Voluntary Life Insurance SUMMARY OF BENEFITS Sponsored by: Spring Arbor University Life Benefit Employee Spouse Dependent Amount Choice of $10,000 increments Not to exceed 7 times your salary. Employees age 70 and older, maximum benefit is $50,000. Choice of $5,000 increments Employee must elect coverage for spouse to be eligible. Not to exceed 50% of employee elected amount. Minimum Amount $10,000 $5,000 $2,500 Maximum Amount $500,000 $250,000 $10,000 Guarantee Issue for Newly Eligible Employees Current Eligible Employees $200,000 under age 70 $20,000 age 70-74 No Guarantee Issue age 75 and older $50,000 under age 60 No Guarantee Issue age 60 and older Child: 14 days to 6 months $2,500, $5,000, $7,500, $10,000 Child: 6 months to age 20 (to age 26 if full-time student) Newborn children to age 14 days are not eligible for a benefit. Employee must elect coverage for dependent to be eligible. $10,000 You or your spouse may elect or increase insurance coverage up to 2 increments on a guaranteed acceptance basis, provided that you or your spouse have not been previously declined for coverage. Those who were previously declined coverage are not eligible for coverage as well as those who are in a pended or withdrawn status. Benefit Reduction Employee Spouse Benefits will reduce: 40% at age 75 An additional 25% of the original amount at age 80 An additional 7% of the original amount at age 85 An additional 7% of the original amount at age 90 An additional 12% of the original amount at age 95 An additional 2% of the original amount at age 100 Benefits will terminate upon retirement. Additional Benefits See Definition: Accelerated Death Benefit Conversion Portability Benefits terminate at spouse age 75. Eligibility Employee Spouse and Dependents All full-time active employees working 30 or more hours per week in an eligible class are eligible for coverage. A delayed effective date will apply if the employee is not actively at work. Cannot be in a period of limited activity on the day coverage takes effect.
Definitions Accelerated Death Benefit Conversion Guarantee Issue Limited Activity Portability Seat Belt, Airbag, and Common Carrier Term Life Exclusion: Suicide Additional Benefits BeneficiaryConnect SM TravelConnect SM Accelerated Death Benefit provides an option to withdraw a percentage of your life insurance coverage when diagnosed as terminally ill (as defined in the policy). The death benefit will be reduced by the amount withdrawn. To qualify, you have satisfied the Active Work rule and have been covered under this policy for the required amount of time as defined by the policy. Check with your tax advisor or attorney before exercising this option. If you terminate your employment or become ineligible for this coverage, you have the option to convert all or part of the amount of coverage in force to an individual life policy on the date of termination without Evidence of Insurability. Conversion election must be made within 31 days of your date of termination. For timely entrants enrolled within 31 days of becoming eligible, the Guarantee Issue amount is available without any Evidence of Insurability requirement. Evidence of Insurability will be required for any amounts above this, for late enrollees or increase in insurance, and it will be provided at your own expense. A period when a spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex. If coverage has been in force for at least 12 months, you may continue coverage for a specified period of time after your employment by paying the required premium. Portability is available if you cease employment for a reason other than total disability or retirement at Social Security Normal Retirement Age. A written application must be made within 31 days of your termination. If you die as a result of a covered auto accident while wearing a seat belt or in a vehicle equipped with an airbag, additional benefits are payable up to $10,000 or 10% of the principal sum, whichever is less. If loss occurs for you due to an accident while riding as a passenger in a common carrier, benefits will be double the amount that would otherwise apply as outlined in the certificate. Coverage provided to the designated beneficiary upon the death of the insured. Coverage is provided for the time period that you are eligible and premium is paid. There is no cash value associated with this product. Benefits will not be paid if the death results from suicide within 2 years after coverage is effective. May apply if employee contributes toward the premium. Support services for beneficiaries who have experienced a loss. Travel assistance services for employees and eligible dependents traveling more than 100 miles from home. For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to www.lincolnfinancial.com NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations.
Employee Premium for Non-Smokers AGE Rate per $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 < 30 $0.050 $ 0.50 $ 1.00 $ 1.50 $ 2.00 $ 2.50 $ 3.00 $ 3.50 $ 4.00 $ 4.50 $ 5.00 30-34 $0.060 $ 0.60 $ 1.20 $ 1.80 $ 2.40 $ 3.00 $ 3.60 $ 4.20 $ 4.80 $ 5.40 $ 6.00 35-39 $0.065 $ 0.65 $ 1.30 $ 1.95 $ 2.60 $ 3.25 $ 3.90 $ 4.55 $ 5.20 $ 5.85 $ 6.50 40-44 $0.105 $ 1.05 $ 2.10 $ 3.15 $ 4.20 $ 5.25 $ 6.30 $ 7.35 $ 8.40 $ 9.45 $ 10.50 45-49 $0.175 $ 1.75 $ 3.50 $ 5.25 $ 7.00 $ 8.75 $ 10.50 $ 12.25 $ 14.00 $ 15.75 $ 17.50 50-54 $0.290 $ 2.90 $ 5.80 $ 8.70 $ 11.60 $ 14.50 $ 17.40 $ 20.30 $ 23.20 $ 26.10 $ 29.00 55-59 $0.500 $ 5.00 $ 10.00 $ 15.00 $ 20.00 $ 25.00 $ 30.00 $ 35.00 $ 40.00 $ 45.00 $ 50.00 60-64 $0.690 $ 6.90 $ 13.80 $ 20.70 $ 27.60 $ 34.50 $ 41.40 $ 48.30 $ 55.20 $ 62.10 $ 69.00 65-69 $1.050 $ 10.50 $ 21.00 $ 31.50 $ 42.00 $ 52.50 $ 63.00 $ 73.50 $ 84.00 $ 94.50 $ 105.00 70-74 $2.200 $ 22.00 $ 44.00 $ 66.00 $ 88.00 $110.00 N/A N/A N/A N/A N/A 75-79 $2.200 $ 6,000 $12,000 $18,000 $24,000 $30,000 N/A N/A N/A N/A N/A $ 13.20 $ 26.40 $ 39.60 $ 52.80 $ 66.00 N/A N/A N/A N/A N/A 80-84 $2.200 $ 3,500 $13,000 $19,500 $26,000 $32,500 N/A N/A N/A N/A N/A $ 7.70 $ 15.40 $ 23.10 $ 30.80 $ 38.50 N/A N/A N/A N/A N/A 85-89 $2.200 $ 2,800 $ 5,600 $ 8,400 $11,200 $14,000 N/A N/A N/A N/A N/A $ 6.16 $ 12.32 $ 18.48 $ 24.64 $ 30.80 N/A N/A N/A N/A N/A 90-94 $2.200 $ 2,100 $ 4,200 $ 6,300 $ 8,400 $10,500 N/A N/A N/A N/A N/A $ 4.62 $ 9.24 $ 13.86 $ 18.48 $ 23.10 N/A N/A N/A N/A N/A 95-99 $2.200 $ 900 $ 1,800 $ 2,700 $ 3,600 $ 4,500 N/A N/A N/A N/A N/A $ 1.98 $ 3.96 $ 5.94 $ 7.92 $ 9.90 N/A N/A N/A N/A N/A 100+ For benefit and premium amounts please see your Plan Administrator. Use this formula to calculate premium for benefit amounts over $100,000. Age Rate Per X Benefit In s = Cost 33 $0.060 X 150 = $9.00
Employee Premium for Smokers AGE Rate per $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 < 30 0.075 $ 0.75 $ 1.50 $ 2.25 $ 3.00 $ 3.75 $ 4.50 $ 5.25 $ 6.00 $ 6.75 $ 7.50 30-34 0.090 $ 0.90 $ 1.80 $ 2.70 $ 3.60 $ 4.50 $ 5.40 $ 6.30 $ 7.20 $ 8.10 $ 9.00 35-39 0.140 $ 1.40 $ 2.80 $ 4.20 $ 5.60 $ 7.00 $ 8.40 $ 9.80 $ 11.20 $ 12.60 $ 14.00 40-44 0.225 $ 2.25 $ 4.50 $ 6.75 $ 9.00 $ 11.25 $ 13.50 $ 15.75 $ 18.00 $ 20.25 $ 22.50 45-49 0.370 $ 3.70 $ 7.40 $ 11.10 $ 14.80 $ 18.50 $ 22.20 $ 25.90 $ 29.60 $ 33.30 $ 37.00 50-54 0.610 $ 6.10 $ 12.20 $ 18.30 $ 24.40 $ 30.50 $ 36.60 $ 42.70 $ 48.80 $ 54.90 $ 61.00 55-59 0.940 $ 9.40 $ 18.80 $ 28.20 $ 37.60 $ 47.00 $ 56.40 $ 65.80 $ 75.20 $ 84.60 $ 94.00 60-64 1.060 $ 10.60 $ 21.20 $ 31.80 $ 42.40 $ 53.00 $ 63.60 $ 74.20 $ 84.80 $ 95.40 $ 106.00 65-69 1.440 $ 14.40 $ 28.80 $ 43.20 $ 57.60 $ 72.00 $ 86.40 $100.80 $115.20 $129.60 $ 144.00 70-74 2.600 $ 26.00 $ 52.00 $ 78.00 $104.00 $130.00 N/A N/A N/A N/A N/A 75-79 2.600 $ 6,000 $12,000 $18,000 $24,000 $30,000 N/A N/A N/A N/A N/A $ 15.60 $ 31.20 $ 46.80 $ 62.40 $ 78.00 N/A N/A N/A N/A N/A 80-84 2.600 $ 3,500 $13,000 $19,500 $26,000 $32,500 N/A N/A N/A N/A N/A $ 9.10 $ 18.20 $ 27.30 $ 36.40 $ 45.50 N/A N/A N/A N/A N/A 85-89 2.600 $ 2,800 $ 5,600 $ 8,400 $11,200 $14,000 N/A N/A N/A N/A N/A $ 7.28 $ 14.56 $ 21.84 $ 29.12 $ 36.40 N/A N/A N/A N/A N/A 90-94 2.600 $ 2,100 $ 4,200 $ 6,300 $ 8,400 $10,500 N/A N/A N/A N/A N/A $ 5.46 $ 10.92 $ 16.38 $ 21.84 $ 27.30 N/A N/A N/A N/A N/A 95-99 2.600 $ 900 $ 1,800 $ 2,700 $ 3,600 $ 4,500 N/A N/A N/A N/A N/A $ 2.34 $ 4.68 $ 7.02 $ 9.36 $ 11.70 N/A N/A N/A N/A N/A 100+ For benefit and premium amounts please see your Plan Administrator. Use this formula to calculate premium for benefit amounts over $100,000. Age Rate Per X Benefit In s = Cost 33 $0.090 X 150 = $13.50
Spouse Premium for Non-Smokers AGE Rate per $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 < 30 0.050 $ 0.25 $ 0.50 $ 0.75 $ 1.00 $ 1.25 $ 1.50 $ 1.75 $ 2.00 $ 2.25 $ 2.50 30-34 0.060 $ 0.30 $ 0.60 $ 0.90 $ 1.20 $ 1.50 $ 1.80 $ 2.10 $ 2.40 $ 2.70 $ 3.00 35-39 0.065 $ 0.33 $ 0.65 $ 0.98 $ 1.30 $ 1.63 $ 1.95 $ 2.28 $ 2.60 $ 2.93 $ 3.25 40-44 0.105 $ 0.53 $ 1.05 $ 1.58 $ 2.10 $ 2.63 $ 3.15 $ 3.68 $ 4.20 $ 4.73 $ 5.25 45-49 0.175 $ 0.88 $ 1.75 $ 2.63 $ 3.50 $ 4.38 $ 5.25 $ 6.13 $ 7.00 $ 7.88 $ 8.75 50-54 0.290 $ 1.45 $ 2.90 $ 4.35 $ 5.80 $ 7.25 $ 8.70 $ 10.15 $ 11.60 $ 13.05 $ 14.50 55-59 0.500 $ 2.50 $ 5.00 $ 7.50 $ 10.00 $ 12.50 $ 15.00 $ 17.50 $ 20.00 $ 22.50 $ 25.00 60-64 0.690 $ 3.45 $ 6.90 $ 10.35 $ 13.80 $ 17.25 $ 20.70 $ 24.15 $ 27.60 $ 31.05 $ 34.50 65-69 1.050 $ 5.25 $ 10.50 $ 15.75 $ 21.00 $ 26.25 $ 31.50 $ 36.75 $ 42.00 $ 47.25 $ 52.50 70-74 2.200 $ 11.00 $ 22.00 $ 33.00 $ 44.00 $ 55.00 $ 66.00 $ 77.00 $ 88.00 $ 99.00 $ 110.00 75+ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Use this formula to calculate premium for benefit amounts over $50,000. Age Rate Per X Benefit In s = Cost 33 $0.060 X 75 = $4.50
Spouse Premium for Smokers AGE Rate per $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 < 30 0.075 $ 0.38 $ 0.75 $ 1.13 $ 1.50 $ 1.88 $ 2.25 $ 2.63 $ 3.00 $ 3.38 $ 3.75 30-34 0.090 $ 0.45 $ 0.90 $ 1.35 $ 1.80 $ 2.25 $ 2.70 $ 3.15 $ 3.60 $ 4.05 $ 4.50 35-39 0.140 $ 0.70 $ 1.40 $ 2.10 $ 2.80 $ 3.50 $ 4.20 $ 4.90 $ 5.60 $ 6.30 $ 7.00 40-44 0.225 $ 1.13 $ 2.25 $ 3.38 $ 4.50 $ 5.63 $ 6.75 $ 7.88 $ 9.00 $ 10.13 $ 11.25 45-49 0.370 $ 1.85 $ 3.70 $ 5.55 $ 7.40 $ 9.25 $ 11.10 $ 12.95 $ 14.80 $ 16.65 $ 18.50 50-54 0.610 $ 3.05 $ 6.10 $ 9.15 $ 12.20 $ 15.25 $ 18.30 $ 21.35 $ 24.40 $ 27.45 $ 30.50 55-59 0.940 $ 4.70 $ 9.40 $ 14.10 $ 18.80 $ 23.50 $ 28.20 $ 32.90 $ 37.60 $ 42.30 $ 47.00 60-64 1.060 $ 5.30 $ 10.60 $ 15.90 $ 21.20 $ 26.50 $ 31.80 $ 37.10 $ 42.40 $ 47.70 $ 53.00 65-69 1.440 $ 7.20 $ 14.40 $ 21.60 $ 28.80 $ 36.00 $ 43.20 $ 50.40 $ 57.60 $ 64.80 $ 72.00 70-74 2.600 $ 13.00 $ 26.00 $ 39.00 $ 52.00 $ 65.00 $ 78.00 $ 91.00 $104.00 $117.00 $ 130.00 75+ N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A Use this formula to calculate premium for benefit amounts over $50,000. Age Rate Per X Benefit In s = Cost 33 $0.090 X 75 = $6.75