All full-time employees scheduled to work at least 30 hours per week are eligible for Life and AD&D coverage on the first of the month after completing two full calendar months of employment.
J M Smith Corporation’s Life and AD&D insurance provides important financial protection for you and your survivors. J M Smith pays the premiums for Basic Life insurance and Accidental Death and Dismemberment (AD&D) coverage for all eligible employees. Basic Life insurance is $25,000 for you and $5,000 for your spouse and your children if covered under the medical plan.
Accidental Death and Dismemberment coverage in the amount of $25,000 is provided for covered employees.
You may purchase supplemental insurance on your own life. If you purchase supplemental life coverage, you may also purchase supplemental coverage for your spouse and your dependents.
| Coverage Type | Amount | Cost Per Pay Period | Notes |
|---|---|---|---|
| Basic Employee Life and AD&D | $25,000 | Paid by J M Smith | |
| Basic Dependent Life Insurance | $5,000 for spouse $5,000 per child | Paid by J M Smith | Must be covered under the medical plan |
| Supplemental Employee Life Insurance | Increments of $25,000 up to the lesser of 3 times your salary or $375,000 | Based on age rate per amount selected | Evidence of Insurability is required when employees increase their own coverage by more than $25,000 during annual open enrollment. New employees may elect any available amount up to the plan maximum without providing Evidence of Insurability. |
| Supplemental Spouse Life Insurance | Increments of $12,500 up to the lesser of $50,000 or 50% of supplemental employee life insurance | Based on age rate per amount selected | Evidence of Insurability is required if an employee increases spouse life by more than $12,500 during annual open enrollment. New employees may elect any available amount up to the plan maximum without providing Evidence of Insurability. |
| Supplemental Child Life Insurance | Choice of $2,500, $5,000, $7,500 or $10,000 | Ranges from $0.40 to $1.60 | Employee must elect supplemental employee life insurance to be eligible to purchase supplemental child life insurance. |
This basic coverage is fully paid at this time by J M Smith Corporation and is automatically provided to you.
You pay the cost of any supplemental insurance you purchase on your own life, your spouse or your dependent children.
Purchasing additional coverage
J M Smith has several types of insurance coverage you may purchase:
Supplemental Employee Life Insurance –
(Rates are monthly; divide by 2 for your per-paycheck cost.)
**Age-based rates are based on the age of the covered individual attained as of
January 1, 2019.
| Age | $25,000 | $50,000 | $75,000 | $100,000 | $125,000 | $150,000 | $175,000 | $200,000 |
|---|---|---|---|---|---|---|---|---|
| 29 & below | $1.50 | $3.00 | $4.50 | $6.00 | $7.50 | $9.00 | $10.50 | $12.00 |
| 30-34 | $1.75 | $3.50 | $5.25 | $7.00 | $8.75 | $10.50 | $12.25 | $14.00 |
| 35-39 | $2.25 | $4.50 | $6.75 | $9.00 | $11.25 | $13.50 | $15.75 | $18.00 |
| 40-44 | $4.00 | $8.00 | $12.00 | $16.00 | $20.00 | $24.00 | $28.00 | $32.00 |
| 45-49 | $7.50 | $15.00 | $22.50 | $30.00 | $37.50 | $45.00 | $52.50 | $60.00 |
| 50-54 | $11.75 | $23.50 | $35.25 | $47.00 | $58.75 | $70.50 | $82.25 | $94.00 |
| 55-59 | $19.25 | $38.50 | $57.75 | $77.00 | $96.25 | $115.50 | $134.75 | $154.00 |
| 60-64 | $27.50 | $55.00 | $82.50 | $110.00 | $137.50 | $165.00 | $192.50 | $220.00 |
| 65-69 | $47.50 | $95.00 | $142.25 | $190.00 | $237.50 | $285.00 | $332.50 | $380.00 |
| 70+ | $71.00 | $142.00 | $213.00 | $284.00 | $355.00 | $426.00 | $497.00 | $568.00 |
| Age | $225,000 | $250,000 | $275,000 | $300,000 | $325,000 | $350,000 | $375,000 |
|---|---|---|---|---|---|---|---|
| 29 & below | $13.50 | $15.00 | $16.50 | $18.00 | $19.50 | $21.00 | $22.50 |
| 30-34 | $15.75 | $17.50 | $19.50 | $21.00 | $22.75 | $24.50 | $26.25 |
| 35-39 | $20.25 | $22.50 | $24.75 | $27.00 | $29.25 | $31.50 | $33.75 |
| 40-44 | $36.00 | $40.00 | $44.00 | $48.00 | $52.00 | $56.00 | $60.00 |
| 45-49 | $67.50 | $75.00 | $82.50 | $90.00 | $97.50 | $105.00 | $112.50 |
| 50-54 | $105.75 | $117.50 | $129.50 | $141.00 | $152.75 | $164.50 | $176.25 |
| 55-59 | $173.25 | $192.50 | $211.75 | $231.00 | $250.25 | $269.50 | $288.75 |
| 60-64 | $247.50 | $275.00 | $302.50 | $330.00 | $357.50 | $385.00 | $412.50 |
| 65-69 | $427.5 | $475.00 | $522.50 | $570.00 | $617.50 | $665.00 | $715.50 |
| 70+ | $639.00 | $710.00 | $781.00 | $852.50 | $923.00 | $994.00 | $1065.00 |
(Rates are monthly; divide by 2 for your per-paycheck cost.)
**Age-based rates are based on the age of the covered individual attained as of January 1, 2019.
| Age | $12,500 | $37,500 | $25,000-$50,000 |
|---|---|---|---|
| 29 & below | $0.75 | $2.25 | Same as Employee Rates** |
| 30-34 | $0.88 | $2.63 | |
| 35-39 | $1.13 | $3.38 | |
| 40-44 | $2.00 | $6.00 | |
| 45-49 | $3.75 | $11.25 | |
| 50-54 | $5.88 | $17.63 | |
| 55-59 | $9.63 | $28.88 | |
| 60-64 | $13.75 | $41.25 | |
| 65-69 | $23.75 | $71.25 | |
| 70+ | $35.50 | $100.50 |
(Rates are monthly; divide by 2 for your per-paycheck cost.)
| Cost of Coverage | Cost |
|---|---|
| $2,500 | $0.40 |
| $5,000 | $0.80 |
| $7,500 | $1.20 |
| $10,000 | $1.60 |
When evidence of insurability is required for you or your spouse, you must fill out the employee portion of the personal health application for the person(s) requiring evidence of insurability.
If Medical Underwriting approves the application, you will receive a letter confirming the requested coverage. If the application is not approved, you will receive a letter declining the coverage.
Pending approval, your coverage for the year will be set at the level that does not require evidence of insurability. If coverage is declined, your coverage will remain the same for the remainder of the year.
If you terminate employment, you may have the right to convert your Group Life coverage without having to submit evidence of good health.
Your group insurance certificate or booklet contains the specific conversion privilege.
Group Life Insurance may be converted to a plan of individual permanent life insurance.
You may convert any amount up to the benefit level you had under the group plan.
Special restrictions and limits apply when coverage on an entire class of employees or members terminates.
For more information, please contact your Human Resources Department.
If you do not designate a beneficiary for your group life insurance, your profit-sharing and 401(k) account, and your elected voluntary insurance, death benefits will be paid to your estate.
Each plan requires a separate beneficiary designation, so be sure to follow the instructions below for each applicable plan.
If your situation changes (through marriage, divorce, separation, birth of a child, etc.) be sure to review your beneficiary designations for each plan to make sure they reflect your current wishes.
To choose or change your beneficiaries for Group Life Insurance (basic and supplemental) go to the enrollment site (click on the Online Enrollment bar on the J M Smith benefits home page and sign in).
Select My Current Benefits from the list on the left. Choose “Change Beneficiaries” for Basic Life.
Enter identifying information for your primary and secondary beneficiaries (name, relationship, date of birth and Social Security number if known) and the percentage of your death benefit you want to he paid to each.
Click Save and Exit. Note that your primary beneficiaries will receive the benefit if they survive you. Your secondary beneficiary will receive a benefit only if the primary beneficiaries predecease you.
Repeat the process for Supplemental Life (if applicable).
Equitable
1290 Avenue of the Americas
New York, NY 10104
866.274.9887
www.equitable.com
EBCustomerService@equitable.com
There in this form.