Life Insurance, AD&D

For Employees Only

The Life Insurance benefits are available to employees only. Dependents are not eligible for Life Insurance benefits. Those making self-payments under COBRA are not eligible for this benefit. Life Insurance is provided through a contract with Standard Insurance Company.

Summary of Life Insurance Benefit

The Plan provides $15,000 of Group Term Life Insurance. (24 hour coverage)

Reductions in Insurance

Your Life Insurance amount will be reduced based on your age, as shown below:

Age
Benefit Amount
70 through 74

65%

$9,750

75 or over

50%

$7,500

 

Life Insurance Effective Date

Your Life Insurance becomes effective on the date you qualify for group health and welfare benefits.

When Life Insurance Ends

Your Life Insurance automatically ends on the earliest of:

  1. The date the last period ends for which a required premium is made on your behalf to Standard Insurance Company by the I.B.E.W./NECA Sound and Communications Health & Welfare Plan;
  2. The date the group policy terminates; or
  3. The date you cease to be eligible for the Self-Funded Plan due to the lack of employer, or a combination of employer and employee contributions for the health and welfare benefits. A self-payment under COBRA to continue health and welfare benefits WILL NOT serve to extend your Life Insurance benefits.
Waiver of Premium

Life Insurance will continue without premium payment while you are totally disabled if:

  1. You become totally disabled while insured under the group policy prior to age sixty;
  2. You remain totally disabled for at least one-hundred and eighty (180) days;
  3. Satisfactory proof of total disability is furnished to Standard Insurance Company; and
  4. Such proof is submitted to Standard Insurance Company no later than eighteen (18) months after you become totally disabled.

Totally Disabled means that, as a result of sickness, accidental injury, or pregnancy, you are unable to perform with reasonable continuity the material duties of any gainful occupation for which you are reasonably fitted by training, education or experience.

Premium payment must continue to be made during the first one-hundred and eighty (180) days of total disability. If you qualify for the Waiver of Premium Benefit, those premiums will be refunded to the Trust.

The amount of Life Insurance continued under the Waiver of Premium Benefit will be the amount of your Life Insurance in effect on the day preceding total disability. If you receive an Accelerated Benefit, the Life Insurance amount will be reduced according to the Accelerated Benefit provision.

Accelerated Benefit

1. Qualifying for an Accelerated Benefit.

If you qualify for a Waiver of Premium and you have a Qualifying Medical Condition, Standard Insurance Company will pay an accelerated benefit, after receiving satisfactory proof of loss. Qualifying Medical Condition means that you are terminally ill with a life expectancy of less than twelve (12) months.

Standard Insurance Company may have you examined at their expense in connection with your claim for an Accelerated Benefit. Any examination will be conducted by one or more physicians of their choice.

2. Application for Accelerated Benefit.

You must have at least $10,000 of Insurance in effect to be eligible (in other words, you must be age 70 or younger).

You must apply for an Accelerated Benefit. To apply you must give Standard Insurance Company satisfactory proof of loss on their forms. Proof of loss must include a statement from a physician that you have a Qualifying Medical Condition.

3. Amount of Accelerated Benefit.

You may receive an Accelerated Benefit of up to 75% of your insurance. The minimum Accelerated Benefit is $5,000.

If the amount of your insurance is scheduled to reduce within twenty-four (24) months following the date you apply for the Accelerated Benefit, your Accelerated Benefit will be based on the reduced amount.

The Accelerated Benefit will be paid to you once in your lifetime in a lump sum. If you recover from your Qualifying Medical Condition after receiving an Accelerated Benefit, Standard Insurance Company will not ask you for a refund.

4. Effect on Insurance and Other Benefits.

The amount of your Life Insurance after payment of the Accelerated Benefit will be:

• The amount of your Insurance as if no Accelerated Benefit had been paid; minus

• The amount of the Accelerated Benefit; minus

• An interest charge calculated as follows:
(A) times (B) times (C) divided by 365 = interest charge.
(A) = The amount of the Accelerated Benefit.
(B) = The monthly average of Standard’s variable policy loan interest rate.
(C) = The number of days from payment of the Accelerated Benefit to the earlier of:

(i) The date you die, and
(ii) The date you have a right to convert.

Life Insurance Claims

1. Filing a Claim

Claims should be filed on Standard Insurance Company forms. You may obtain a claim form by contacting us at 408-288-4400 or infos&c@uastpa.com.

2. Time Limits on Filing Proof of Loss

Proof of Loss must be provided within ninety (90) days after the date of the loss. If that is not possible, it must be provided as soon as reasonable possible, but not later than one (1) year after that ninety (90) day period.

Proof of Loss for Waiver of Premium must be provided within eighteen (18) months after the date of total disability. Further Proof of Loss will be required at reasonable intervals, but not more often than once a year after you have been continuously disabled for two years.

3. Proof of Loss

Proof of loss means written proof that a loss occurred:

a. For which the group policy provides benefits;

b. Which is not subject to any exclusions; and

c. Which meets all other conditions for benefits.

Proof of Loss includes any other information which may reasonably be required in support of a claim. Proof of Loss must be in writing and must be provided at the expense of the claimant. No benefits will be provided until Standard Insurance Company receives Proof of Loss.

BENEFIT PAYMENT AND BENEFICIARY PROVISIONS

1. Payment of Benefits

Benefits payable because of your death will be paid to the beneficiary you name. Beneficiary means a person you name to receive death benefits.

2. Naming a Beneficiary

You may name one or more beneficiaries. Two or more surviving beneficiaries will share equally, unless you specify otherwise. You may name or change beneficiaries at any time without the consent of a beneficiary.

You must name or change beneficiaries in writing. Your beneficiary designation:

a. Must be dated and signed by you;
b. Must be delivered to the Fund Administrator, United Administrative Services, during your lifetime;
c. Must relate to the insurance provided under the group policy; and
d. Will take effect on the date it is delivered to the Fund Administrator.

You may obtain a beneficiary designation form by calling us at 408-288-4400.

The address and telephone number of Standard Insurance Company is:

Standard Insurance Company
920 SW Sixth Avenue
Suite #1002
Portland, OR 97204
Telephone: (503) 321-7000

Accidental Death & Dismemberment

For Employees Only

Accidental Death and Dismemberment insurance benefits are available to employees only. Dependents are not eligible for Accidental Death and Dismemberment insurance benefits. Those making self-payments under COBRA are not eligible for this benefit. Accidental Death and Dismemberment insurance is provided through a contract with Standard Insurance Company.

SUMMARY OF ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE BENEFIT

Accidental Death and Dismemberment insurance (AD&D) provides benefits for dismemberment or death resulting from accidental bodily injuries. The Accidental Death and Dismemberment insurance benefit is summarized below.

1. When Benefits are Payable

If you have an accident while insured for AD&D insurance, and the accident results in a loss, Standard

Insurance Company will pay benefits according to the terms of the group policy after satisfactory proof of loss is received.

2. Definition of Loss for AD&D Insurance

Loss means loss of life, hand, foot or sight, which:

a. Is caused solely and directly by an accident;

b. Occurs independently of all other causes; and

c. Occurs within 365 days after the accident.

With respect to a hand or foot, loss means actual and permanent severance from the body at or above the wrist or ankle joint. With respect to sight, loss means entire and irrevocable loss of sight.

3. Amount Payable

The amount payable is equal to a percentage of your AD&D insurance in effect on the date of the accident. Your AD&D insurance is $15,000. The amount payable is as follows:

LOSS
AMOUNT
Life

$15,000

One hand, one foot, or sight of one eye

$ 7,500

Two or more of the above losses

$15,000

 

No more than 100% of your AD&D insurance will be paid for all losses resulting from one accident.

Filing a Claim 

Claims should be filed on Standard Insurance Company forms. You may obtain a claim form by contacting us at 408-288-4400 or infos&c@uastpa.com.

For more information on Life Insurance or Accidental Death & Dismemberment Insurance, please see your Summary Plan Description.

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