Voluntary Accidental Death and Dismemberment Insurance

SUMMARY OF BENEFITS

Sponsored by:

East Baton Rouge Parish School System

Effective date:

January 1, 2009

 

Benefit Employee Only Plan Family Plan
Amount Choice of $25,000 increments. Not to exceed ten times annual salary. Choice of $25,000 increments. Not to exceed ten times annual salary.
Spouse: 50% of the employee benefit (Spouse and employee covered)
Each Child: 15% of employee benefit (Children and employee covered)
Spouse + Each Child: Spouse 40% and Child 10% of the employee benefit (Spouse, children and employee covered)
Minimum Amount $25,000 $25,000
Maximum Amount $250,000 $250,000
Guarantee Issue Not applicable Not applicable
Benefit Reduction Employee Spouse
Benefits will reduce: 35% at age 70.
An additional 25% of original amount at age 75;
An additional 15% of original amount at age 80
Benefits terminate at retirement.
Benefits terminate at Spouse age 70 or Employee retires, whichever occurs first.
Eligibility Employee Spouse and Dependents
  All full-time active employees working 25 or more hours per week in an eligible class are eligible for coverage on the policy effective date. A delayed effective date will apply if the employee is not actively at work. Cannot be in a period of limited activity on the day coverage takes effect.


East Baton Rouge Parish School System

Employee Monthly Premium
Accidental Death and Dismemberment premium for sample benefit amounts


Refer to Program Specifications for your maximum benefit amounts.
Benefits and premium amounts reflect age reductions.

AGE Monthly Rate per $1,000 $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000
<70 $0.017 $0.43 $1.75 $2.63 $3.50 $4.38 $5.25 $6.13 $7.00 $7.88 $8.75
70-74 $0.017 $16,250 $32,500 $48,750 $65,000 $81,250 $97,500 $113,750 $130,000 $146,250 $162,500
    $0.28 $0.55 $0.83 $1.11 $1.38 $1.66 $1.93 $2.21 $2.49 $2.76
75-79 $0.017 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
    $0.17 $0.34 $0.51 $0.68 $0.85 $1.02 $1.19 $1.36 $1.53 $1.70
80 + $0.017 $6,250 $12,500 $18,750 $25,000 $31,250 $37,500 $43,750 $50,000 $56,250 $62,500
    $0.11 $0.21 $0.32 $0.43 $0.53 $0.64 $0.74 $0.85 $0.96 $1.06


Family Monthly Premium
Accidental Death and Dismemberment premium for sample benefit amounts


Refer to Program Specifications for your maximum benefit amounts.
Benefits and premium amounts reflect age reductions.

 

AGE Monthly Rate per $1,000 $25,000 $50,000 $75,000 $100,000 $125,000 $150,000 $175,000 $200,000 $225,000 $250,000
<70 $0.037 $0.93 $1.85 $2.78 $3.70 $$4.63 $5.55 $6.48 $7.40 $8.33 $9.25
70-74 $0.037 $16,250 $32,500 $48,750 $65,000 $81,250 $97,500 $113,750 $130,000 $146,250 $162,500
    $0.60 $1.20 $1.80 $2.41 $3.01 $3.61 $4.21 $4.81 $5.41 $6.01
75-79 $0.037 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000
    $0.37 $0.74 $1.11 $1.48 $1.85 $2.22 $2.59 $$2.96 $3.33 $3.70
80 + $0.037 $6,250 $12,500 $18,750 $25,000 $31,250 $37,500 $43,750 $50,000 $56,250 $62,500
    $0.23 $0.46 $0.69 $0.93 $1.16 $1.39 $1.62 $1.85 $2.08 $2.31

This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency.

Example: Use this formula to calculate premium for benefit amounts over $250,000.

 


 
Monthly Rate Per $1,000 X Benefit In $1,000’s = Monthly Cost
Example: $0.037 X 300 = $11.10
    X   =  

Definitions

 

AD&D

Accidental Death and Dismemberment (AD&D) insurance provides specified benefits for a covered accidental bodily injury that directly causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from a covered accident, both the life and the AD&D benefit would be payable. This insurance is optional and can be purchased by you and your spouse.
 

Limited Activity

A period when a spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex.
 

Exclusion: Suicide

Benefits will not be paid if the death results from suicide within two years after coverage is effective. May apply if employee contributes toward the premium.



For assistance or additional information
Contact Lincoln Financial Group at (800) 423-2765 or email
clientservices@lfg.com.

NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern.

©2008 Lincoln National Corporation

Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations.