Benefit Details
Click the links below to see the details for each benefit.
All eligible employees are automatically covered for life insurance and a matching amount of accidental death & dismemberment (AD&D) insurance. The employer chooses the amount of basic coverage ($10, $15, $25 or $50 thousand) and pays the entire premium which is deducted from the defined contribution the employer has agreed to make.
In the event of accidental death, the AD&D benefit is payable in addition to the life insurance benefit. Benefits for dismemberment are a percentage of the accidental death benefit based on the type of injury.
Basic Life and AD&D benefits reduce 35% at age 65, 50% at age 70 and 75% at age 75.
Benefits terminate upon the employee's retirement or when no longer actively working for the employer.
Up to $100,000 (in units of $10,000) of additional life insurance coverage (with a matching amount of AD&D) is available for employees on a guaranteed issue basis if applying when first eligible.
Coverage can also be purchased on a guarantee issue basis for the employee's spouse. The maximum spouse coverage is $25,000 or 50% of the employee's coverage amount, whichever is less. Spouse coverage also includes matching AD&D.
Benefit options for children are $2,500, $5,000, $7,500 or $10,000. There is no AD&D coverage for children.
All eligible employees are automatically covered for life insurance and a matching amount of accidental death & dismemberment (AD&D) insurance. The employer chooses the amount of basic coverage ($10, $15, $25 or $50 thousand) and pays the entire premium which is deducted from the defined contribution the employer has agreed to make.
In the event of accidental death, the AD&D benefit is payable in addition to the life insurance benefit. Benefits for dismemberment are a percentage of the accidental death benefit based on the type of injury.
Voluntary Life and AD&D benefits reduce to 65% at age 65, reduce to 50% at age 70, reduce to 35% at age 75, reduce to 20% at age 80.
Benefits terminate upon the employee's retirement or when no longer actively working for the employer.
Short term disability is an income replacement plan that pays 60% of income* if a covered employee is unable to work due to sickness or accident. Benefits begin after a 15 day waiting period and can continue for up to 13 or 26 weeks, as provided by your plan.
The maximum weekly benefit payable is $1,250.
Maternity is covered.
Pre-existing conditions (defined as any accident or illness for which advice or treatment has been received in the prior twelve months) are excluded for short term disability. The pre-existing conditions exclusion does not apply after the insured has been covered for 12 months.
* Provided that the premium is paid entirely by the employee, disability benefits are non-taxable.
Please Note: This benefit may not be available in all states.
You may use any licensed dentist. Dentists participating in the DenteMax Provider Network, however, accept the insurance company’s allowance as payment in full. Non-participating dentists may bill you for the balance. CLICK HERE to find a participating dentist at one of Dentemax's 232,000 dental access points nationwide.
Deductible |
$100 lifetime per person |
Preventive Services- Examples:
oral exams & cleanings (2 every 12 months); bitewing X-rays (1 every
12 months) |
Paid at 100% of allowable charge |
Basic Services - Examples:
fillings; pain treatment; sealers; full mouth X-rays; space
maintainers |
Paid at 80% of allowable charge |
Major Services - Examples: anesthesia; endodontics; periodontics; extractions; oral surgery; crowns; inlays; onlays; dentures; bridges; implants |
Paid at 50% of allowable charge 12 month waiting period |
Annual Maximum Benefits Per Person |
$1,000 |
Orthodontics For Children |
Paid at 50% of allowable charge 12 month waiting period Lifetime orthodontia maximum per child - $1,000 |
Please Note:
This benefit is not be available in NC.
You may use any licensed vision provider. Going to a participating EyeMed Vision Care network provider or retailer lowers your cost.
The EyeMed Vision Care network includes:
- More than 66,000 providers nationwide (Ophthalmologists, Optometrists, Opticians)
- 27,000 locations
- Retailers include: LensCrafters, Pearle Vision, Sears Optical, Target Optical and JC Penney Optical
Payment is based on allowable charges in area where service is rendered. CLICK HERE to find a participating provider.
Vision Care Services |
In-Network |
Out-of-Network |
Exam with dilation |
$10 copay |
$35 allowance |
Contact lenses fit and 2 follow-up visits: - Standard lenses - Premium lenses |
$0 copay $0 copay / 10% off retail then apply $55 allowance |
$40 allowance $40 allowance |
Frames (any available frame at provider location) |
$130 allowance then 20% off balance over allowance |
$72 allowance |
Standard plastic lenses: - Single - Bifocal - Trifocal |
$10 copay $10 copay $10 copay |
$25 allowance $40 allowance $55 allowance |
Lens Options: - UV coating - Tint (solid and gradient) - Standard scratch resistant coating - Standard polycarbonate - Standard anti-reflective coating - Standard progressive (add-on to bifocal) - Other add-ons and services |
Member pays: $15 $15 $15 $40 $45 $65 20% off retail |
Discounts only available at network providers and retailers |
Contact Lenses (Material Only) Medically Necessary |
Conventional and disposable $0 copay; $120 allowance; 15% off balance over allowance (conventional only) Paid in full |
$96 allowance $200 allowance |
Frequency - Examination - Frames - Eyeglass Lenses - Contact Lenses (in lieu of eyeglass lenses) |
12 months 24 months 12 months * 12 months ** |
12 months 24 months 12 months * 12 months ** |