May 19, 2012

Group Accidental Death & Dismemberment Insurance Coverage Limits and Rates 

COVERAGE LIMITS 

Members may select a principal sum ranging from $50,000 to $500,000 (in units of $50,000).

You have a choice of two plans—the Member Only Plan or the Family Plan. The Member Only Plan pays benefits for covered accidental death or injury for you alone. The Family Plan places 100% of the principal sum on the member, 50% of the principal sum on your spouse, and 10% of the principal sum on each child.**

An individual may not be insured under one or more AD&D Group Policies underwritten by New York Life for a total amount of AD&D coverage that exceeds current over-insurance standards.

When the member reaches age 70, coverage converts to Common Carrier Travel Accident Insurance and any principal sum in excess of $100,000 reduces to $100,000.

RATES

 

MEMBER ONLY PLAN ANNUAL PREMIUM CONTRIBUTIONS

Member's
Principal Sum

When Member is
Under Age 70

When Member is
Age 70 & Over*

$50,000

$24.00

$24.00

100,000

48.00

48.00

150,000

72.00

N/A

200,000

96.00

N/A

250,000

120.00

N/A

300,000

144.00

N/A

350,000

168.00

N/A

400,000

192.00

N/A

450,000

216.00

N/A

500,000

240.00

N/A

 

FAMILY PLAN ANNUAL PREMIUM CONTRIBUTIONS

Principal Sums**

Annual Premium Contributions
When Member is

Member

Spouse

Each Child

Under Age 70

Age 70 & Over*

$50,000

$25,000

$5,000

$36.00

$36.00

100,000

50,000

10,000

72.00

72.00

150,000

75,000

15,000

108.00

N/A

200,000

100,000

20,000

144.00

N/A

250,000

125,000

25,000

180.00

N/A

300,000

150,000

30,000

216.00

N/A

350,000

175,000

35,000

252.00

N/A

400,000

200,000

40,000

288.00

N/A

450,000

225,000

45,000

324.00

N/A

500,000

250,000

50,000

360.00

N/A

 

*Renewal Only. On the premium due date on or immediately after the date the member reaches age 70, the member may not carry more than $100,000 Principal Sum and all coverage converts to Common Carrier Travel Accident.

**Under the Family Plan, if on the date of the accident no dependent spouse is covered, dependent child coverage increases to 15% (instead of 10%). Under the Family Plan, if on the date of the accident spouse only is covered, the percentage is 60%.

The premium contributions shown reflect the current rate and benefit structure. Premium contributions may be changed by New York Life Insurance Company on any premium due date and any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds. For example, a class of insureds is a group of people all with the same issue age. Benefit option amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the Trustee of the American Institute of Chemical Engineers Insurance Trust.