GROUP VOLUNTARY LIFE & AD&D INSURANCE PLAN

(Underwritten by Boston Mutual Life Insurance Company, 120 Royall Street, Canton, MA 02021)

Who Is Eligible ?

You, as an active full time employee, working 20 hours or more per week, your Spouse under age 70, your unmarried children age 14 days to 19 years (to age 25 if full-time student), and handicapped children over the age of 19.

Dependents may not be insured if they are confined in a medical facility.

How Much Insurance May I Select ?

You have the flexibility to choose coverage in units of $10,000. However, the amount may not exceed five times your annual salary or $300,000, whichever is less.

What About Coverage For My Family ?

You may insure your spouse (in units of $5,000) for up to 50% of your coverage but not more than $50,000. Dependent children age one year to 19 years {to age 25 if full time student} are eligible for Life Insurance in the amount of $5,000 and children 14 days to one year for $500.

What Is AD&D ?

Accidental Death and Dismemberment coverage is available for employees and their spouses only. It doubles the Life Insurance benefit if death is due to an accident. Dismemberment benefits are payable for loss of eyesight or limbs according to policy provisions.

How Much Does Voluntary Life and AD&D Cost ?

Because of group purchasing power this term life insurance is very affordable. Monthly rates are shown below:

Monthly Employee Rates and Sample Costs
		Volume of Insurance
Age	Rate	$10,000	$20,000	$50,000	$100,000	$150,000	$200,000	$250,000	$300,0000
<20	0.23	2.30	4.60	11.50	23.00	34.50	46.00	57.50	69.00
20-24	0.14	1.40	2.80	7.00	14.00	21.00	28.00	35.00	42.00
25-29	0.13	1.30	2.60	6.50	13.00	19.50	26.00	32.50	39.00
30-34	0.13	1.30	2.60	6.50	13.00	19.50	26.00	32.50	39.00
35-39	0.17	1.70	3.40	8.50	17.00	25.50	34.00	42.50	51.00
40-44	0.25	2.50	5.00	12.50	25.00	37.50	50.00	62.50	75.00
45-49	0.38	3.80	7.60	19.00	38.00	57.00	76.00	95.00	114.00
50-54	0.60	6.00	12.00	30.00	60.00	90.00	120.00	150.00	180.00
55-59	1.00	10.00	20.00	50.00	100.00	150.00	200.00	250.00	300.00
60-64	1.43	14.30	28.60	71.50	143.00	214.50	286.00	357.50	429.00
65-69	2.38	23.80	47.60	119.00	238.00	357.00	476.00	595.00	714.00
70-74	4.17	41.70	83.40	208.50	417.00	625.50	834.00	1042.50	1251.00
75-79	7.00	70.00	140.00	350.00	700.00	1050.00	1400.00	1750.00	2100.00
80-84	11.18	111.80	223.60	559.00	1118.00	1677.00	2236.00	2795.00	3354.00
Monthly Spouse Rates and Sample Costs
		Volume of Insurance
Age	Rate	$10,000	$20,000	$25,000	$30,000	$35,000	$40.000	$45,000	$50,000
< 20	0.23	2.30	4.60	5.75	6.90	8.05	9.20	10.35	11.50
20-24	0.14	1.40	2.80	3.50	4.20	4.90	5.60	6.30	7.00
25-29	0.13	1.30	2.60	3.25	3.90	4.55	5.20	5.85	6.50
30-34	0.13	1.30	2.60	3.25	3.90	4.55	5.20	5.85	6.50
35-39	0.17	1.70	3.40	4.25	5.10	5.95	6.80	7.65	8.50
40-44	0.25	2.50	5.00	6.25	7.50	8.75	10.00	11.25	12.50
45-49	0.38	3.80	7.60	9.50	11.40	13.30	15.20	17.10	19.00
50-54	0.60	6.00	12.00	15.00	18.00	21.00	24.00	27.00	30.00
55-59	1.00	10.00	20.00	25.00	30.00	35.00	40.00	45.00	50.00
60-64	1.43	14.30	28.60	35.75	42.90	50.05	57.20	64.35	71.50
65-69	2.38	23.80	47.60	59.50	71.40	83.30	95.20	107.10	119.00
Premium rates for you and your spouse are based on attained age and change as each moves to a higher age bracket. Premium rates for Employees age 85 and over are available. Please ask your employer for details.

How Much Does Dependent Children Cost ?

The cost per month to insure all eligible dependent children for Life Insurance is only $0.95 per family.

What About Medical Questions ?

If you and your dependents enroll within 31 days of becoming eligible, you and your spouse may purchase a specific amount of Life and Accidental Death & Dismemberment Insurance on a guaranteed basis. All Life coverage on dependent children is Guaranteed Issue. Medical questions will not be required for coverage at or under the Guaranteed Issue Amount.

Guaranteed Issue Amounts
Age -->	Under 60	60 - 69	70 & over
Employee	$70,000	$30,000	$15,000
Spouse	$15,000	$7,500	Not eligible

Guaranteed Issue coverage will become effective for eligible enrollees on the later of, the effective date of the group policy or the date the application is received by Boston Mutual, provided it is received within 31 days of the date you first became eligible. Proof of good health satisfactory to Boston Mutual is required for amounts in excess of the Guaranteed Issue Amount.

What If I Leave My Employer ?

If you leave your employment the coverage is "portable". You may continue life insurance coverage for yourself, spouse, and dependent children under the group term policy by making payments directly to Boston Mutual. This coverage does not include Waiver of Premium or Accidental Death & Dismemberment.

What Happens If I Become Totally Disabled ?

If you become totally disabled prior to age 60 and remain totally disabled for the qualification period, Boston Mutual will continue your insurance without any further payment of premiums.

Is There A Conversion Privilege For All or Part of My Insurance Benefit ?

Yes, you may convert your Voluntary Life coverage for yourself, spouse, and children to a whole life policy without proof of good health, if you apply within 31 days of the date coverage terminated, and it did not terminate due to non-payment of premium. The premium will be based on the usual rate for the insured's age on the date of conversion.

What Is Accelerated Death Benefit ?

The Accelerated Death Benefit provision enables an employee diagnosed with a terminal illness, resulting in a life expectancy of twelve months or less, to receive a portion of the life insurance benefit prior to death. The remaining benefit will be paid to the beneficiary.

What Is The Education Benefit ?

We will pay a percentage of an employee's life insurance benefit to a maximum of $2,500 per year, for up to four years of education, to each qualifying dependent if the employee's death is the result of an accident while covered under Group Voluntary Accidental Death & Dismemberment.

What Is The Seat Belt Benefit ?

We will pay an additional 50% of the Accidental Death & Dismemberment benefit, not to exceed $10,000, in the event of an insured's death as a result of an automobile accident while wearing a properly secured seat belt.

How Do I Apply ?

Complete the enrollment form. We will process your application quickly. Coverage in excess of the Guaranteed Insured amount will become effective on the date Boston Mutual approves your application. To request enrollment form click here for email request or call the contact number below.

Are There Reductions or Exclusions ?

Yes, they are stated in the policy and your certificate. You may contact your Benefit Administrator to review the policy. This site is intended only to provide a summary of available coverage. State variations to plan design and / or benefit maximums may apply.