What coverage does the employee have to be insured for in to cover dependents? Dependent Coverage Requirement Choices: -Basic Only -Supp Only -Basic and Supp Provide coverage amounts. Include maximum and minimum benefit amounts. Also include limits on whether Dependent cannot have more than 50% of coverage. Spouse/Child units or Spouse Benefit Coverage Example Amount Spouse/Child Life Unit: Spouse $10,000 Chile $3,000 (birth to age 26* regardless of FTS) -OR- Example Stand-Alone: Spouse $5,000 increments Child $2,000 increments A) Enter Spouses Reduction A) A) Schedule, does this? B) B) -Matches employees reduction or Special (include Spouse Benefit Reduction reduction if different from Schedule employee's) B) Is the reduction based on the spouse's or employee's age? Dependent Accelerated Reliance standard benefit: Benefit* 75% to $500,000 Expected death within 12 months requirements may apply to some areas) If other than the above percentage and amount, please describe. RSL standard: Default: Yes, if EE WOP is If EE is approved for WOP, approved. Dependent Waiver of Premium dependents’ premium is also waived. Confirm if the Portability provision has been added to Dependent Portability this Plan. (Yes or No) RSL standard: Special Note: - available on GL (if included, As a standard, portability is both life and AD&D coverage not available to retirees or may be ported, if AD&D is on the retiree’s dependents. If we policy) must do this, it requires a - NOT available VAR filing. ALSO, Spouse cannot port unless the Employee ports
Dependent Coverage Requirement What coverage does the employee have to be insured for in to cover dependents? Choices: -Basic Only -Supp Only -Basic and Supp Spouse Benefit Coverage Amount Provide coverage amounts. Include maximum and minimum benefit amounts. Also include limits on whether Dependent cannot have more than 50% of coverage. Spouse/Child units or Example Spouse/Child Life Unit: Spouse $10,000 Chile $3,000 (birth to age 26* regardless of FTS) -OR- Example Stand-Alone: Spouse $5,000 increments Child $2,000 increments Spouse Benefit Reduction Schedule A) Enter Spouses Reduction Schedule, does this? -Matches employees reduction or Special (include reduction if different from employee's) B) Is the reduction based on the spouse's or employee's age? A) B) A) B) Dependent Accelerated Benefit* requirements may apply to some areas) Reliance standard benefit: 75% to $500,000 Expected death within 12 months If other than the above percentage and amount, please describe. Dependent Waiver of Premium RSL standard: If EE is approved for WOP, dependents’ premium is also waived. Default: Yes, if EE WOP is approved. Dependent Portability RSL standard: - available on GL (if included, both life and AD&D coverage may be ported, if AD&D is on the policy) - NOT available VAR Confirm if the Portability provision has been added to this Plan. (Yes or No) Special Note: As a standard, portability is not available to retirees or retiree’s dependents. If we must do this, it requires a filing. ALSO, Spouse cannot port unless the Employee ports
COP%20-%20Supp%20Life-%20AD&D-Dep-FINAL082017.docx