Basic Life and AD&D
Symetra Life Insurance Company
Basic Life and AD&D for JPS insurance for Class 3 JPS Health Network team members enrolled in the buy-up option, providing employer-paid coverage of 1x earnings up to $1,000,000 with full guaranteed issue, benefit reductions beginning at age 70, and included AD&D riders.
Life and AD&D Benefit Schedule
| Service | Details |
|---|---|
| Team Member Life Benefit | |
| Amount | 1.00 x Earnings; Rounded to the next higher $1,000 |
| Minimum Amount | $10,000 |
| Maximum Amount | $1,000,000 |
| Guaranteed Issue | $1,000,000 |
| Team Member AD&D Benefit | |
| Amount | 1.00 x Earnings; Rounded to the next higher $1,000 |
| Minimum Amount | $10,000 |
| Maximum Amount | $1,000,000 |
| Benefit Reduction — Team Member | |
| Original Benefit Amount Reduced By | 45% at age 70; 65% at age 75; 75% at age 80. |
Additional Benefits
| Benefit | Details |
|---|---|
| Additional Benefits | |
| Accelerated Death Benefit | If a team member has been diagnosed as terminally ill, Symetra Life Insurance Company may pay a portion of the death benefit in advance to the team member. Please refer to your team member certificate for additional information. |
| Conversion | A conversion benefit is available that allows you to convert your group coverage to an individual policy if certain conditions apply. Please refer to your team member certificate for additional information. |
| Waiver of Premium | With proof of disability, Symetra Life Insurance Company will waive Life Insurance premiums for a team member that becomes disabled. Certain restrictions apply. Please refer to your team member certificate for additional information. |
| AD&D Riders | Includes Seat Belt, Airbag, Repatriation, Child Education, Day Care and Spouse Education benefits. Please refer to your team member certificate for additional information. |
1.Beneficiary Companion: Support services for beneficiaries who have experienced a loss.
2.Travel Assist: Travel assistance services for team members and eligible dependents traveling
more than 100 miles from home.
3.Identity Theft Protection: Help is just a phone call away wherever team members travel, including lost
wallet protection, translation service and emergency cash.
This summary provides only a brief description of the Life Insurance coverage insured by Symetra Life Insurance Company under the LGC-13000 8/06 series Group Life Insurance policy. For a complete description, including all definitions, exclusions, limitations, and reductions in coverage, as well as information on termination of benefits, please contact your benefit administrator or refer to the Group Insurance Certificate you will receive when you become insured. Coverage will be offered under Group Policy number 01-020008-00. All benefits are subject to the terms and conditions of the Group Policy. If there is a difference between the information in this summary and the information contained in the Group Insurance Certificate, the terms of the Group Insurance Certificate will prevail. The terms of coverage may change over time; always refer to your current Group Insurance Certificate for information regarding your insurance benefits.
Phone: 1-877-377-6773
Fax: 1-877-737-3650
Symetra Life Insurance Company
Life and Absence Management Center
P.O. Box 1230
Enfield, CT 06083-1230
Symetra
1-877-377-6773
symetra.com