GROUP TERM LIFE INSURANCE with Accidental Death and Dismemberment Coverage
Issued by the Prudential Insurance Company of America
Valuable coverage at economical rates that do not increase with age
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Eligibility RequirementsTo enroll, you must be an active full-time or part-time federal employee. Coverage may be carried into retirement, provided you are enrolled in the Plan for at least one year prior to retirement.
Benefits offered by the Plan:Term Life Insurance: This plan provides a lump-sum benefit that gives your family financial peace of mind should they lose you to an illness or accidental injury.
Accidental Death and Dismemberment (AD&D): This feature provides benefits in the event you are killed or lose your hands, feet, or eyesight as the result of a covered Accidental injury.
This benefit applies whether the Accident occurs on or off the job. And the AD&D amount is paid in addition to the Group Term Life benefit.
If Killed in the Line of Duty: Your AD&D benefit increases by 50%. (explain)
Accelerated Death Benefit: If you have a Terminal Medical Condition (explain), the Accelerated Death Benefit can make a difficult time a little easier for your family. The Plan can make available up to 75% of the Group Term Life insurance amount, up to a maximum of $250,000.
How benefits and rates are determinedYour benefit amount and rate are determined by your job grade when you enroll in the plan. Evidence of insurability is required. When you are promoted to a higher job grade,
you can increase your benefit amount. Plus, if you apply for an increase within 12 months of being promoted, and your benefit amount is at your maximum benefit amount allowed in your
previous job grade, evidence of insurability is not required. View rate table.
Your Gateway to Additional CoverageIf you are enrolled in the Group Term Life Insurance Plan, you may also enroll your spouse and dependent children in the Dependent Group Term Life Insurance. You can further protect the financial future of your family by enrolling yourself and your spouse for additional coverage in the Supplemental Group Term Life Insurance.
Your coverage can continue when you retireThere are eight plan options from which to choose, depending on your age and the amount of Group Term Life Insurance you had prior to retirement. You may at any time select a lower plan option if your needs change. Your
coverage automatically reduces at different age brackets. View rate table.
Beyond Age 70: The Group Term Life Insurance plan coverage ends at age 70. If you wish to continue coverage, SAMBA has made arrangements for you to purchase
up to $10,000 of insurance coverage under another policy.
Limitations and Exclusions (explain)
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Rate Tables
| Rates Effective January 1, 2004 |
| Group Term Life Insurance for Active Employees |
| Job Classification |
Insurance Amount when Death is from Natural Causes |
Insurance Amount when Death is from Accidental Causes |
Insurance Amount when Death is in the Line of Duty |
Biweekly Premium |
| GS-5 & Below |
$80,000 |
$160,000 |
$200,000 |
$6.00 |
| GS-6 thru GS-9 |
$100,000 |
$200,000 |
$250,000 |
$8.00 |
| GS-10 thru GS-12 |
$140,000 |
$280,000 |
$350,000 |
$13.00 |
| GS-13 thru GS-14 |
$175,000 |
$350,000 |
$437,500 |
$17.00 |
| GS-15 |
$200,000 |
$400,000 |
$500,000 |
$20.00 |
| SES & SL |
$250,000 |
$500,000 |
$625,000 |
$23.00 |
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Rates Effective January 1, 2004 |
| Group Term Life Insurance Retirement Options |
| Plan Options |
Quarterly Premium |
Amount of Insurance |
| Thru Age 54 |
Ages 55-59 |
Ages 60-64 |
Ages 65-69 |
| 1 |
$37.50 |
$25,000 |
$15,000 |
$10,000 |
$7,500 |
| 2 |
$75.00 |
$50,000 |
$30,000 |
$20,000 |
$15,000 |
| 3 |
$112.50 |
$75,000 |
$45,000 |
$30,000 |
$22,500 |
| 4 |
$150.00 |
$100,000 |
$60,000 |
$40,000 |
$30,000 |
| 5 |
$187.50 |
$125,000 |
$75,000 |
$50,000 |
$37,500 |
| 6 |
$225.00 |
$150,000 |
$90,000 |
$60,000 |
$45,000 |
| 7 |
$262.50 |
$175,000 |
$105,000 |
$70,000 |
$52,500 |
| 8 |
$300.00 |
$200,000 |
$120,000 |
$80,000 |
$60,000 |
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