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Benefits at a Glance for IBEW 1253
Policy #140571
Effective Date March 1, 2006
Group Basic Life and Accidental
Death and Dismemberment Insurance
Basic Life Insurance from Standard Insurance Company helps provide financial protection by
promising to pay a benefit in the event of an eligible employee’s covered death. Basic Accidental
Death and Dismemberment (AD&D) Insurance may provide an additional amount in the event of a
covered death or dismemberment as a result of an accident.
The cost of this insurance is paid by IBEW 1253. Any enrollment materials needed to elect this
coverage will be provided.
Eligibility
Eligible Employee
A Member in good standing of the Policyholder. An eligible employee does not include a full-time
member of the armed forces, leased employee or an independent contractor.
Class Definition
Class 1 Union Members other than Retired Union Members
Class 2 Retired Union Members
Waiting Period Before Becoming Eligible for Insurance
None for those that meet the definition of an eligible employee on the group policy effective date. All
other employees become eligible on the date you become a Member
Benefits
Employee Coverage Amount
The Basic Life coverage amount is
Class 1 $40,000
Class 2 $20,000
AD&D Insurance
Class 1 $40,000
Class 2 None
For accidental loss of life, the amount of this insurance benefit is equal to the employee Basic Life
coverage amount. For other covered losses, the amount of this benefit is a percentage of the Basic
Life coverage amount.
Dependents Life Insurance
The insurance policy provides
Class 1 $7,500 of coverage for the employee’s eligible spouse and $7,500 of coverage for the
employee’s eligible dependent(s).
Class 2 $4,000 of coverage for the employee’s eligible spouse and $4,000 of coverage for the
employee’s eligible dependent(s).
Age Reductions
Under this policy, insurance coverage will not be reduced because of your age unless your insurance
is subject to termination under the Waiver of Premium provision.
Other Life Features & Services
•
Right to Convert Provision•
Waiver of Premium (Class 1 only)•
Repatriation benefit•
Accelerated benefit (Class 1 only)•
MEDEX® Travel Assist•
Standard Secure Access accountpayment option
Other AD&D Features
•
Seat Belt Benefit (Class 1 only)•
Air Bag Benefit (Class 1 only)•
Family Benefits Package (Class 1 only)This information is only a brief description of the group Basic Life/AD&D insurance policy sponsored
by IBEW 1253. The controlling provisions will be in the group policy issued by The Standard. The
group policy contains a detailed description of the limitations, reductions in benefits, exclusions and
when The Standard and the employer may increase the cost of coverage, amend or cancel the policy.
A group certificate of insurance that describes the terms and conditions of the group policy is
available for employees who become insured according to its terms. For costs and more complete
details of coverage, contact your human resources representative