HOW TO ADMINISTER YOUR NCPERS GROUP LIFE INSURANCE PROGRAM

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1 HOW TO ADMINISTER YOUR NCPERS GROUP LIFE INSURANCE PROGRAM ADMINISTRATOR NCPERS Group Life Administrator HealthSmart Benefit Solutions, Inc E Dry Creek Rd, Suite 200 Englewood, CO ncpers@healthsmart.com NCPERS is a non-profit organization organized to provide education and support of public member retirement systems. NCPERS has no role in the administration of the life insurance program and the benefits are guaranteed solely by the insurance carrier. NCPERS is compensated solely for the use of its name, service marks and mailing lists.

2 NCPERS GROUP LIFE INSURANCE PROGRAM Table of Contents PAGE Section I Introduction 2 Section II Definitions 6 Section III Effective Date of Coverage 7 Section IV Processing New Enrollments 7 Section V Billing Statements/Premium Payments 8 Section VI Past due accounts/member Payments 8 Section VII Terminations 8 - Processing Terminations 9 - Transfer of Members 9 Section VIII Processing Retirees 9 Section IX Reporting Changes/Beneficiaries 10 Section X Waiver of Premium 10 Section XI Conversion Privilege 10 Section XII How to File A Claim Form for Death Benefits 11 Section XIII How to File for a Living Benefit Option 11 Section XIV Forms and Supplies 11 Appendix A Sample Beneficiary Designations 12 Appendix B Sample Billing Statement 13 Appendix C Sample Letter for Retirees 14 Appendix D Conversion Form 15 Appendix E Sample Letter for New Enrollees 16

3 NCPERS GROUP LIFE INSURANCE PROGRAM I. Introduction Your public retirement system has made available a voluntary group life insurance plan for members of the Public Employees Retirement System. The program is national in scope, and is available through the retirement system s affiliation with The National Conference on Public employees Retirement Systems (NCPERS). General Explanation: The NCPERS adopted this program in After formal bidding and negotiations, The Prudential Financial was selected to underwrite the plan. The program is in force in several states and offers many features not normally found in group insurance plans. Nationally, approximately 88,000 active and retired members of Public Employees Retirement Systems are insured, and over $10 million has been paid in benefits to Members or their beneficiaries by this plan. The plan is designed to supplement other coverage, not to replace them, and it is completely voluntary, both on the part of the employer and the member. Administrator: HealthSmart Benefit Solutions, Inc. (HealthSmart) administers this plan and can answer questions on the benefits, administration and claims. PREMIUM STATEMENTS, CHECKS, QUESTIONS & ADMINISTRATIVE ITEMS SHOULD BE SENT TO HEALTHSMART--NOT TO THE RETIREMENT SYSTEM. Since HealthSmart maintains all records regarding this plan, anything sent to your retirement system will simply delay processing of the request. Monthly Billing Statements and checks should be sent in the envelope provided or to the address on your billing statement. Please reference your unit number on your check to ensure accurate posting of your payments. For questions regarding administration, claims (including beneficiary names), the monthly Billing Statement, or for premium remittances, call This is the NCPERS Group Life Insurance Administration direct line. You may also contact us through our address at Ncpers@healthsmart.com. The premiums are collected by the participating Employer Unit though payroll deduction and remitted to HealthSmart along with the monthly Billing Statement. Premium not received through payroll deduction will be direct billed to the member. 2

4 Plan Features: THE HIGHLIGHTS OF THE PLAN ARE: A. Participation is completely voluntary. B. No minimum number or percentage of eligible members is required to participate. C. No evidence of insurability or other proof of good health is required if enrollment is during an open enrollment period or for newly hired, eligible members enrolling within 90 days of hire. The Member only needs to be actively at work for the insurance to become effective. D. The premium remains the same per month, regardless of age ($9.00 or $12 for prior plans.) E. Coverage is usually effective on the first day of the calendar month following the first payroll deduction in which a full premium is received. F. Coverage may be continued into retirement provided the member was covered as an active member at time of retirement and the member will be receiving a retirement check. The monthly premium will be deducted by your retirement system from the member s retirement check. Members are direct billed for any premiums not deducted from their pension checks. G. Eligible dependents spouse, domestic partner ($16 plan only), and child(ren) 14 days to 21 years of age are covered at no additional cost. (See Page 6.) Domestic partners may not be recognized in all states and may not be eligible. H. Children are covered to age 21 as long as they are dependent upon the member for support and maintenance. I. A husband and wife who are both members of the retirement system and who are both enrolled have separate policies. The member and dependent benefits are payable under both policies. J. In the event of terminal illness, members may elect to receive up to 50% of their Group Term Life Insurance benefits in advance through the living benefit option, provided they have been covered under the plan for at least one year. When the member dies, the balance of the insurance will be paid to the beneficiary. 3

5 Schedule of Benefits for the $16 Contribution Plan: (contact HealthSmart for programs other than the $16 Contribution Plan) Schedule of Benefits - $16 Monthly Contribution (Covers You, Your Spouse or Domestic Partner of Your Children) Member s Age at Time of Claim Group Term Life Insurance 1 MEMBER DEPENDENT _ Group Accidental Death & Group Term Life Insurance Dismemberment Total Benefit for Spouse/Domestic Insurance Accidental Death Partner Child(ren)* Less than 25 $225,000 $100,000 $325,000 $20,000 $4, $170,000 $100,000 $270,000 $20,000 (Age 14 days, $100,000 $100,000 $200,000 $20,000 but less than $65,000 $100,000 $165,000 $18, years) $40,000 $100,000 $140,000 $15, $30,000 $100,000 $130,000 $10, $18,000 $100,000 $118,000 $7, $12,000 $100,000 $112,000 $5, and over $7,500 $7,500 $15,000 $4,000 Coverage: The coverage for members and dependents offered through this program is called "decreasing term" insurance. This means that the amount of the insurance paid is based on the member s age at the time of the claim. As the member grows older, the amount of coverage decreases, but the premium remains the same. A. Member Benefit 1. In the event of the member s death from any cause, the full amount of life insurance is paid to the member s beneficiary. 2. The beneficiary of the member s life insurance is named by the member. This may be changed at any time upon completion of the appropriate form supplied by HealthSmart. 3. Settlement Options available to Beneficiary: a. Benefit checks under $5,000 are paid to the beneficiary for the full amount in a lump sum. HealthSmart mails the check via certified returned receipt. b. Benefit checks over $5,000 are paid utilizing a Prudential Alliance Account. The Alliance Account is a personalized interest-bearing account for beneficiaries of group life insurance. Once paid, Prudential will open an interest bearing account in the beneficiary s name the next business day. Beneficiaries receive an Alliance Starter Kit and an initial supply of personal checks. 4

6 4. Waiver of Premium. (See Page 10 for details.) If a member is less than 60 years old and becomes totally disabled for at least nine months, the member s insurance may be continued without further premiums, as long as the member furnishes annual proof of the continued total disability satisfactory to Prudential. The dependent spouse and child(ren) life insurance coverage is discontinued (see conversion privilege under the plan). 5. Conversion Privilege. (See Page 10 for details.) (a) If a member terminates employment and is no longer eligible to participate, the insurance coverage can be continued by converting to an individual policy through Prudential. Application for this conversion must be made within 31 days from the date of termination of the insurance and may be for any policy then being offered by Prudential. The policy will be issued by Prudential regardless of the physical condition of the applicant. (b) Upon conversion, the group rate will no longer apply. The premium paid will be the same rate as is currently being paid for any individual policy of equal value offered by the Prudential Life Insurance Company of America. No medical examination or questions will be required to convert to the individual policy. (c) If a member should die within the 31-day conversion period, the current amount of group life insurance coverage will be paid to the beneficiary. 6. Accidental Death and Dismemberment. (a) In the event of the accidental death of an insured member, or in the event of the accidental loss of a hand, foot, or the sight of an eye, benefits may be payable. The total payment for any one accident may not be more than the full amount of the accidental death benefit. The loss must occur within 90 days from the date of the accident. (b) Full AD&D Benefits are Payable for Accidental Loss of: One hand and one foot One hand and the sight of an eye One foot and the sight of an eye Both hands Both feet Sight of both eyes (c) One-half AD&D Benefits are Payable for Accidental Loss of: One hand One foot Sight of one eye (d) Benefits are payable for accidents occurring on or off the job. 5

7 7. Accidental Death & Dismemberment Exclusions: This coverage does not include any loss resulting from: "War, suicide or attempted suicide; any bacterial or viral infection (unless the infection was the result of an accidental cut or wound), bodily or mental infirmity or disease, or medical or surgical treatment thereof, or by aircraft travel if you have any duties aboard the aircraft or if you are giving or receiving training for such duties." B. Dependents Group Life Insurance 1. In the event of the death of an insured member s dependent, the amount of the dependent's insurance will be paid to the member in a lump sum or with a Prudential Alliance Account. The amounts of the dependent's insurance are shown in the Schedule of Insurance. The benefit is based on the insured member s age at time of claim. 2. Eligible Dependents The eligible dependents of an insured member are the member s spouse, domestic partner and unmarried children who are at least 14 days but less than 21 years of age. Dependent children are defined as natural born children, step-children, legally adopted children or foster children. The child(ren) must be dependent upon the insured member for support and maintenance. Dependents in military service are not eligible. 3. Effective Date of Coverage The dependent's insurance coverage is effective the same date as the newly enrolled Member s coverage. However, if a dependent is confined in an institution or confined at home for medical treatment, the dependent's insurance will become effective when the dependent is given a release by the doctor from such confinement. II. Definitions Definitions of regularly used terms in this manual are: Eligible Members: All active non-retired members who are contributing members of MN Public Employees Retirement Association. Eligible Dependents: Spouse, domestic partner and unmarried dependent children who are at least 14 days but less than 21 years of age and dependent upon the member for support and maintenance. Eligible Retired Members: A Member who has been insured as an actively at work Member and has had at least one month's premium deducted as an actively at work Member AND upon retirement will be receiving a retirement system pension check. PERA Authorized Agent: The person authorized to transact retirement system administrative functions at the employer unit. Participating Employer Unit: Retirement system employers who have agreed to make the necessary payroll deductions and provide the routine administration. Waiver of Premium: If the member is less than 60 years old and becomes totally disabled for at least nine months, the member s insurance may be continued without further premiums, as long as the member furnishes annual proof of the continued total disability satisfactory to Prudential. The dependent spouse and child(ren) life insurance coverage is discontinued (see conversion privilege under the plan). 6

8 III. Effective Date Of Coverage The date when member and dependent coverage begins is listed below. Premiums are collected in the month prior to the Premium Month; i.e., moneys collected during a January pay period would be for a February Premium month with an effective date of February 1. Member: Coverage begins the first of the month following the date the member becomes an eligible member, provided that the member has completed an enrollment card or form and payroll deduction for the required contribution has begun in the previous month. See the following for examples. Dependents: Dependent coverage will become effective on the date the member s coverage becomes effective. However, if a dependent is confined in an institution or at home for medical treatment, the dependent's insurance will become effective when the dependent is given a release by the doctor from all such confinement. EXAMPLES OF EFFECTIVE DATE OF COVERAGE: Member date of hire: June Member submits Enrollment Card on June 15 and payroll deduction begins in July. Effective date of coverage is August Member submits Enrollment Card on June 15 and payroll deduction begins in June. Effective date of coverage is July 1. IV. Processing New Enrollments When a new member is hired by a participating employer, provide the new member with the brochure explaining the Group Life Insurance coverage along with the other materials related to employment. If the member is interested in joining the program, he/she should complete, date and sign the Enrollment Card which is part of the brochure, and turn it in to the person designated by the employer to handle payroll deductions. We recommend that the foregoing be done when the member is hired to ensure that the member completes the form during the 90 day enrollment period for new members. Members who do not enroll within 90 days must wait until the next open enrollment period to enroll. When a completed Enrollment Card is received, make arrangements for the payroll deductions to begin as soon as possible. Remember the effective date is always the 1st of the month following the date of the 1st payroll deduction. Send the completed Enrollment Card directly to HealthSmart at the address on the card, being certain to include your employer number in the space provided on the enrollment card. Also, complete the date payroll withholding started. You will receive a Certificate of Insurance for the new member within 60 days after the first payment has been credited to your account, except those enrolling during the Annual Open Enrollment. Certificates of Insurance for members enrolled during open enrollment will be processed during the month of March. NOTE: See Appendix A for instructions regarding the naming of a beneficiary. 7

9 V. Billing Statements/Premium Payments The post office box where you send your payment is a lockbox account at Harris Bank & Trust in Chicago. Once received, the payments are batch processed, recorded and remittance statements and check copies are sent to HealthSmart. It takes approximately 3 working days for HealthSmart to receive the information from the bank. Terminations, retirements and cancellations received after the 10th of each month will be reflected on the following month's billing statements. Payment is due by the 10th of the month for which premium is billed. See Appendix B for sample billing statement. Premiums are to be submitted monthly as billed. Partial or fractional premium will be direct billed to the member. Premium payments are to be submitted monthly. If a member does not have a payment deducted by payroll during the month, please use the following codes denoting this information on the invoice. T = Terminated M = Medical Leave of Absence C = Death P = Personal Leave of Absence Q = No earnings paid this month W = Worker's compensation X = Military leave R = Retired Payment must still be received for coverage to be continued. HealthSmart will send a letter to the member, at their home address, to verify the reason for non-payment and invoice the participant so there will be no lapse in coverage. VI. Past Due Accounts/Member Payments If the Employer account is more than 90 days past due, coverage for all members will be terminated effective the last day of the covered period for which HealthSmart has received the premium. A member s insurance terminates when he/she: Terminates employment. VII. Terminations Is no longer a contributing retirement system member (works less than the hourly standard, on an extended leave of absence, on military leave, or laid off). Becomes eligible for retirement benefits - see Section VIII, Processing Retirees, for additional instruction. Decides to withdraw from coverage, see the following Processing Terminations. 8

10 When termination occurs, coverage will cease at the end of the month for which the last contribution was made. Members are eligible to continue their insurance coverage at the group rate for up to 18 months. HealthSmart will mail the member a confirmation form, giving them the option to continue coverage. See Conversion Privilege section which outlines conversion rights available. PROCESSING TERMINATIONS When notified of a termination of employment or voluntary termination of coverage, lineout the member on your next billing statement and indicate the date of termination to the right of the name and the last full month for which premiums have been withheld. If a payroll deduction was not withheld, subtract the member s premium amount from the CURRENT MONTH CHARGES and pay the difference TRANSFER MEMBER When a member transfers from one participating employer to another participating employer, the new employer unit will have the member complete a new enrollment form and indicate on the top of the form the effective date and the previous employer. The Employer Unit the member has left will report the member terminated in the usual manner. VIII. Processing Retirees When a member retires, follow the termination procedures previously outlined except in the "Comments" section, write "Retired" and provide the date of retirement and the last month for which premium has been paid. If members are eligible for a retirement system pension, they are eligible to continue the coverage. HealthSmart will mail a letter to the member at their home address to verify continuation in the Life Insurance Program. (See Appendix C.) Upon receipt by HealthSmart of this letter, we will coordinate with PERA for deductions to be made from the members pension check. As long as the retiree has authorized premiums to be deducted from their recurring pension check, coverage will be continuous until the retirement system begins deductions. Examples of determining last month for which premium was paid: Joan S. retires August 12 and pension benefits begin September 1st. A full deduction was taken from the last payroll in the month of July. Joan S. is paid for the month of August and pension deductions will begin September. Joan S. retires August 12; a partial deduction was taken from 1st payroll period in August for September premium. You can either refund the partial deduction (month last paid is then August), or you can deduct another partial deduction and month last paid is then September. Joan S. retires August 25. Payroll deductions were made in August totaling the full months deduction for the September premium. Month last paid is September and pension deductions will begin in October. 9

11 IX. Reporting Changes/Beneficiaries In the event of a change in member name or a change of beneficiary, have the member complete a Change of Beneficiary and/or Name Form, and send a copy directly to HealthSmart. A copy should be retained for your records and a copy given to the member. X. Waiver of Premium If a member UNDER AGE 60 becomes totally disabled, he/she may be eligible for premium waiver. When disability occurs and payroll deductions can no longer be made, the member will receive monthly billing statements from HealthSmart. The member should continue remitting a check to pay for his/her premium. After 6 months, HealthSmart will send the appropriate forms to the employer and instructions on how to apply for waiver of premium. No more premium payments need to be made after Waiver of Premium has been submitted. When approved, premiums will be refunded back to the disability date. The dependent spouse and child(ren) life insurance coverage is discontinued (see conversion privilege under the plan). Member XI. Conversion Privilege In the event of insurance termination, other than voluntary discontinuance of contributions, a member will be eligible to convert the Group Term Life Insurance to one of a number of Prudential individual life policies. The conversion privilege must be exercised within 31 days of the date of the member s termination of coverage and cannot exceed the amount of the current coverage available through the policy with NCPERS. Spouse or Domestic Partner If an insured member should die, terminate or be approved for waiver of premium, the life insurance for the member s spouse or domestic partner (if recognized in state of residence), will be continued for 31 days. The insurance coverage can be continued beyond this time by converting to an individual policy through Prudential. Application for this conversion must be made within 31 days from the date of the member s death or termination of coverage. The spouse or domestic partner may apply for any individual policy being offered by Prudential, other than the Group Policy with NCPERS. However, the individual policy cannot exceed the amount of the current coverage available through this policy with NCPERS. Upon conversion, the low monthly group rate will no longer apply. The premium to be paid will be the same rate as is currently being paid for any individual policy of equal value offered by the Prudential Life Insurance Company. No medical examination will be required to convert to the individual policy. To initiate the conversion privilege, the member will need to have his/her Certificate of Insurance. A form has been enclosed in the Administration Manual (See Appendix D) with the necessary information that is needed for conversion. A letter from the Employer Unit should accompany the conversion form stating the last date worked and the last date of payroll deduction for the plan. The member can then call any local Prudential agent, stating that he/she is interested in converting a group term life policy (Group #92860) to an individual policy. Or the member may call The Prudential conversion unit directly at

12 XII. How To File A Claim Form for Death Benefits In the event of the death of a covered member, the Employer Unit should contact HealthSmart. at for the most current claim form and instructions. All claims and claim forms are filed with Prudential Financial by HealthSmart. XIII. How to File for a Living Benefit Option In the event of terminal illness, members may elect to receive up to 50% of their Group Term Life Insurance benefits in advance, provided they have been covered under the plan for one year or longer. The employer unit or member should contact HealthSmart, who will send the appropriate forms. XIV. Forms and Supplies Enclosed with this manual is: 1. Sample cover letter to use with new members, 2. Sample letter mailed to retirees, and 3. Conversion Form. You can order forms as needed from: NCPERS Group Life Administrator HealthSmart E Dry Creek Rd, Suite 200 Englewood, Colorado ncpers@healthsmart.com Or fax your request for additional brochures to the NCPERS Plan Administrator at: (303) Please be sure to include your mailing address and the number of brochures you need. 11

13 Appendix A EXAMPLES FOR BENEFICIARY DESIGNATIONS 1. To designate one person, insert the name and relationship in the spaces provided. If your beneficiary is not related to you, show relationship as "Friend". 2. If you wish to name your estate, insert "Estate" in the blank space. 3. Show a member of religious order in this manner: Mary L. Jones, niece, known in religious life as Sister Mary Agnes. 4. It is inadvisable to name a beneficiary who is a permanent resident of a foreign county. If such a person is named, furnish full address. 5. More than one beneficiary - here are the most common examples: Two beneficiaries Three or more beneficiaries - John J. Jones, father and Mary R. Jones, mother - James O. Jones, brother; Peter I. Jones, brother; and Martha N. Jones, sister Unnamed children - My children, living at my death, from my marriage to Lois P. Jones One contingent beneficiary More than one contingent beneficiary Unnamed children as contingent beneficiaries - Lois P. Jones, wife, if living; otherwise Herbert I. Jones, son - Lois P. Jones, wife, if living; otherwise Herbert I. Jones, son, Alice B. Jones, daughter, and Ann Y. Jones, daughter - Lois P. Jones, wife if living; otherwise my children living at my death from my marriage to said wife If one of the above examples fit your wishes, insert your designation in the blank space, using the language of the selected example. 6. If none of the above is suitable, explain in the blank space what is desired, or attach a note. If you name more than one beneficiary, settlement will be made in equal shares to the designated beneficiaries (or beneficiary) that survive you, unless otherwise provided in the designation. If no named beneficiary survives you, settlement will be made to your estate, unless otherwise provided in the Group Contract. 12

14 Appendix B NCPERS GROUP LIFE INSURANCE MONTHLY BILLING ATE: 05/24/2010 MINN Premiums are due by the 10th of the Premium Month. UNIT NUMBER:SAMPLE BILLING: PREMIUM FOR MONTH OF: 6/2010 This statement is for May payroll deductions. SAMPLE INVOICE CITY Make check payable and return to: 111 W 1 ST AVE MN NCPERS Life Insurance SAMPLE CITY, ST Treasury Center Chicago, IL Participating Members MEMBER NAME SSN PREMIUM CODE COMMENTS DOE, JOHN J XXX-XX EXAMPLE, GENERIC Q XXX-XX SAMPLE, BOB J XXX-XX CURRENT MONTH CHARGES: $33.00 PREVIOUS MONTH BALANCE FORWARD: $0.00 TOTAL DUE: $33.00 Payments Received/Not Yet Applied $0.00 TOTAL PREMIUM SUBMITTED SIGNATURE PHONE DATE DO NOT SEND THIS TO YOUR RETIREMENT SYSTEM. Premiums are to be sent to the Insurance Plan Administrator at the address listed above. If you have any questions, call SAMPLE INVOICE CITY Inv Date: 06/01/2010 SAMPLE Page 1 13

15 Voluntary Group Life Insurance Plan HealthSmart Benefit Solutions, Inc East Dry Creek Road, Suite 200 Englewood, CO Appendix C Generic Example 123 Main St Anytown, ST May 24, 2010 NCPERS GROUP LIFE INSURANCE Dear Mr. Example, We have been notified by your employer of your recent retirement. While you were employed, you carried Group Life Insurance through your participation in PERA. You may continue this valuable insurance coverage into retirement if you are, or will be, receiving a monthly pension check from PERA. Please read the following choices carefully and select one. I retired on / / and wish to continue coverage. Please sign after reading the following statement: MEMBER S Deduction Authorization for Retirees Group Term Life Insurance Program I hereby authorize the MN Public Employees Retirement Association (PERA) to withhold the appropriate premium deduction from my retirement benefits. This premium is to be paid to HealthSmart. I understand I may revoke participation in this program by written notification to HealthSmart Date: Signature: I retired and wish to cancel participation in the insurance program. I did not retire, but terminated employment. Your Signature: Date: Sincerely, Plan Administrator E Dry Creek Rd, Suite 200 Phone: 800/ Fax: 303/

16 Notice of Group Life Conversion Privilege Appendix D The Prudential Insurance Company of America Subject to the conversion privilege contained in the Group Contract and described in your certificate you may convert your Group Life insurance amount to an individual contract by applying for the conversion and the paying the first premium within the period of time described in your booklet or certificate. Application for conversion may be made at any insurance office of The Prudential. If you visit a Prudential office be sure to take your certificate and this notice with you. To be completed by Contract Holder Policy No./control No. Claim Branch No. (if applicable) Name of Member Member s Social Security no. Address City State Zip code Date of termination of employment Date of termination of insurance if other than date of termination of employment Explanation Amount of Group Life insurance eligible for conversion: (Please indicate in script and numeric) Amount of AD&D insurance eligible for conversion: (Please indicate in script and numeric) Name of Employer $ $ Employer's address Area code/telephone no. Signature of authorized Employer representative Date Signature of Member Date of notice received ORD Ed 5-88 Litho in U.S.A. by PruPress Cat #

17 Appendix E YOUR LETTERHEAD To our system members: We are pleased to offer you the NCPERS Group Life Insurance Program sponsored by MN Public Employees Retirement Association. This program is designed to give you the additional insurance you may need for such things as mortgage redemption, protection while your family is growing, additional insurance benefits to carry into retirement, etc. The enclosed brochure will provide you with the details of this coverage; however, the following features are worth emphasizing: Health questions or medical exams are not required if you enroll within 90 days of becoming an eligible member of PERA, or during Open Enrollment. Coverage may be continued into retirement as long as you will be receiving a PERA pension check with no lapse in deductions. Coverage for members' eligible dependents is automatically included. The monthly premium is made through convenient payroll deduction. If you have any questions, please call HealthSmart, at or us at ncpers@healthsmart.com. 16

18 NCPERS Group Life Insurance Program Retirement System Authorized Agent Dear Administrator: Enclosed is the Administration Manual for use in administering the NCPERS Group Life Insurance Plan insured by Prudential. This manual will help answer general questions that you may have regarding the Group Life Insurance plan. Any questions regarding this plan or suggestions to improve the manual should be sent (or phoned) to: NCPERS Group Life Administrator HealthSmart Benefit Solutions, Inc E Dry Creek Rd, Suite 200 Englewood, CO ncpers@healthsmart.com NCPERS Group Life Insurance Plan Administrator

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