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Accidental Death & Dismemberment

 Accidental Death & Dismemberment Benefits at a Glance

 

The Basic Life Insurance Plan is an Erlanger-paid group term life insurance and accidental death and dismemberment insurance plan.

Eligibility
To be eligible for Basic Life and Accidental Death & Dismemberment (AD&D) benefits you must be hired to work a minimum of 19.5 hours per week (0.52 – 1.00 FTE) and be classified as a regular employee.

Eligibility is lost if an employee’s status changes to below a 0.52 FTE or upon separation of employment.

Effective Date
Your coverage is effective after 6 months of employment.

Benefit Amount
The amount of the group term life insurance coverage is equal to your base annual salary and is employer paid. The beneficiary must comply with the terms of the underwriter in making the claim for a benefit. This plan provides double indemnity for accidental death and dismemberment. This plan also has an accelerated death benefit.

Accelerated Death Benefit
If you become terminally ill while insured under the Basic Life Insurance provision, you may apply for this Living Benefit Option. This election is allowed only once in your lifetime and is subject to the conditions shown below.

Terminally ill means your life expectancy is less than 6 months. This must be certified by a Physician and accepted by Unum.

Living benefits will be payable when Unum receives acceptable proof from your Physician that you are terminally ill. Such proof must be in a form that is satisfactory to Unum. At the time such proof is given, Unum may have you examined by a Physician of Unum’s choice. This will be at Unum’s expense.

The amount of the Living Benefit will be:

  • 50% of the Life Insurance amount shown in the Schedule of Benefits;
  • determined as of the date Unum accepts proof that you are terminally ill;
  • payable only if you are living when payment is made; and
  • not more that $100,000.

In no event will the amount payable to your beneficiary upon your death, plus the amount payable to you for this Living Benefit, exceed the amount that would have been payable to your beneficiary if you had not applied for this Living Benefit.

The amount available for you to convert to a personal policy under the Conversion of Life Insurance provision will be reduced by the amount of the Living Benefit paid to you.

NOTE: Benefits paid under this Living Benefit Option may be taxable.  If so, you or your beneficiary may incur a tax obligation. As with all tax matters, you should consult your personal tax advisor to assess the impact on this benefit.

AD & D Exclusions
The AD & D (Accidental Death and Dismemberment) benefit plan does not cover any accidental losses caused by, contributed to by, or resulting from:

  • suicide, self destruction while sane, intentionally self-inflicted injury while sane, or self-inflicted injury while sane, or self-inflected injury while insane.
  • active participation in a riot.
  • an attempt to commit or commission of a crime under state or federal law.
  • the use of any prescription or non-prescription drug, poison, fume or other chemical substance unless used according to the prescription or direction of your physician. This exclusion will not apply to you if the chemical substance is ethanol.
  • disease of the body or diagnostic, medical or surgical treatment or mental disorder as set forth in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders.
  • being intoxicated
  • operating any motorized vehicle while intoxicated.
  • war, declared or undeclared, or any act of war.

Beneficiary
Your beneficiary designation is maintained in your Human Resources personnel file and may also be viewed through Employee Direct Access.  You can change your beneficiary at any time by completing a new beneficiary designation form.  The change is effective the date that it is received by Human Resources.  A person’s right as a beneficiary ends if:

  • you name more than one beneficiary, they will share equally unless you state otherwise,
  • a beneficiary dies before you, his or her share will be paid equally to the surviving beneficiaries, unless you state otherwise.  Any amount for which a beneficiary is not named will be paid to your estate.

Enrolling
If you meet the eligibility criteria, you are automatically covered under this plan.

Funding
Erlanger Health System pays the entire cost of the plan for active, eligible employees.