Optional Group Term Life Insurance September 2003 This information booklet insert has been prepared to give you an informal summary of the main features of your voluntary term life insurance program. This insert is not an insurance policy and does not grant or confer any contractual rights. All rights under this program shall be governed by the provisions of the master policy and by applicable law. Eligibility All full-time employees, regular part-time employees and recurring sessional employees are eligible for optional group term life insurance as follows on a voluntary basis and at the employee s own expense. Plan Coverage The plan provides optional term life insurance coverage beyond that provided under the University s basic program to eligible employees and/or their spouses and dependent children. Amount of Benefit Employees under age 65 may apply for this coverage in units of $10,000 subject to a maximum of 20 units ($200,000). Employees under age 65 may also apply for this coverage for their spouse, if under age 65, in units of $10,000 subject to a maximum of 20 units ($200,000) and for 1 unit for each dependent child ($10,000). Coverage will become effective subject to approval by the insurer of the medical information provided in the application. Evidence of insurability, satisfactory to the insurer, shall be required for all amounts in excess of $50,000. An employee must apply within 31 days of the date of eligibility otherwise all amounts of insurance are subject to evidence of insurability. This coverage is available in addition to, not in lieu of, basic life. Definition of Dependents Dependents are defined as your spouse (as described below), and unmarried, unemployed dependent children including natural, adopted or stepchildren who are dependent upon the employee for financial care and support. Dependent children of a conjugal spouse may be covered if they are living with the employee. The term spouse is defined as a person who is legally married to the employee, or a person who is married to the employee by a marriage that is voidable and has not been declared null and void, or, although not legally married to the employee, has continuously cohabited with the employee in a conjugal relationship (which includes a conjugal relationship between parties of 1
the same sex) for not less than one full year and who has been publicly represented as the employee s spouse. Unless the covered employee has requested coverage for a conjugal spouse in writing to the insurer, the person legally married to the insured employee shall be considered to be the spouse. Discontinuance of cohabitation with the employee shall terminate coverage of the conjugal spouse. Dependent children are eligible for benefits if they are less than 21 years of age or; if 21 years of age but less than 25 years of age, they must be attending an accredited educational institution, college or university on a full-time basis. Unmarried, unemployed children 21 years of age or older qualify if they are dependent upon the covered employee by reason of a mental or physical disability and have been continuously so disabled since the age of 21. Any mentally or physically handicapped child who was insured as a dependent shall remain insured beyond any limiting age for dependents, provided the child is incapable of self-sustaining employment and is wholly dependent upon the employee for support and maintenance. Dependent coverage begins for your eligible dependents on the same date as your coverage, or as soon as they become eligible dependents if added later, provided that dependent benefits were applied for within 31 days of their becoming eligible. Evidence of health is required for amounts in excess of $50,000. If coverage is not applied for within this 31-day period, evidence of health on the dependents may have to be submitted for all amounts of insurance and approved before coverage begins. If evidence of insurability is required and/or the dependent is confined, the effective date of insurance shall be the first date the dependent is not confined on or after the date the insurer approves evidence of insurability, if required. Beneficiary The employee may appoint any beneficiary desired; the beneficiary of the spouse s insurance or dependent child insurance will be the employee. Payment of Premiums Premiums will be applicable from the first of the month following the date coverage is approved, however, coverage will be effective from the date the application is approved. The monthly premium is based on the age of the employee, smoker or non-smoker, and the amount of coverage selected. Please note that the rate applicable to the spouse s coverage will also be based on the age of the employee. 2
Optional Group Term Insurance Age of Monthly Rate Per $10,000 of Coverage EE/Spouse Smoker Non-Smoker 20 29 $ 0.50 $ 0.30 30 34 0.64 0.37 35 39 0.95 0.48 40 44 1.38 0.77 45 49 2.39 1.20 50 54 3.66 2.07 55 59 6.35 3.51 60 64 9.71 5.47 65 16.00 11.46 Dependent Child 0.37 0.37 Premiums will increase on July 1 st for employees who enter a higher age bracket during the previous year. Misstatement of Non-Smoker Clause Misstatement of non-smoker status by you or your spouse shall constitute fraud, and the insurer will not pay any part of optional life insurance, regardless of the cause of death. Benefit Limitations Benefits are payable as a result of a death from any cause, however, if death is due to suicide, benefits will not be payable during the first two years after purchase of insurance. Waiver of Premium for Disabled Employees If you become totally disabled before age 65 and are receiving long term disability benefits, your optional group term life insurance may be continued free of charge until you cease to be totally disabled or you reach age 65, whichever occurs first. You must submit proof of your continuing disability as may be required by the insurer. Your entitlement to waiver of premium benefit for dependent optional life ceases on the earlier of: (a) (b) the date the waiver of premium for employee optional life insurance ceases, or the date the policy or coverage terminates. Note: In order to qualify for the waiver of premium benefit, you must notify the insurer of your disability within one (1) year of your last active day at work, and must furnish proof of your disability satisfactory to the insurer within 18 months of that last active working day. 3
Conversion Privileges Please refer to the Conversion Privilege under the basic group life insurance insert for details regarding conversion for the employee. The optional dependent life insurance continues for 31 days following your death, your classification changing to one in which you are not insured or termination of employment. During this 31-day period, your spouse s amount of optional life insurance may be converted, subject to a maximum of $200,000 and provided the spouse is under 66 years of age, to any individual ordinary life or convertible one-year term or term to age 65 plan without submitting evidence of health. The premium rate will be determined from your spouse s age and class of risk at the time of conversion. If your group policy terminates and your spouse has been continuously insured under it for at least 5 years, you have the same conversion privilege as above but the maximum amount of insurance that may be converted shall be: Three times (3X) the Year s Maximum Pensionable Earnings as established under the Canada Pension Plan less Any amount your spouse becomes eligible for under another group policy within 31 days of the date of termination. Termination of Coverage Your insurance terminates in the event of: (a) non-payment of premium; (b) a change in your classification to one not insured; (c) termination of your employment; (d) termination or amendment of the master policy; (e) your commencing active duty in the armed forces; (f) your attainment of age 65 with respect to optional life; (g) your spouse s attainment of age 65 for optional life for spouses, if earlier, or; (h) your retirement 4
How to Claim When you have a claim, you should contact Dalhousie University Employee Benefits who will supply you with the proper forms with instructions for completion. In order to quickly process your claim, all claim forms should clearly indicate the following: (a) your full name and address (b) the name of your employer (c) your identification number (d) your Group Policy Number (e) (031260) Manulife Life Financial) Claims for benefits must be submitted within 12 months of the date incurred. S:\Human_Resources\EB\EB Share\EB_SHARE\BENEFITS\Benefit Documents\New Benefit package\optional Term Life Insurance.doc 5