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January,
2007
Your
Basic Accidental Death & Dismemberment
and Terrorism Plan Certificates
Dear Health Benefit Plan Member,
SAMBA members enrolled in the 2007 Health
Benefit Plan are provided $10,000 coverage
($5,000 if age 70 or older) in SAMBA's Basic
Accidental Death and Dismemberment
(AD&D) plan. This plan is
underwritten by the Prudential Insurance
Company of America and is paid for by the
SAMBA Association. The plan provides
valuable protection for you and your family
in the event of a serious accident.
Enclosed is your Basic AD&D Statement of
Coverage and the policy certificate booklet.
In the event of your accidental death, the
life insurance benefit will be paid to the
first of the following: (1) your spouse; (2)
your surviving children in equal shares; (3)
your surviving parents in equal shares; (4)
your surviving siblings in equal shares; or
(5) to your estate. Should you wish to
designate a different beneficiary (or change
the beneficiary order) for this policy, a
designation of beneficiary form is enclosed
for you to complete and return to SAMBA.
Also enclosed you will find a certificate of
insurance issued by the Zurich North America
Company, the carrier for SAMBA's Terrorism
Plan. SAMBA members enrolled in the Health
Benefit Plan are covered by this $100,000
accident policy, payable upon the death or
dismemberment of the SAMBA member caused by
an act of terrorism within the United States
or $50,000 if on official assignment
overseas. This coverage is provided by the
SAMBA Association.
Due to a printing error in the 2007 Health
Benefit Plan brochure, a corrected page to
replace page 58 of the brochure, the Non-FEHB
benefits available to Plan members, is
enclosed.
Be sure to keep this communication and
enclosures with your important papers. If
you have any questions please contact SAMBA.
Sincerely,

Walter E. Wilson
Executive Director
Enclosures
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