Life, Long Term Disability (LTD) and Accidental Death and Dismemberment (AD&D) Plans

Group Term Life Insurance

Basic Life	Supplemental Life and AD&D	Dependent Life and AD&D	Plan Documents
Life Insurance Plan Highlights Employee life and accidental death and dismemberment benefits are provided by Cigna (Life Insurance Company of North America). Basic life and accidental death and dismemberment coverage are provided at no cost to employees. The value of basic life is one time the employee's annual salary, rounded to the next $1,000. Value of employer provided, basic life insurance above $50,000 is taxed as "imputed income". You will see this amount on your pay stub as "GTL". The policies offered by AUI are "Term" life policies. They have no cash value. Conversion of life insurance is available upon termination. Ask HR for details. Beneficiary Designations If you have a life event, be sure to check your assigned beneficiaries for basic and supplemental life coverage. In the event of a claim the insurance carrier will provide benefits to whoever is listed on your most recent enrollment/change form. If you are unsure who your beneficiary is contact Sarah Arnold. Life & AD&D Policy Numbers Life Insurance: FLX-963782 Accidental Death and Dismemberment: OK 965412 Age Based Reductions When you are age 65 or older, your Life Insurance Benefit (Basic and Supplemental) will reduce to the percentage shown below: 67% of the Benefit at age 65 45% of the Benefit at age 70 30% of the Benefit at age 75 20% of the Benefit at age 80 This reduction happens immediately after your birthday when you turn one of the qualifying ages.	Supplemental Life Insurance In addition to the Basic Life Insurance coverage provided by AUI/NRAO, supplemental life insurance coverage is also offered. Coverage is available in increments of one or two times your annual salary rounded to the next $1,000. If you elect supplemental life insurance, you are automatically enrolled in the complimentary amount of accidental death and dismemberment insurance. Guaranteed Issue Guaranteed Issue is the term used to indicate no medical underwriting is necessary for coverage. If elected at the time of hire, there is no need for medical underwriting. Additions to employee coverage after hire will always require medical underwriting. Premiums Premiums are post-tax and 100% employee funded. Rates are based on your age on January 1st of the current year. Accidental Death and Dismemberment (AD&D) coverage is included in the premium. If you have a tier change during the calendar year, it will go into affect on January 1st of the next year. Monthly Rates are based on units of $1,000. Under Age 25 $.050 Age 25 – 29 $.053 Age 30 - 34 $.050 Age 35 - 39 $.070 Age 40 - 44 $.100 Age 45 - 49 $.150 Age 50 - 54 $.230 Age 55 - 59 $.417 Age 60 - 64 $.598 Age 65 - 69 $1.190 Age 70 and over $2.060	Spouse and Child Coverage Employees may elect life insurance coverage for their spouse and children. Spouse Coverage You may choose coverage for your spouse up to 50% of the value of your own supplemental coverage, in increments of $5,000. You cannot elect spouse coverage if you do not have your own supplemental life. Spouse coverage is guaranteed issue to the first $30,000. Any coverage requested above that amount requires medical underwriting. Spouse Insurance Premiums Premiums are post-tax and 100% employee funded. Rates are based on your spouse's age on January 1st of the current year. Accidental Death and Dismemberment (AD&D) coverage is included in the premium. If you have a tier change during the calendar year, it will go into affect on January 1st of the next year. Monthly Rates are based on units of $1,000. Under Age 25 $.059 Age 25 – 29 $.062 Age 30 - 34 $.059 Age 35 - 39 $.079 Age 40 - 44 $.109 Age 45 - 49 $.159 Age 50 - 54 $.239 Age 55 - 59 $.426 Age 60 - 64 $.607 Age 65 - 69 $1.199 Age 70 and over Not available. Child Insurance Coverage for dependent children is always guaranteed issue. Effective April 1, 2017: Children can be covered to age 26 regardless of student status. Coverage is available in increments of $2,000 up to $10,000. Premium $.20 Per $1,000	Enrollment and Changes To elect supplemental life insurance or to change your beneficiaries complete the form below and return to human resources at benefitforms@nrao.edu. Enrollment/Change form Life-LTD enrollment form Dependent Life enrollment form Plan Documents (Life & LTD) Life-LTD Plan Document Document regulating AUI's benefit plan (excluding medical) administration. Plan definitions, eligibility, funding, COBRA and HIPAA requirements, claims and appeals are covered. Summary of Life-LTD Benefits Life Evidence of Coverage Certificate of Coverage

Basic Life

Supplemental Life and AD&D

Dependent Life and AD&D

Plan Documents

Life Insurance Plan Highlights

Employee life and accidental death and dismemberment benefits are provided by Cigna (Life Insurance Company of North America).

Basic life and accidental death and dismemberment coverage are provided at no cost to employees. The value of basic life is one time the employee's annual salary, rounded to the next $1,000.
Value of employer provided, basic life insurance above $50,000 is taxed as "imputed income". You will see this amount on your pay stub as "GTL".
The policies offered by AUI are "Term" life policies. They have no cash value.
Conversion of life insurance is available upon termination. Ask HR for details.

Beneficiary Designations

If you have a life event, be sure to check your assigned beneficiaries for basic and supplemental life coverage. In the event of a claim the insurance carrier will provide benefits to whoever is listed on your most recent enrollment/change form. If you are unsure who your beneficiary is contact Sarah Arnold.

Life & AD&D Policy Numbers

Life Insurance: FLX-963782
Accidental Death and Dismemberment: OK 965412

Age Based Reductions

When you are age 65 or older, your Life Insurance Benefit (Basic and Supplemental) will reduce to the percentage shown below:

67% of the Benefit at age 65

45% of the Benefit at age 70

30% of the Benefit at age 75

20% of the Benefit at age 80

This reduction happens immediately after your birthday when you turn one of the qualifying ages.

Supplemental Life Insurance

In addition to the Basic Life Insurance coverage provided by AUI/NRAO, supplemental life insurance coverage is also offered.

Coverage is available in increments of one or two times your annual salary rounded to the next $1,000.

If you elect supplemental life insurance, you are automatically enrolled in the complimentary amount of accidental death and dismemberment insurance.

Guaranteed Issue

Guaranteed Issue is the term used to indicate no medical underwriting is necessary for coverage. If elected at the time of hire, there is no need for medical underwriting.
Additions to employee coverage after hire will always require medical underwriting.

Premiums

Premiums are post-tax and 100% employee funded. Rates are based on your age on January 1st of the current year. Accidental Death and Dismemberment (AD&D) coverage is included in the premium. If you have a tier change during the calendar year, it will go into affect on January 1st of the next year. Monthly Rates are based on units of $1,000.

Under Age 25 $.050

Age 25 – 29 $.053

Age 30 - 34 $.050

Age 35 - 39 $.070

Age 40 - 44 $.100

Age 45 - 49 $.150

Age 50 - 54 $.230

Age 55 - 59 $.417

Age 60 - 64 $.598

Age 65 - 69 $1.190

Age 70 and over $2.060

Spouse and Child Coverage

Employees may elect life insurance coverage for their spouse and children.

Spouse Coverage

You may choose coverage for your spouse up to 50% of the value of your own supplemental coverage, in increments of $5,000. You cannot elect spouse coverage if you do not have your own supplemental life. Spouse coverage is guaranteed issue to the first $30,000. Any coverage requested above that amount requires medical underwriting.

Spouse Insurance Premiums

Premiums are post-tax and 100% employee funded. Rates are based on your spouse's age on January 1st of the current year. Accidental Death and Dismemberment (AD&D) coverage is included in the premium. If you have a tier change during the calendar year, it will go into affect on January 1st of the next year. Monthly Rates are based on units of $1,000.

Under Age 25 $.059

Age 25 – 29 $.062

Age 30 - 34 $.059

Age 35 - 39 $.079

Age 40 - 44 $.109

Age 45 - 49 $.159

Age 50 - 54 $.239

Age 55 - 59 $.426

Age 60 - 64 $.607

Age 65 - 69 $1.199

Age 70 and over Not available.

Child Insurance

Coverage for dependent children is always guaranteed issue. Effective April 1, 2017: Children can be covered to age 26 regardless of student status. Coverage is available in increments of $2,000 up to $10,000.

Premium

$.20 Per $1,000

Enrollment and Changes

To elect supplemental life insurance or to change your beneficiaries complete the form below and return to human resources at benefitforms@nrao.edu.

Enrollment/Change form

Life-LTD enrollment form

Dependent Life enrollment form

Plan Documents (Life & LTD)

Life-LTD Plan Document
Document regulating AUI's benefit plan (excluding medical) administration. Plan definitions, eligibility, funding, COBRA and HIPAA requirements, claims and appeals are covered.

Summary of Life-LTD Benefits

Life Evidence of Coverage

Certificate of Coverage

Long-Term Disability (LTD) Insurance

Plan Info

Premiums

Claims & Benefits

LTD Plan Highlights

Long-term disability (LTD) insurance provides income protection if you become disabled from an accident or illness for longer than six months of time. Long-term disability is often confused with long-term care insurance. Long-term care provides coverage for you or your family members if you need skilled home care, or are admitted to a nursing home.

As an AUI employee, you are enrolled in an LTD insurance plan automatically if you are age 30 or older. You may not opt out of LTD coverage. Employees under 30 can voluntarily elect at any time prior to their 30th birthday. If you are approved, the monthly benefit payments provided are equal to 60% of your basic monthly earnings less any benefits received fromLong term disability benefits are provided by Cigna (Life Insurance Company of North America).

LTD Policy Numbers

Long Term Disability: LK-962685
Long Term Disability Under Age 30: LK-962685
Long Term Disability Over Age 65: LK-962685

LTD Evidence of Coverage (SPD)

Under Age 30

Age 30 to 65

Over Age 65

Premiums - UPDATE FOR 2017

Premiums in 2017 will increase 62% over 2016. Our LTD plan is experience rated. During the past three years of our services contract we experienced a significant increase in LTD claims costs. A competitive bid process was conducted in the second half of 2016, resulting in only one bidder, Cigna.

Examples of the impact of this change at various salary levels is given below. Employee premium rates for individuals under age 65 increase from $0.185 to $0.30 per $100 of covered salary. Premium rates for employees over 65 increase from $0.098 to $0.161 per $100 of covered salary.

Monthly Examples (under 65)

Annual Salary	2016 Rate	2017 Rate	Difference
$30,000.00	$4.63	$7.50	$2.87
$50,000.00	$7.71	$12.50	$4.79
$70,000.00	$10.79	$17.50	$6.71
$150,000.00	$23.13	$37.50	$14.37

Bimonthly Examples (under 65)

Annual Salary	2016 Rate	2017 Rate	Difference
$30,000.00	$2.31	$3.75	$1.44
$50,000.00	$3.85	$6.25	$2.40
$70,000.00	$5.40	$8.75	$3.35

Monthly Example (65 and over)

Annual Salary	2016 Rate	2017 Rate	Difference
$30,000.00	$2.45	$4.03	$1.58
$50,000.00	$4.08	$6.71	$2.63
$70,000.00	$5.72	$9.39	$3.67
$150,000.00	$12.25	$20.13	$7.88

Bimonthly Example (65 and over)

Annual Salary	2016 Rate	2017 Rate	Difference
$30,000.00	$1.23	$2.02	$0.79
$50,000.00	$2.04	$3.36	$1.32
$70,000.00	$2.86	$4.70	$1.84
$150,000.00	$6.13	$10.07	$3.94

File a Claim

If you believe you are eligible for LTD please contact your local HR representative about your FMLA rights and how to proceed.

Claim Forms

Disability Claim Form

Disability Management

Telephonic: 1.800.36.Cigna (362.4462)
7:00am–7:00pm CST Monday–Friday

Fax or mail: Mail or fax both the completed and signed disability claim form, the physician's statement, and any requested documentation available through Cigna's website to:

Cigna Disability Management Solutions
Paper Intake Team
P.O. Box 709015
Dallas, TX 75370-9015
Fax: 800.642.8553

LTD Benefits Payment & Info

If you are approved for LTD Cigna will provide 60% of your annualized salary per month in income. This income is not taxed due to the premiums being paid on a post-tax basis, 100% by the employee.

In addition, Cigna will make a retirement contribution to your 401a account on your behalf each month.

Approved LTD participants can continue to carry AUI medical, dental and vision insurance at their active employee rate. Life insurance continuation is dependent on approval by Cigna. Life insurance conversion options are available.