This summary is provided for your convenience only and is not intended to be inclusive of all
policy provisions. Please see your certificate for complete details. If there is any discrepancy
between this document and the master policy, master policy provisions will prevail.
Lincoln County School District Confidential Employees
Benefits as of July 1, 2010
Life and Accidental Death & Dismemberment (AD&D)
Basic Life Insurance
Basic AD&D Insurance
Age Reduction
$50,000
$50,000
If you are still working the required number of hours to be eligible for this insurance at age 70, your
benefits will reduce according to the following scale.
Benefits reduce to:
At age:
65%
70
50%
75
AD&D Schedule
If due to an accident you die, lose a limb, sight of an eye or become paralyzed, the following benefits
are available.
100% of the Basic AD&D
75% of the Basic AD&D
50% of the Basic AD&D
Life
Paraplegia
One hand
Both hands
Triplegia
One foot
Both feet
Sight of one eye
Sight of both eyes
25% of the Basic AD&D
Speech
One hand and one foot
Thumb and Index finger
Hemiplegia
One hand and sight of one eye Uniplegia
Hearing
One foot and sight of one eye
Quadriplegia
Seat Belt Benefit
If you die in an automobile accident and were wearing your seat belt, your beneficiary (ies) will
collect an amount equal to the AD&D benefit to a maximum of $10,000 in addition to the Basic Life
and Basic AD&D benefits described above.
Accelerated Benefit
You may collect part of your Basic Life insurance prior to death if you are diagnosed as terminally ill
and have a life expectancy of less than 12 months. You may apply for up to 80% of the Basic Life
insurance in force, to a $40,000 maximum. The remaining benefit you do not elect is payable to your
beneficiary upon your death.
Total Disability
If you become totally disabled (as defined by the policy) prior to age 60 and are disabled for at least 6
consecutive months, your basic life insurance may be continued until you reach age 65 without further
premium payment by either your employer or you. At age 65 coverage terminates, however you may
continue coverage by applying for a conversion policy at that time.
Additional Benefits Included
Adaptive Home/Vehicle, AirBag, Child Education, Coma, Day Care, Exposure and Disappearance,
Felonious Assault, Rehabilitation, Repatriation, Spouse Education.
Basic Life Insurance Exclusions None
AD&D Insurance Exclusions
Benefits are not payable for losses due to suicide or attempted suicide, riot, war or act of war, military
service, felony, voluntary use of a controlled substance.
You may convert your Basic Life insurance to an individual policy if your coverage is terminated due to
Conversion
termination of employment or other loss of eligibility. You have 31 days from the earliest of, the date your
employment terminates or other loss of eligibility to apply for the Conversion policy.
Dependent Life
Dependent Life Benefits
Eligible Dependents
Exclusions
Conversion
Document1 2/6/2016
$2,000 Spouse, $200 per Child. Price is $.75 for dependent coverage, regardless of number of dependents.
Legal spouse and children to age 26. See certificate for definition of eligible dependent child.
None
You may convert your Dependent Life insurance to an individual policy if your coverage is terminated due
to termination of employment or other loss of eligibility. You have 31 days from the earliest of, the date
your employment terminates or other loss of eligibility to apply for the Conversion policy.
All Coverage Underwritten by Regence Life and Health Insurance Company
This summary is provided for your convenience only and is not intended to be inclusive of all
policy provisions. Please see your certificate for complete details. If there is any discrepancy
between this document and the master policy, master policy provisions will prevail.
Lincoln County School District Confidential Employees
Benefits as of July 1, 2010
Long Term Disability Benefits
Benefits Begin:
Benefit Replacement Percentage
Maximum Monthly Benefit
Maximum Benefit Period
Minimum Monthly Benefit
Definition of Total Disability
Partial Disability Qualification
Pre-existing Condition Exclusion
Exclusions & Limitations
Taxability
Document1 2/6/2016
Benefits begin after 60 days of disability or end of accumulated sick leave, whichever is longer.
Benefits are paid monthly. Waiting period may be served with total or partial disability or a
combination of both.
66.67% of your basic monthly earnings (Does not include bonuses or overtime)
$2,000
If you become disabled, as defined by the policy prior to age 61, benefits are generally payable
to normal retirement age as currently defined by Social Security. Please see your certificate for
complete details.
$100
You are considered totally disabled if you are unable to do the material duties of your own
occupation during the first 24 months of disability, thereafter you must be disabled from any
occupation that you are fitted for by reason of training, experience or education.
If you are working and because of a disability are earning less than 80% of what you were
earning before you became disabled, you may qualify for a partial disability benefit.
A pre-existing condition is one that exists 3 months prior to your effective date of LTD
coverage. LTD benefits are not payable for any disability caused by a pre-existing condition, if
the disability begins during the first 12 months of your coverage. However, if during the first
12 months of coverage you can be treatment free for the pre-existing condition for 6 consecutive
months, you will have coverage for such condition upon completion of the 6 month treatment
free period.
Benefits are not payable for losses due to intentional self inflicted injuries, war or any act of
war, active participation in a riot, and committing or attempting to commit a felony. There is a
24 month mental/nervous benefit limitation.
All benefits received are taxable.
All Coverage Underwritten by Regence Life and Health Insurance Company
This summary is provided for your convenience only and is not intended to be inclusive of all
policy provisions. Please see your certificate for complete details. If there is any discrepancy
between this document and the master policy, master policy provisions will prevail.
Lincoln County School District Confidential Employees
Benefits as of July 1, 2010
Voluntary Life Insurance (Payroll Deduction)
Eligibility
Amounts Available
Employees enrolled in the Basic Life plan, their spouses and eligible dependent children.



Employees may select from a minimum of $10,000 to $500,000 in $10,000 increments.
Spouses may select from a minimum of $10,000 to $250,000 in $10,000 increments, not to exceed 100% of the
employee’s elected amount. Spouses may enroll in the Voluntary Life plan even if the employee does not enroll.
Dependent Child(ren) coverage may be selected if the employee or spouse is approved for coverage. Coverage may
be elected from a minimum of $2,000 to $10,000 in $2,000 increments. Dependent children are eligible from birth
to age 26.
Age Reduction
If you are still working the required number of hours to be eligible for this insurance at age 70, your benefits
will reduce according to the following scale.
Benefits reduce to:
At age:
65%
70
50%
75
Accelerated Benefit
You may collect part of your Voluntary Life insurance prior to death if you are diagnosed as terminally ill and have a
life expectancy of less than 12 months. You may apply for up to 80% of the Voluntary Life insurance in force, to a
$150,000 maximum. The remaining benefit you do not elect is payable to your beneficiary upon your death.
Employees and Spouses – For new employees, the first $50,000 of Employee Voluntary Life coverage will be offered
on a guarantee issue basis (no health statement required) if applied for within 31 days of initial eligibility. For new
spouses, the first $10,000 will be offered on a guarantee issue basis (no health statement required) if applied for within
31 days of initial eligibility.
Child(ren) – All amounts of coverage are guarantee issue (no health statement required) if coverage is elected within 31
days of initial eligibility. All amounts of coverage applied for after the initial 31 day eligibility period require a health
statement to be submitted and approved by Regence Life and Health.
Underwriting and
Effective Date
Any coverage requiring approval of a health statement is not effective until approved in writing by Regence Life and
Health. The effective date of approved coverage will be assigned by Regence Life and Health.
Total Disability
Cost - Rates
Exclusions
Conversion
Portability
Document1 2/6/2016
In some cases, we may request a Paramed Exam. If requested, the Paramed Exam will be at Regence Life and Health’s
expense.
If you become totally disabled (as defined by the policy) prior to age 60 and are disabled for at least 6 consecutive
months, your Voluntary Life insurance may be continued until you reach age 65 without further premium payment by
either your employer or you.
Employee and Spouse premiums are based on their individual ages and are paid through the employee’s
payroll deduction.
Employee and Spouse Monthly Rate per $1,000 of Coverage
Age
Rate
Age
Rate
Age
Rate
Under age 25
$.057
45-49
.207
70-74 $1.668
25-29
.061
50-54
.353
75+
2.550
30-34
.070
55-59
.554
Child(ren) - $.14 per $2,000 increment regardless of
35-39
.085
60-64
.753
the number of covered children.
40-44
.125
65-69
1.078
Benefits are not payable for losses due to suicide or attempted suicide during the first two years of coverage.
You may convert your Voluntary Life insurance to an individual policy if your coverage is terminated due to
termination of employment or other loss of eligibility. You have 31 days from the earliest of, the date your
employment terminates or other loss of eligibility to apply for the Conversion policy.
Portability allows you and your covered dependents to continue your Voluntary Life insurance if your coverage ends,
provided you are under age 65, not retiring and are not disabled. The rates charged will be the current rates plus a
billing fee. To elect coverage, please complete the Portability Application and return it with your premium check to
Regence Life and Health within 31 days from the date your group coverage ends. If elected, Portability coverage will
end the earliest of when you reach age 65 or when this master policy terminates.
All Coverage Underwritten by Regence Life and Health Insurance Company
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