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Optional Accidental Death & Dismemberment (AD&D) Insurance

You have the choice to purchase Optional Accidental Death & Dismemberment (AD&D) insurance coverage for yourself only or for yourself and your dependent family members in units of $20,000.

AD&D insurance pays a benefit if you or a covered family member die(s) as a result of an accident. Also, accident insurance may pay a benefit if you suffer the loss of the use of a limb or sensory perception (e.g., hearing, sight) as a result of an accident.

You are required to pay the full cost of your Optional AD&D insurance coverage via FlexDollars or payroll deduction.

Coverage

This benefit is available to you and your eligible spouse, as well as eligible dependent children.

Accidental Death and Dismemberment Insurance provides coverage 24 hours a day, 365 days a year against covered accidents in the course of business or pleasure. Coverage includes (but is not limited to) accidents on or off the job, in the home, while driving an automobile, traveling as a passenger by train, airplane, automobile or other public or private conveyance. The benefits provided under this plan are payable in addition to any other insurance which may be in effect at the time of accident. There are no geographical limits; it is worldwide accident protection.

Your options are:

Optional AD&D Insurance Summary	Your Options
Member only	Units of $20,000 to maximum $200,000 Evidence of insurability is not required
Member + 1 or Member +2 or more	Units of $20,000 to maximum $200,000 Evidence of insurability is not required If you do not have dependent children, your spouse will be insured for 50% of the amount you select for yourself If you and your spouse have dependent children, your spouse will be insured for 40% of your amount and each dependent child will be insured for 5% of your amount If you do not have a spouse, each dependent child will be insured for 10% of your amount.

Schedule of Benefits

Optional AD&D Insurance provides coverage in the event of accidental death or other eligible losses, based on the following schedule of benefits:

Schedule of Benefits
Loss	Payable
Life	100% of your selected amount
Hearing in both ears and speech	100% of your selected amount
Use of both hands or both feet	100% of your selected amount
Hemiplegia, paraplegia,or quadriplegia	200% of your selected amount
Loss or loss of use of one arm or one leg	75% of your selected amount
Loss or loss of use of one hand or one foot	66-⅔% of your selected amount
Entire sight in one eye	66-⅔% of your selected amount
Speech or hearing in both ears	66-⅔% of your selected amount
Thumb and index finger or four fingers-of the same hand	33-⅓% of your selected amount
All toes on one foot	25% of your selected amount
Hearing in one ear	25% of your selected amount

To be eligible for benefits, the accident must happen while you are insured and the loss must occur within one year following the accident.

The plan also provides (under certain circumstances) Education, Rehabilitation, Repatriation, Seat Belt and Family Transportation benefits. For further details please consult the handbook or contact our office.

What is a Loss?

For hands and feet – complete severance through or above the wrist or ankle joints
For eyes – total and permanent loss of sight
For thumb, finger or toe – complete severance through or above the first phalange
For arm and leg – complete severance through or above the elbow or knee joints
For hearing and speech – total and permanent loss of hearing and speech

Are any losses not covered?

AD&D benefits are not payable for any loss caused or resulting from:

Self-inflicted injury or suicide, while sane or insane
Civil disorder or war, whether or not war was declared
Injury sustained in aircraft, if you are the pilot, operator or crew member, or if the aircraft is owned, operated or leased on behalf of your employer
An infection (except pyogenic infections from an accidental cut or wound), illness or disease or the medical treatment of any illness or disease, or bodily or mental infirmity
The committing of or attempt to commit an assault or criminal offence
Injuries sustained while operating a motor vehicle, either while under the influence of any intoxicant

The aggregate liability as a result of any one accident is $1,000,000. If claims resulting from the same accident should exceed this amount, individual benefit payments will be reduced proportionally.

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