Benefits Summary

Note: Benefits are deducted from each of the 26 pay periods per year.

 In Network

 Out of Network

$1500

 $1500

Individual $50/Family Limit of 2

100% Deductible Waived

90% after Deductible

80% after Deductible

60% after Deductible

50% after Deductible

50% after Deductible Lifetime Maximum of $2000 per individual

Wisdom Tooth Extraction
(lifetime Maximum of $4,000)

90% after Deductible

80% after Deductible

2017 Vision Care Cost Per Pay Period

Employee and Management development programs, In-Service Education, Nursing and other Professional Continuing Education Units and computer training.

You are eligible if you are an active full time Employee who works at least 30 hours per week on a regularly scheduled basis.

Coverage goes into effect subject to the terms and conditions of the policy. In no case will newly elected benefits become effective sooner than 1/1/2012 or six months of continuous active service. You must be Actively at Work with your employer on the day your coverage takes effect.

The maximum amount you can purchase cannot be more than the lesser of 3 times your annual Salary or $500,000. Annual Salary is as defined in The Hartford's contract with your employer.

If you elect Supplemental Life Insurance for yourself - You may choose to purchase Spouse Supplemental Life Insurance in the amount of 50% of your Employee Supplemental Life Insurance coverage to a maximum of $250,000.

Coverage cannnot exceed 50% of the amount of your Employee Voluntary/Supplemental Life Insurance coverage. You may not elect coverage for your Spouse if they are an active member of the armed forces of any country or international authority, or is already covered as an Employee under this policy.

If you elect an amount that exceeds the guaranteed issue amount of $50,000, your Spouse will need to provide evidence of insurability that is satisfactory to The Hartford before the excess can become effective.

If you elect Supplemental Life Insurance for yourself - You may choose to purchase Child(ren) Supplemental Life Insurance coverage in the amount(s) of $10,000 for each Child - no medical information is required. You may not elect coverage for your Child if your Child. You may not elect coverage for your Child if your Child is an active member of the armed forces of any country or international authority.

• Children may be covered up to age 26 
• Children from Live Birth to 6 months are limited to a reduced benefit of $1000 

You have the option of converting your group Life coverage to your own individual policy (policies).

If you leave your employer, Portability is an option that allows you to continue your Life Insurance coverage. To be eligible, you must terminate your employment prior to Social Security Normal Retirement Age. This option allows you to continue all or a portion of your Life Insurance coverage under a separate Portability term policy. Portability is subject to a minimum of $1,000 and a maximum of $750,000 and does include coverage for your Spouse and Child(ren). To elect Portability, you must apply and pay the premium within 31 days of the termination of your Life Insurance. Evidence of Insurability will not be required.

Dependent Spouse Portability is subject to a maximum of $250,000 with a minimum of $1,000.

Dependent Child Portability is subject to a maximum of $10,000 with a minimum of $1,000.

Living Benefits Option

If you are diagnosed as having a terminal illness with a 12 month life expectancy, the Living Benefits Option allows you to receive an accelerated payment of a portion of your life Insurance. The option available to individuals with at least $10,000 in group coverage from The Hartford and is subject to a maximum age limit of 60. You may request a minimum accelerated payment of $3,000 up to a maximum of 80% of your coverage not to exceed $750,000. Funds are paid directly to you, with no policy restrictions on how you use them. The remaining benefit is then payable to your beneficiary.

Waiver of Premium

Limitations and Exclusions

As is standard with most term life Insurance plans, death by suicide is covered only after the Employee has been insured for two years. Therefore, if death results from suicide, no benefit will be payable for any Life coverage that became effective within two years of the date of death.

Other exclusions may apply depending upon your coverage. Refer to your policy.

This Benefit Fact Sheet is an overview of the Insurance being offered and is provided for illustrative purposes only and is not a contract. It in no way changes or affects the policy as actually issued. Only the Insurance policy issued to the policyholder (your employer) can fully describe all of the provisions, terms, conditions, limitations and exclusions of your Insurance coverage. In the event of any difference between the Benefit Fact Sheet and the Insurance policy, the terms of the Insurance policy apply.

Short Term Disability

Income protection for 60% of weekly salary after 30 days of disability Effective after 3 months

Extended Illness Bank

Employees may accumulate up to 120 paid hours for time missed resulting from a personal illness or injury that causes them to miss more than 40 hours of work.