VOLUNTARY TERM LIFE & AD&D INSURANCE



Our voluntary Employee-paid term life insurance plan can be designed

to meet the needs of each individual or family. This insurance allows

you to add protection, above the Basic Term Life Insurance coverage.



ANTHEM LIFE INSURANCE COMPANY VOLUNTARY TERM LIFE
Employee Benefit
You may enroll in additional age-rated coverage in $10,000 increments to a maximum of $300,000 for yourself.
Guaranteed coverage is available to $30,000 if you are under age 60, provided you apply within your initial
eligibility period. Amounts in excess of the guaranteed amount, if you are over age 60, and if you apply after your
initial eligibility period are subject to evidence of insurability. Rates are factored in five-year bands.

Spousal and Civil Union Partner Coverage
You can enroll in additional coverage for your spouse or your Civil Union Partner (under age 70) even if you do not
enroll yourself. Spousal or Civil Union Partner coverage is also available in $10,000 increments to a maximum of
$300,000. Guaranteed coverage is available to $30,000, if the spouse or Civil Union Partner is under age 60, during
the Employee’s initial eligibility period only. Amounts in excess of the guaranteed amount, spouses or Civil Union
Partners over age 60, and if the spouse or Civil Union Partner applies after the Employee’s initial eligibility period
are subject to evidence of insurability.

Dependent Children
For a flat rate of $1.50 per month for all legally dependent children, ages six months to 26 years, you can enroll in
additional life insurance, provided you or your spouse, partner in civil union are accepted for insurance coverage.
Children are covered at $5,000 per child.

Children of Civil Union Partners
For a flat rate of $1.50 per month for all legally dependent children of your Civil Union Partner, ages six months to
26 years, you can enroll in additional life insurance, provided you or your Civil Union Partner are accepted for
insurance coverage. Children are covered at $5,000 per child.

Accelerated Benefit
If the covered person is terminally ill, he or she may choose the Accelerated Benefit, subject to conditions and
approval. If approved, a lump sum payment of 50% of the life insurance policy or $100,000, whichever is the lesser
amount, will be issued to the insured. The same conditions apply as under Basic Term Life plan. See your Human
Resources/Benefits Office if this applies to you.

Insurance Premium Waiver
If you or your spouse or Civil Union Partner are under age 60 and become totally disabled for nine consecutive
months, your insurance will continue to age 65, without further premium payments.

Suicide Exclusion
If an Employee, Employee’s spouse, or Civil Union Partner dies by suicide, while sane or insane, within one year
after the effective date of the person’s coverage, Anthem Life will refund premiums only.

Claim Notification
Written notice of the death of the covered person must be provided to Anthem Life within two years after the
date of death. If such notice is not given, Anthem Life will not be liable for any benefit payments.
NOTE: This is a general summary of your Basic & Voluntary Term Life Insurance Plans. Final interpretations and a complete listing and description of any and all benefits,
limitations and exclusions are found in, and governed by the Anthem Life Master Contracts.



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VOLUNTARY TERM LIFE & AD&D INSURANCE

MUTUAL OF OMAHA INSURANCE COMPANY
ACCIDENTAL DEATH & DISMEMBERMENT



This voluntary Employee-paid supplemental Accidental Death and Dismemberment

Insurance is designed to offer you high limit protection against covered accidents.


Maximum Limits

You may choose to purchase coverage from $10,000 to $500,000
You may include coverage on your spouse, Civil Union Partner and dependent children
The amount of coverage purchased cannot exceed ten times your annual salary
Under the family plan coverage spouse and Civil Union Partner coverage is 50% or the employee
elected amount and dependent child coverage is 10% of the employee elected amount
If no dependent children are covered the spouse or Civil Union Partner benefit increase to 60%
If no spouse of Civil Union Partner is covered, children are covered at 20%

Benefit Payments

When covered injuries result in a loss of life within 12 months after the date of an accident, the full
benefit amounts are payable for loss of life. The full amount is also payable for the loss of two limbs,
the sight of both eyes or the loss of one limb and the sight of one eye when these losses are the result
of the same accident. One-half payment is payable for the loss of one limb, one eye, speech or hearing.
One-quarter benefit is payable for the loss of the thumb and index finger of the same hand. See the
Mutual of Omaha AD&D brochure for a complete description of loss payment schedules.

NOTE: This is only an overview of your Accidental Death & Dismemberment Plan. Please review the Mutual of Omaha AD&D brochure for further
details and explanations. If discrepancies are found, depend upon the policy itself for accuracy.



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