|
Plan name: |
Voluntary Critical Illness |
| Plan year: |
2021 |
|
Group number: |
5973711 |
|
Carrier: |
MetLife |
Disclaimer: Every effort has been made to ensure that the information in this summary is accurate; however no warranty of complete accuracy is made. If a discrepancy is found between this summary and the benefits you selected or the Summary Plan Description (SPD), your selections and the provisions of the SPD will govern.
| Eligible Individual | Benefit Amount | Requirements |
| Coverage Options | ||
| Employee | $10,000, $20,000 or $30,000 | Coverage is guaranteed provided you are actively at work. |
| Spouse/Domestic Partner | 50% of the Employee’s Initial Benefit | Coverage is guaranteed you are actively at work and your spouse/domestic partner is not subject to a medical restriction as set forth on the enrollment form and in the coverage Certificate. |
| Dependent Child(ren) | 50% of the Employee’s Initial Benefit | Coverage is guaranteed provided you are actively at work and the dependent is not subject to a medical restriction as set forth on the enrollment form and in the coverageCertificate. |
Disclaimer: Every effort has been made to ensure that the information in this summary is accurate; however no warranty of complete accuracy is made. If a discrepancy is found between this summary and the benefits you selected or the Summary Plan Description (SPD), your selections and the provisions of the SPD will govern.
Monthly Premium per 1,000$ of Coverage – After Tax
| Attained Age | Employee Only | Employee + Spouse | Employee + Child(ren) | Employee + Spouse and Child(ren) |
| <25 | $0.50 | $0.81 | $0.76 | $1.07 |
| 25 – 29 | $0.56 | $0.90 | $0.82 | $1.16 |
| 30 – 34 | $0.68 | $1.08 | $0.94 | $1.35 |
| 35 – 39 | $0.82 | $1.30 | $1.08 | $1.56 |
| 40 – 44 | $1.08 | $1.69 | $1.34 | $1.96 |
| 45 – 49 | $1.47 | $2.27 | $1.73 | $2.53 |
| 50 – 54 | $2.15 | $3.22 | $2.41 | $3.48 |
| 55 – 59 | $3.05 | $4.44 | $3.31 | $4.71 |
| 60 – 64 | $4.33 | $6.22 | $4.59 | $6.48 |
| 65 – 69 | $6.15 | $8.73 | $6.41 | $8.99 |
| 70 – 74 | $8.13 | $11.58 | $8.39 | $11.84 |
| 75+ | $10.89 | $15.71 | $11.15 | $15.98 |
This premium is paid for with after tax dollars, resulting in tax-free benefits from this plan.
Disclaimer: Every effort has been made to ensure that the information in this summary is accurate; however no warranty of complete accuracy is made. If a discrepancy is found between this summary and the benefits you selected or the Summary Plan Description (SPD), your selections and the provisions of the SPD will govern.
|
Title/Department: |
Metlife |
|
Phone: |
800-GET-MET8 |