ELIGIBILITY
As a member of one of these groups listed below, you are eligible to be insured under the Employee Group Life Insurance program of the Commonwealth of Kentucky.
A "state employee" is defined as an employee of the Commonwealth of Kentucky who is regularly employed working 100 hours per month by the State and is a contributing member of any of the retirement systems administered by the State.
An "employee of a local board of education" shall be defined as follows:
"Regular, full-time, non-certified employee" means an employee having the expectation that he is to be employed for the full school term (or the remainder of the school term) as defined in KRS 158.070, and whose assignments require a minimum of eighty (80) hours per school month as defined in KRS 158.060.
"Regular, full-time, certified employee" means an employee with the expectation that he is to perform duties for the full school term (or the remainder of the school term) as defined in KRS 158.070 but in no instance shall such employment require less than seventy (70) percent of the school day or school month as defined in KRS 158.060.
A "local health department employee" means an employee of a county, district or independent health department who is designated in a regular full-time or part-time 100 hour status.
An "elected state official" means a member of the General Assembly of the Commonwealth of Kentucky, Judge of the Court of Justice, Circuit Clerks, Commonwealth Attorneys, and Property Valuation Administrators.
A "quasi-agency" means an agency whose employers pays into a state-sponsored retirement system and has elected to participate in the state sponsored life insurance program.
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BASIC INSURANCE AMOUNT
All eligible employees will be covered for the Basic amount of $20,000 with Accidental Death and Dismemberment benefits included.
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STATE PAYS COSTS OF BASIC INSURANCE
The Commonwealth of Kentucky pays for your Basic Group Life Insurance. There is no cost to you.
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OPTIONAL LIFE INSURANCE
In addition to the Basic Insurance, the Commonwealth of Kentucky Group Life Insurance Program offers you the option of purchasing additional insurance. You can choose the amount of coverage that is right for you.
Plan 1 $5,000
Plan 2 $10,000
Plan 3 One times annual salary*
Plan 4 Two times annual salary*
*Under Plans 3 and 4, insurance amounts will be the annual salary at the time of enrollment and will be rounded to the nearest multiple of $1,000. Evidence of insurability will be required for insurance amounts over $150,000.
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MONTHLY COST OF INSURANCE
| AGE |
RATE PER $1,000 |
| Under 40 |
$0.25 |
| 40-59 |
$0.57 |
| 60 and over |
$0.90 |
Premium rates are current as of July 1, 2005. Rates may change as the insured enters a higher age category or if the plan experience requires a change for all insured's.
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DEPENDENT TERM LIFE INSURANCE
You also have the option of selecting coverage for your family by choosing one of the following plans:
| |
PLAN A |
PLAN B |
PLAN C |
PLAN D |
PLAN E |
| Insurance on Spouse |
$10,000 |
$5,000 |
$5,000 |
$10,000 |
$ - |
| Insurance on each child to age 6 months |
$2,500 |
$1,500 |
$ - |
$ - |
$2,500 |
| 6 months to 18 years of age or 18 and older if attending an educational institution and relying on employee for financial support |
$5,000 |
$3,000 |
$ - |
$ - |
$5,000 |
| Monthly Premium |
$10.90 |
$5.90 |
$2.50 |
$8.70 |
$3.60 |
Premium rates are current as of July 1, 2005.
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ELIGIBLE DEPENDENTS
Eligible dependents include your spouse (legally married) and unmarried dependent children from live birth to age 18, provided they are not in the military service.
Unmarried dependent children include your children by birth or adoption, stepchildren, foster children or other children that depend on you for support and live with you in a regular parent-child relationship.
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WHEN YOU CAN ENROLL OR CHANGE COVERAGE
The enrollment for Optional Life Insurance or Dependent Life Insurance can be made between the date of your employment by the Commonwealth of Kentucky and 30 days following the date of your employment without evidence of insurability.
If you are enrolled in Optional Life Insurance Plan 3 or Plan 4, you have 30 days following the date of a pay increase to adjust your insurance to corresponding plan coverage amounts.
You are also eligible to enroll in Dependent Life Insurance the first day of the month after you first acquire a dependent.
You can enroll in or increase Optional and/or Dependent coverage at any time with evidence of insurability.
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EFFECTIVE DATE
Your insurance takes effect on the first day of the second month following the month you were employed.
If you choose to purchase Optional Life Insurance and/or Dependent Life Insurance for your family at the time of your employment, this insurance coverage becomes effective on the first day of the second month following the month you were employed.
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ACCIDENTAL DEATH & DISMEMBERMENT BENEFIT (AD&D)
Benefits will be paid under the Basic Life and AD&D, and Optional Life and AD&D, (if applicable) in the event of your death, dismemberment, or loss of sight, as a result of an accidental injury. The full amount of your benefit will be paid to your beneficiary if the covered accident you suffer results in your death. Full or partial benefits will be paid to you according to the following schedule if the accident results in dismemberment or loss of sight:
| Loss of or by Reason of: |
Percent of the Person’s
Amount of Insurance |
| Life |
100% |
| Both Hands |
100% |
| Both Feet |
100% |
| Sight of Both Eyes |
100% |
| One Hand and One Foot |
100% |
| One Hand and Sight of One Eye |
100% |
| One Foot and Sight of One Eye |
100% |
| Speech and Hearing |
100% |
| Quadriplegia |
100% |
| Paraplegia |
75% |
| One Hand |
50% |
| One Foot |
50% |
| Sight of One Eye |
50% |
| Speech |
50% |
| Hearing |
50% |
| Hemiplegia |
50% |
| Thumb and Index Finger of the Same Hand |
25% |
| Coma |
1% per month, up to 100 months |
Seat Belt Benefit - The plan pays an additional benefit of 10% of your coverage amount, up to a maximum of $25,000.
Air Bag Benefit - The plan pays an additional benefit of 5% of your coverage amount, up to a maximum of $12,500.
Amount Limitation: The amount payable for all losses of the insured as a result of the same accident is limited to the total amount of insurance under this coverage.
EXCLUSIONS: No AD&D Insurance benefit is payable if the accident or loss is caused or contributed to by any of the following:
- Suicide or attempted suicide, while sane or insane.
- Intentionally self-inflicted Injuries, or any attempt to inflict such Injuries.
- Sickness, whether the Loss results directly or indirectly from the Sickness.
- Medical or surgical treatment of Sickness, whether the Loss results directly or indirectly from the treatment.
- Any infection. But, this does not include:
– a pyogenic infection resulting from an accidental cut or wound; or
– a bacterial infection resulting from accidental ingestion of a contaminated substance.
- Taking part in any insurrection.
- War, or any act of war. "War" means declared or undeclared war and includes resistance to armed aggression.
- An accident that occurs while the person is serving on full-time active duty for more than 30 days in any armed forces. But this does not include Reserve or National Guard active duty for training.
- Commission of or attempt to commit a felony.
- Being intoxicated or under the influence of any narcotic or any hallucinogenic unless administered on the advice of a Doctor.
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TERM LIFE INSURANCE BENEFIT
In the event of your death, your beneficiary will be paid the amount of the Basic Insurance and any additional amount purchased under the Optional Life Insurance plan.
If the loss of life is caused by an accident, the Accidental Death Benefit is payable to your beneficiary in an amount equal to your Basic Life Insurance and Optional Life Insurance, if selected. If you select the Dependent Life Insurance for your family and the covered dependent dies, benefits will be paid to you.
As an enhanced benefit when you are terminally ill, with a life expectancy of 12 months or less, you can get a partial payment of your group life insurance benefit. The Terminal Illness Proceeds are equal to 75% of the amount in force on your life on the date Prudential receives the proof that you are a Terminally Ill Employee, but not more than $50,000. You can use this payment as you see fit. The payment to your beneficiary will be reduced by the amount you receive with the Accelerated Benefit Option.
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BENEFICIARY DESIGNATION
You have the right to choose a Beneficiary. If there is a Beneficiary for the insurance, it is payable to that Beneficiary at your death. If there is no Beneficiary designated, payment will be paid to the first surviving class of the following classes: (a) surviving spouse, (b) surviving children, (c) surviving parents, (d) surviving brothers and sisters, (e) estate.
You may designate a new beneficiary at any time by completing a Beneficiary Designation form.
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LEAVE WITHOUT PAY
Your insurance may be continued up to a maximum of one year during an approved leave of absence without pay. After one year has expired your coverage will terminate unless you return to work as a full-time eligible employee. While on leave, you are required to make timely payments of the required contributions for Basic, Optional and Dependent Group Life Insurance. If no payments are received while on leave, the coverage will be terminated.
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FAMILY LEAVE
The Commonwealth of Kentucky will continue paying your Basic Life Insurance. You are responsible for timely payments of your insurance premiums for Optional Life Insurance and Dependent Life Insurance. If no payments are received for your Optional and/or Dependent coverage while on leave, the coverage will be terminated.
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CONVERSION
If you terminate employment (including through retirement), you are guaranteed the opportunity to convert all or part of your Basic, Optional and Dependent Group Life Insurance to an individual policy within 31 days following the date your insurance coverage ends. Evidence of insurability will not be required.
If you are enrolled in Dependent Group Life Insurance, a covered dependent can convert to an individual policy should your insurance end due to death or employment termination. A spouse in a divorce situation and a dependent child who reaches the limiting age may also convert.
Information regarding the policies available for conversion and their associated costs can be obtained by calling the Group Life Insurance Administration at 502-564-4774 or 1-800-267-8352.
Written application, and payment of the first contribution, must be made within 31 days of the insurance termination date. If you or an insured dependent dies during the 31 day period, your insurance will be paid whether or not you applied for an individual policy.
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TERMINATION OF COVERAGE
Your Basic Insurance, Optional Insurance and Dependent Group Life coverage will end on the first day of the second month following the month employment ends.
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OTHER IMPORTANT INFORMATION
These materials may be available in alternate formats under the provisions of the American with Disabilities Act (ADA). Please ask your Insurance Coordinator.
Important: This information is designed to answer some common questions about the Group Life and AD&D insurance coverage being offered. It is not intended to provide a detailed description of the coverage. If you become insured, a more detailed description of the insurance coverage will be available in a group insurance certificate provided to you. The controlling provisions of coverage are in the group insurance policy. This information and the group insurance certificate do not modify the group insurance policy of the insurance coverage in any way.
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