Supplemental Term Life

Baylor University's employees have different life insurance needs. For some of you, the basic benefits may be sufficient. For others, the opportunity to supplement the basic coverage and provide your families with increased financial security is of utmost importance. Through Dearborn National Insurance Company's (DNIC) supplemental group term life and AD&D coverage, you can elect to add an extra layer of protection easily through payroll deduction.


Employee

Amounts of coverage are available using your current basic annual salary as a base. Select the plan that best fits your needs. Maximum amount available is $500,000.

Plan 1: 100% of your basic annual salary

Plan 2: 200% of your basic annual salary

Plan 3: 300% of your basic annual salary

Plan 4: 400% of your basic annual salary

Plan 5: 500% of your basic annual salary

Premium Calculation Table


Dependents

Baylor University already provides a basic dependents' life benefit in the amount of $2,000. Supplemental dependent life coverage through DNIC will offer financial protection at an affordable price in the event of a spouse's or child's death. Should you elect to enroll for Employee Supplemental Term Life and AD&D, you become eligible to select supplemental coverage on your dependents.

Spouse

The spouse's amount of coverage is equal to 50% of your supplemental amount, up to $100,000.

Children

Select the amount of coverage that best fits your needs. Each child will be covered for the amount selected at one low monthly cost, regardless of the number of eligible children.

Coverage amounts are available from $2,500 to $10,000, in increments of $2,500.

Dependent coverage cannot exceed 50% of your amount of insurance.


Your Basic and Supplemental Group Term Life coverages include:

Extended Insurance Benefit

Your term life coverage may continue to age 70 at no cost to you if you become totally disabled prior to age 60, subject to the requirements of this benefit.

Accelerated Death Benefit

If you are diagnosed with a Terminal Condition which with reasonable medical certainty will result in your death within 6 months, you may choose to accelerate up to 50% of your term life death benefit, up to $100,000. An administrative fee of $150.00 and a 6 month interest rate discount based on an annual interest rate of 8% will be deducted from the payment. The amount of the accelerated payment will reduce the death benefit payable under the term life coverage by the amount of the requested payment. The monthly premium due for the remaining amount will be the same as if the accelerated payment had not been made, DISCLOSURE: The Accelerated Benefit offered under this group policy/certificate is intended to qualify for favorable tax treatment under the Internal Revenue Code of 1986. If the Accelerated Benefit qualifies for such favorable tax treatment,

the benefits will be excludable from your income and not subject to federal taxation. Tax laws relating to Accelerated Benefits are complex. You are advised under which you could receive the Accelerated Benefit excludable from income under federal law.

Receipt of an Accelerated Benefit payment may affect your, your spouse, or your family's eligibility for public assistance programs such as medical assistance (Medicaid), Aid to Families with Dependent Children (AFDC), supplemental social security income (SSI) and drug assistance programs. You are advised to consult with a qualified tax advisor and with social service agencies concerning how receipt of such a payment will affect your, your spouse, or your family's eligibility for public assistance.

Conversion Privilege

Should you leave your employment with Baylor University, you may convert your term life coverage to an individual whole life insurance policy.


Child(ren) Supplemental Term Life

You may also elect to purchase Dependents' Term Life on your children). Should a child die for any reason while you are actively at work for Baylor University, benefits will be paid to you.

Plan 1

Plan 2

Plan 3

Plan 4

Children: Age 0 days to age 6 months

$2,500

$2,500

$2,500

$2,500

Age 6 months to age 19

$2,500

$5,000

$7,500

$10,000

Students:
Age 19 to age 26

$2,500

$5,000

$7,500

$10,000

           
Monthly Cost

$ .44

$ .88

$1.32

$1.76




Employee Cost:$ _________
Spouse Cost:$ _________Total Monthly Payroll Deduction
Child(ren) Cost:$ _________


Coverage is guaranteed issue to those new hires enrolling within their eligibility period.

Late enrollees and those who originally enroll for Supplemental and decide to increase their selection to a higher amount at a later date will be required to furnish evidence of insurability satisfactory to DNIC. Coverage will not become effective until the first of the month following approval by DNIC.

This enrollment package is for illustrative purposes only and does not constitute a contract.

The full terms and conditions of the coverages you select will be contained in the policies issued to Baylor University.