Benefits Description
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GCERT2000
Basic Life Insurance/AD&D
for 2-9 Lives
MetLife is the industry leader in group life insurance, with
over 1.4 trillion dollars of coverage in force.1 Group life
insurance from MetLife means competitive rates with
superior administrative support from communications to
enrollment and claims processing.
What’s Available
Insurance Schedules
◆ Flat amount of coverage:
$20,000, $30,000 or $50,000
◆ Multiple of Salary:
1x Annual Earnings up to $50,000
1x Annual Earnings up to $100,000
Definitions
✓ Definition of Earnings
Annual earnings means gross annual rate of pay as
determined by the employer, excluding overtime and
other extra pay. Annual earnings for salespeople includes
commissions and/or bonuses which shall be averaged
for twenty-four months, or from the date of employment
if less than twenty-four months. The average will be
multiplied by twelve to determine annual earnings.
Features
✓ Continuation of Life Insurance While Totally
Disabled
Continuation of Life Insurance is provided for eligible
employees who become totally disabled before the age
of 60. Total Disability means the employee is unable to
perform the duties of his/her job and is unable to
perform any other job for which he/she is qualified for by
education, training or experience. The Total Disability
must continue for at least nine consecutive months during
which time premiums are required to be paid. When
MetLife has approved the claim for total disability,
subsequent premiums will be waived. We may periodically
request that the employee send us proof that he/she
continues to be Totally Disabled. This benefit terminates
on the earliest of the following: the date the employee
dies; the date total disability ends; the date he/she refuses
to be examined by our physician as required; the date the
employee reaches 65; or the date we do not receive
required proof of total disability, as required. Retirees are
not eligible for this benefit.
1 Based on total life insurance in force as of 12/31/01. Employee Benefit Plan Review,
May 2002.
✓ Accelerated Benefits Option (ABO)
ABO is available for Life Insurance amounts of $20,000 or
more (certain states may have restrictions). Benefits are
payable if an employee or employee’s legal representative
requests payment of the ABO while the employee’s life
benefits are in effect, and his/her life expectancy is
certified by a physician to be six months or less.
The amount of accelerated benefits is up to 50% of
the covered amount to a maximum of $250,000.
✓ Conversion Privilege
The conversion privilege allows a covered person whose
life insurance coverage ends to obtain an individual policy
at his/her own expense, without providing evidence of
insurability. The premiums will be based on the amount
of coverage and the covered person’s age and class of
risk at the time of conversion. Refer to the certificate of
insurance for more information regarding conversion.
✓ Total Control Account
®
(TCA)
The TCA Money Market Option is the automatic settlement option for all life and AD&D benefits of $7,500 or
more. The TCA helps to provide financial flexibility and
security to an employee’s beneficiaries through immediate
access to, and control of, their insurance proceeds. These
benefits are paid through an interest-bearing account
with the principal and interest guaranteed by MetLife
and with free check writing privileges. All or some of
the funds held in a TCA can be transferred into other
available settlement options, such as a guaranteed interest
certificate which “locks in” competitive interest rates for
periods of six months up to seven years. Annuity and
monthly income plan settlement options are also available.
✓ List Billing Services
The employer will receive a monthly premium statement
showing the amount of premium due and providing a list
of insured employees and premium by coverage.
✓ Accidental Death or Dismemberment
AD&D coverage provides 24-hour-a-day, 365-day-a-year
protection in addition to basic life insurance coverage.
Coverage is provided for the covered losses shown below,
if they are caused solely by an accident, occur on or off
the job, and occur within 3 months of the accident. No
more than the full amount of the life insurance benefit
will be paid for all covered losses caused by injuries which
(Continued)
Small Business Center
Basic Life Insurance/AD&D for 2-9 Lives
Features
✓
(continued)
an employee sustains in one accident. The full amount
is equal to the life benefit payable for loss of life. The
seat belt benefit will pay an additional amount.
Covered Loss
Benefit Amount
Life
A hand
A foot
An arm severed at or above the elbow
A leg severed at or above the knee
Sight of an eye
Any combination of a hand,
a foot, and/or sight of an eye
Thumb and Index finger of same hand
Speech and hearing in both ears
Speech
Hearing in both ears
Paralysis of both arms and both legs
Paralysis of both legs
Paralysis of the arm and leg
on either side of the body
Brain Damage
Coma
Full amount
50% of the full amount
50% of the full amount
75% of the full amount
75% of the full amount
50% of the full amount
Full amount
25% of the full amount
Full amount
50% of the full amount
50% of the full amount
Full amount
50% of the full amount
50% of the full amount
Full amount
1% of the full amount
monthly to a maximum
of 60 months
✓ Seat Belt Benefit
If an Accidental Death and Dismemberment benefit is
paid, an additional 10% of the AD&D benefit (minimum
of $1,000 and maximum of $10,000) is payable if the
employee dies as a result of injuries sustained in an
accident while driving or riding in a private passenger
car and wearing a properly fastened seat belt.
✓ Air Bag Benefit
This benefit provides an additional 5% of the AD&D
benefit (minimum of $100 and maximum of $10,000).
The benefit is payable if the seat belt is properly
fastened, the air bag deploys and the covered person
dies as a result of the injuries sustained in the accident.
The combined Air Bag and Seat Belt benefit maximum
is 15% to a maximum of $20,000.
✓ Child Care Benefit
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This benefit provides for child care expense if the
employee dies as a result of an accidental injury. If the
child was enrolled in a child care center on the date of
the employee’s death or enrolls within 12 months of the
employees death, an additional benefit of 10% of the full
amount of the AD&D benefit to a maximum of $5,000 per
year is provided. The benefit will be paid up to 4 consecutive years for each child who qualifies up to age 12. If
no child qualifies, $1,000 will be paid to the beneficiary.
GCERT2000
Common Carrier Benefit
This benefit provides an additional 100% of the full
amount of the AD&D benefit if a covered person dies as
a result of accidental injury while traveling in a Common
Carrier. Common Carrier means a government regulated
entity that is in the business of transporting fare-paying
passengers and does not include chartered or other
privately arranged transportation, taxis or limousines.
Eligibility
Full-time Employees
Only active full-time employees who work at least 30 hours
per week or active full-time salaried employees working at
least 30 hours per week are eligible for coverage.
Actively at Work Requirement
An employee must be actively at work with the employer in
order for benefits to become effective. If the employee is not
actively at work with the employer on the date benefits would
otherwise become effective, the employee’s benefits will
become effective on the date the employee returns to active
work with the employer.
Retirees are not eligible for coverage.
Evidence of insurability is required for:
◆ Groups with 2-4 employees — all employees;
◆ Groups with 5-9 employees — employees with amounts
in excess of the $20,000 non-medical maximum;
◆ Employees who were eligible under the prior plan, but
did not elect coverage; and
◆ Late enrollees (those employees in contributory plans
who do not enroll within 31 days of their eligibility date).
Minimum Participation
Requirements
Contributory Plans
The employer’s contribution must equal at least 25% of the
cost of the insurance; employee participation requirements
are based on the participation table below.
EMPLOYEE COVERAGE
Number Eligible
Minimum Number Insured
2
3
4
5
6
7
8
9
2
3
4
4
5
5
6
7
Small Business Center
Basic Life Insurance/AD&D for 2-9 Lives
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GCERT2000
Participation Requirements
(cont’d)
Non-contributory Plans
The employer’s contribution must equal 100% of the cost of
the insurance and 100% of all eligible employees must enroll.
Limitations
✗ Life insurance and AD&D Benefits are both reduced
by 35% at age 65 and to 50% of the amount in effect
immediately prior to age 65, at age 70 for active
employees; however, all benefits terminate at retirement.
Exclusions
No Seat Belt Benefits will be payable if:
✗ The loss occurs in a commercially licensed car or
any private passenger car which is being used for
commercial purposes.
Cancellation/Termination
Coverage is provided through employer participation in
a multiple employer trust (MET), and is subject to the
terms and provisions in the MET and Master Group Policy
(Form G.2130-S) sitused in the District of Columbia, with
certificates of insurance (Form GCERT2000 ) issued to
each insured employee. In any state validly exercising
extraterritorial jurisdiction, the plan will be modified to
meet applicable laws.
Accelerated Benefits will not be payable if:
✗ The employee or his/her legal representative
has assigned all ABO Eligible Life Insurance;
Coverage terminates:
✗ When the employee’s full-time employment ceases;
✗ ABO Eligible Life Insurance ends; or
✗ When insurance ends for the employee’s class
✗ All ABO Eligible Life Insurance benefits have
been accelerated.
✗ When the employee’s contributions cease (if such
contributions are required);
✗ When the employer’s contributions cease;
For AD&D coverage only, no benefit will be paid for
losses resulting from or caused by:
✗ Physical or mental illnessor infirmity or the diagnosis
or treatment of such illness or infirmity;
✗ An infection, other than infection occurring in an
external accidental wound;
✗ Suicide or attempted suicide;
✗ Intentionally self-inflicted injury;
✗ War, whether declared or undeclared; or act of war,
insurrection, rebellion, riot, or terrorist act;
✗ When this plan ends in whole or in part;
✗ If the group life insurance plan is discontinued by
MetLife for non-payment of premium or if participation
requirements or minimum lives covered requirements
are not met; or
✗ If the Policyholder fails to provide information on a
timely basis or perform any obligations required by the
policy or any applicable law.
✗ AD&D terminates at retirement.
✗ Committing or trying to commit a felony;
✗ The voluntary intake or use by any means of:
- Any drug, medication or sedative, unless it is:
taken or used as prescribed by a physician, or an
“over the counter” drug, medication or sedative
taken as directed; or
- Alcohol in combination with any drug,
medication, or sedative; or
- Poison, gas or fumes.
✗ No benefit will be paid for any loss if the injured party is
intoxicated a the time of the incident and is the operator
of a vehicle or other device involved in the incident.
Note:
Like most group insurance policies, MetLife group policies
contain certain exclusions, limitations, reduction of benefits
and terms for keeping them in force. Your MetLife Small
Business Center sales representative can answer any questions about costs and details of coverage. A full description
of the benefits will be provided in the certificate.
Small Business Center
Metropolitan Life Insurance Company, New York, NY 10010
L03022K17(exp0304)(xMD,NY,OK,OR,PR,SD,TX,VT)MLIC-LD