence of insurability is required for all increases in coverage amounts. Current Partners who were denied coverage in the past, Current Partners who waived coverage in the past or Late Entrants (did not enroll when first eligible): Evidence of insurability satisfactory to The Prudential Insurance Company of America is required for all coverage amounts. Coverage will be reduced as you age - by 50% at age 70. Upon termination of employment, your spouse (if eligible to port) may choose to continue a coverage amount equal to or lower than your current benefit amount. Coverage amounts for you and your spouse will be subject to a maximum of five times your annual earnings or $1 million, whichever is less. Child Optional Term Optional Dependent Term Life Insurance - 100% Partner Paid Purchase coverage for $5,000 or $10,000, not to exceed 100% of your Optional Te amount. There are no health requirements for this coverage. Coverage begins from 14 days, and continues to age 26. Upon termination of employment, you (if eligible to port) may choose to continue a depenent child coverage amount equal to or lower than your current benefit amount. Employee Optional Accidental Death & Dismemberment Insurance - 100% Partner Paid Purchase coverage for 1.0 to 10.0 times your covered annual earnings to a maximum of $2,000,000. Coverage will be reduced as you age - by 50% at age 70. Spouse / Domestic Partner Optional Accidental Death & Dismemberment Insurance - 100% Partner Paid Purchase coverage for your spouse in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional AD&D coverage amount. Coverage will be reduced as you age - by 50% at age 70. Child Optional Accidental Death & Dismemberment Insurance - 100% Partner Paid Purchase coverage for $5,000 or $10,000, not to exceed 100% of your Optional AD&D coverage amount.

3 Longer Term Disability Insurance - 100% Partner Paid Option 1: Your monthly Long Term Disability benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $5,000, less deductible sources of income. No medical questions asked - if enrolling when first eligible. The minimum monthly benefit is the greater of $100 or 10% of your gross monthly benefit. Deductible sources of income may include benefits from statutory plans, Social Security to you and your dependents, workers compensation, unemployment income and other income. Option 2: Your monthly Long Term Disability benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $10,000, less deductible sources of income. No medical questions asked - if enrolling when first eligible. The minimum monthly benefit is the greater of $100 or 10% of your gross monthly benefit. Deductible sources of income may include benefits from statutory plans, Social Security to you and your dependents, workers compensation, unemployment income and other income. If you meet the definition of disability, your benefits will begin 90 days following an accidental injury or sickness. The benefit duration is up to your normal retirement age under the Social Security Act. However, if you become disabled at or after age 65 benefits are payable according to an age-based schedule. Refer to the Booklet-Certificate for details. You are considered disabled when, because of injury or sickness, you are under the regular care of a doctor, you are unable to perform the material and substantial duties of your regular occupation and your disability results in a loss of income of at least 20%. After receiving benefits for 24 months, you are considered disabled when, due to the same sickness or injury, you are unable to perform the material and substantial duties of any gainful occupation for which you are reasonably fitted by education, training or experience, and disability results in a loss of income of a specified percentage determined by your plan. Disabilities due to mental illness are limited to 24 months of benefits during your lifetime. Examples of mental illness include schizophrenia, depression, manic depressive or bipolar illness, anxiety, somatization, substance related disorders (including drug and alcohol abuse), and/or adjustment disorders. Disabilities which are primarily based on self-reported symptoms are limited to 24 months of benefits during your lifetime. Examples of self-reported symptoms include headache, pain, fatigue, stiffness, soreness, ringing in the ears, dizziness, numbness and loss of energy. Disabilities due to mental illness and disabilities which are primarily based on self-reported symptoms have a combined limited pay period during your lifetime. LTD benefits will not be paid for a disability that begins during the first 12 months of coverage and due to a pre-existing condition. A pre-existing condition is an injury or sickness for which you received medical treatment, consultation, diagnostic measures, prescribed drugs or medicines, or for which you followed treatment recommendations during the 12 months prior to your effective date of coverage. During the first 12 months of part-time work while disabled, you can receive full benefits as long as your combined income and disability benefits do not exceed your monthly pre-disability earnings. If you die while collecting disability benefits, a lump sum payment may be paid to your eligible survivors. You are not covered for a disability caused by war or any act of war, declared or undeclared, an intentionally self-inflicted injury, active participation in a riot, and commission of a crime for which you have been convicted. Benefits are not payable for any period of incarceration as a result of a conviction.. Benefits, exclusions and provisions may vary by state. Refer to the plan booklet for details. For your coverage to become effective, you must be actively at work on the effective date of the plan. If you apply for an amount that requires satisfactory evidence of insurability to The Prudential Insurance Company of America, you must be actively at work on the date of approval for the amount requiring satisfactory evidence of insurability.

4 *Accelerated Death Benefit option is a feature that is made available to group life insurance participants. It is not health, nursing home, or long-term care insurance benefit and is not designed to eliminate the need for those types of insurance coverage. The death benefit is reduced by the amount of the accelerated death benefit paid. There is no administrative fee to accelerate benefits. Receipt of accelerated death benefits may affect eligibility for public assistance and may be taxable. The federal income tax treatment of payments made under this rider depends upon whether the insured is the recipient of the benefits and is considered "terminally ill" or "chronically ill." You may wish to seek professional tax advice before exercising this option. + This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. IMPORTANT NOTICE - THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS. ++ This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. All benefit features may not be available in all states. Group Term Life is issued by The Prudential Insurance Company of America, a New Jersey Company, 751 Broad Street, Newark, NJ Life Claims: This brochure is intended to be a summary of your benefits and does not include all plan provisions, exclusions and limitations. Please refer to the Booklet-Certificate, which is made a part of the Group Contract, for all plan details, including any exclusions, limitations and restrictions which may apply. If there is a discrepancy between this document and the Booklet-Certificate/Group Contract issued by The Prudential Insurance Company of America, the terms of the Group Contract will govern. Contract provisions may vary by state. Contract Series: California COA #1179 NAIC # Prudential Financial, Inc. and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide.

5 CINTAS CORPORATION Rate Sheet Full Time Active Salaried Partners All coverages are issued by the Prudential Insurance Company of America. Effective Date: 01/01/2016 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds. How much does life insurance cost? The following steps will show you how to calculate your bi-weekly cost of insurance. Step 1 Enter the amount of Employee coverage you wish to purchase. $ Partner Step 2 Divide the coverage amounts by 1,000. $ Step 3 Step 4 Multiply the dollar amounts in Step 2 by the cost of coverage per $1,000 of coverage, according to your age, that you ll find in the chart that follows. This gives you the monthly cost of insurance. To calculate your paycheck deduction, multiply the monthly cost in Step 3 by 12 to get the annual cost and then divide the annual cost by 26 to get your bi-weekly cost. TOTAL COST FOR PARTNER $ $ $ The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here

6 Cost of Optional Term Life Insurance for You Coverage is available for 1.0 to 10.0 times your covered annual earnings, not to exceed $2,000,000. Refer to the Optional Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule. Partner's Age Partner Non Smoker Rate Partner Smoker Rate < 25 $0.034 $ $0.040 $ $0.053 $ $0.060 $ $0.067 $ $0.101 $ $0.155 $ $0.290 $ $0.445 $ $0.855 $ $1.388 $ $1.388 $1.756 A 35 year-old employee elects Example $60,000 of Optional Term Life for themselves Employee Monthly Cost $3.60 ($60,000 / 1,000 x $0.060) Spouse / Domestic Partner - Optional Dependent Term Life Bi-Weekly Non-Smoker Cost per Coverage Amount Coverage is available in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional Term Life coverage amount. Refer to the Optional Dependent Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule. Age $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 < 25 $0.16 $0.31 $0.47 $0.63 $0.78 $0.94 $1.10 $1.26 $1.41 $ $0.18 $0.37 $0.55 $0.74 $0.92 $1.11 $1.29 $1.48 $1.66 $ $0.24 $0.49 $0.73 $0.98 $1.22 $1.47 $1.71 $1.96 $2.20 $ $0.28 $0.55 $0.83 $1.11 $1.38 $1.66 $1.94 $2.22 $2.49 $ $0.31 $0.62 $0.93 $1.24 $1.55 $1.86 $2.16 $2.47 $2.78 $ $0.47 $0.93 $1.40 $1.86 $2.33 $2.80 $3.26 $3.73 $4.20 $ $0.72 $1.43 $2.15 $2.86 $3.58 $4.29 $5.01 $5.72 $6.44 $ $1.34 $2.68 $4.02 $5.35 $6.69 $8.03 $9.37 $10.71 $12.05 $ $2.05 $4.11 $6.16 $8.22 $10.27 $12.32 $14.38 $16.43 $18.48 $ $3.95 $7.89 $11.84 $15.78 $19.73 $23.68 $27.62 $31.57 $35.52 $ $6.41 $12.81 $19.22 $25.62 $32.03 $38.44 $44.84 $51.25 $57.66 $ $6.41 $12.81 $19.22 $25.62 $32.03 $38.44 $44.84 $51.25 $57.66 $64.06 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds. Spouse / Domestic Partner rate is based on Spouse / Domestic Partner's age.

7 Spouse / Domestic Partner - Optional Dependent Term Life Bi-Weekly Smoker Cost per Coverage Amount Coverage is available in increments of $10,000 to a maximum of $100,000, not to exceed 100% of your Optional Term Life coverage amount. Refer to the Optional Dependent Term Life section for evidence of insurability details. Initial rates based on age as of effective date of your coverage. Rates will change based on the following age schedule. Age $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 < 25 $0.19 $0.38 $0.57 $0.76 $0.95 $1.14 $1.32 $1.51 $1.70 $ $0.22 $0.43 $0.65 $0.87 $1.08 $1.30 $1.52 $1.74 $1.95 $ $0.29 $0.57 $0.86 $1.14 $1.43 $1.72 $2.00 $2.29 $2.58 $ $0.35 $0.70 $1.05 $1.40 $1.75 $2.10 $2.46 $2.81 $3.16 $ $0.38 $0.77 $1.15 $1.53 $1.92 $2.30 $2.68 $3.06 $3.45 $ $0.58 $1.15 $1.73 $2.31 $2.88 $3.46 $4.04 $4.62 $5.19 $ $0.90 $1.81 $2.71 $3.62 $4.52 $5.43 $6.33 $7.24 $8.14 $ $1.69 $3.38 $5.07 $6.76 $8.45 $10.14 $11.82 $13.51 $15.20 $ $2.59 $5.19 $7.78 $10.38 $12.97 $15.56 $18.16 $20.75 $23.34 $ $4.99 $9.99 $14.98 $19.98 $24.97 $29.96 $34.96 $39.95 $44.94 $ $8.10 $16.21 $24.31 $32.42 $40.52 $48.63 $56.73 $64.84 $72.94 $ $8.10 $16.21 $24.31 $32.42 $40.52 $48.63 $56.73 $64.84 $72.94 $81.05 Children - Optional Dependent Term Life Bi-Weekly Cost per Coverage Amount One premium rate covers all eligible children $5,000 $10,000 $0.18 $0.36 Rates may change if plan experience requires a change for all insureds. "How much does this Optional AD&D insurance cost?" Insured Optional AD&D* Monthly Cost of Insurance (rates per $1,000 of Coverage) Partner $0.025 * This is optional coverage and the entire cost of coverage is partner paid. Worksheet for Optional AD&D (Partner) Follow this worksheet to determine the cost of insurance for you. 1. Select the desired amount of coverage $ 2. Locate the monthly rate The monthly rate per $1,000 is $ 3. Divide the selected amount of coverage by $1,000. Then multiply the result by the monthly rate to get the monthly cost of insurance. 4. Multiply the monthly cost of insurance by 12 and divide by 26 to get your bi-weekly cost. $ divided by $1,000 is $ multiplied by $ = $ Total Monthly Cost of Insurance = $ multiplied by 12 = $ $ divided by (26) = $ Total (bi-weekly) cost of insurance = $

8 Spouse/Domestic Partner - Optional Accidental Death & Dismemberment Bi-Weekly Cost per Coverage Amount Coverage is available in increments of $10,000 to a maximum of $100,000. Refer to the Optional AD&D section for evidence of insurability details. $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $0.12 $0.23 $0.35 $0.46 $0.58 $0.69 $0.81 $0.92 $1.04 $1.15 Children - Optional Accidental Death & Dismemberment Bi-Weekly Cost per Coverage Amount One premium rate covers all eligible children Coverage is available for $5,000 or $10,000. $5,000 $10,000 $0.06 $0.12 "How much does this Long Term Disability Insurance cost?" The following steps will show you how to calculate your cost of insurance. Partner's Age Cost of Long Term Disability Option 1 Partner's Rate 0-29 $ $ $ $ $ $ $ $0.970 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds. Partner's Age Cost of Long Term Disability Option 2 Partner's Rate 0-29 $ $ $ $ $ $ $ $1.140 Rates may change as the insured enters a higher age category. Also, rates may change if plan experience requires a change for all insureds.

9 Step 1 Indicate your monthly earnings. $ Partner Step 2 Step 3 If the amount in Step 1 is greater than $16,667, indicate $16,667. Otherwise, indicate the amount from Step 1. Multiply the amount in Step 2 by the rate for your age and divide by 100 to obtain your total LTD monthly cost. Step 4 Multiply the amount in Step 3 by 12 and divide by 26 to get your bi-weekly cost. $ $ $ The cost of insurance will depend upon having a specific percentage of all eligible employees enrolling in the plans. If this enrollment level is not achieved, the cost of these coverages may change from the rates noted here. This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York Department of Financial Services. This policy provides ACCIDENT insurance only. It does NOT provide basic hospital, basic medical, or major medical insurance as defined by the New York Department of Financial Services. IMPORTANT NOTICE THIS POLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS North Carolina Residents: THIS IS NOT A MEDICARE SUPPLEMENT PLAN. If you are eligible for Medicare, review the Guide to Health Insurance for People with Medicare, which is available from the company. Optional Term Life, Dependent Term Life, Long Term Disability, Short Term Disability, Accidental Death & Dismemberment Insurance coverages are issued by The Prudential Insurance Company of America, a Prudential Financial company, 751 Broad Street, Newark, NJ The Booklet Certificate contains all details, including any policy exclusions, limitations, and restrictions, which may apply. Contract Series: Prudential Financial, Inc. and its related entities. Prudential, the Prudential logo, and the Rock symbol are service marks of Prudential Financial, Inc. and its related entities, registered in many jurisdictions worldwide