Underwritten by New York Life Insurance Company
This plan is available exclusively to IEEE members* under age 70, who may request
coverage for themselves, their lawful spouses under age 70 and all unmarried
dependent children ages 14 days through 22 years (24 if a full-time student).
In order to become insured, satisfactory evidence of insurability must be provided
and the required premium must be paid.
A dependent who is also an IEEE member is eligible for either member or dependent coverage, but not both. If both member and spouse are covered as members, neither may insure the other as spouse and only one may insure any eligible children.
This coverage is available only for residents of the U.S. (except territories), Puerto Rico and Canada (except Quebec). Note: This coverage is available to residents of Canada through Marsh Canada Limited. Stephen Fretwell, an employee of Marsh Canada Limited, acts as broker with respect to residents of Canada.
*Participation in the IEEE Member Group Insurance Program requires active IEEE membership status during the life of the plan.
Non-Dependent Family Members: Any eligible "non-dependent" family members may also apply for coverage if they first join the IEEE as an Associate member (for membership information, visit the IEEE home page or call IEEE directly at 1-800-678-IEEE).
APPLY FOR UP TO $1,000,000 OF COVERAGE
You can choose the amount you need. A member has options of $10,000 to $1,000,000
(in multiples of $10,000). A lawful spouse may be insured for $5,000 to $1,000,000
(in multiples of $5,000), not to exceed 100% of member's coverage. Each eligible
dependent child may be insured for $10,000.
Member and spouse coverage decreases as shown under "Amounts of Insurance at Member Ages 69 through 99."
The total amount of coverage an individual may have under all group life insurance plans underwritten by New York Life Insurance Company cannot exceed $2,000,000.
In addition, the total amount of coverage an individual may have under all group policies issued by New York Life Insurance Company to the Trustee of the IEEE-sponsored Life Insurance Plan may not exceed the maximum benefit option for any insured person.
WEIGH THE BENEFITS . . . COMPARE THE COSTS
The more you request, the more you can save. If you become insured for options
of $160,000 through $490,000, you'll receive a discount based on volume; and
for options of $500,000 through $1,000,000 you'll receive another volume discount.
These discounts are continued for members age 69 and older as long as the minimum
number of coverage units is maintained (16 or 50 units for both member and spouse).
Plus, now through 2/28/2015, a 30% premium discount will apply to all premium
contributions due. If plan experience warrants, the Trustee may grant premium
discounts that can reduce your cost to renew coverage. Although not promised
or guaranteed, premium discounts and/or credits have been granted every year
Non-Tobacco/Nicotine Use Discount
And last but not least, if you and/or your spouse qualify, you can take advantage of nonsmoker rates that will reduce your premium payments even further!
Monthly Payment Option
You have the option to pay your premium contributions on a monthly basis via
the monthly Electronic Funds Transfer (EFT). Your monthly cost would be approximately
one-sixth of the amount you calculate from the rate chart.
IMPORTANT NOTICE TO RESIDENTS OF MANITOBA AND ONTARIO, CANADA: Manitoba and Ontario, Canada have enacted laws requiring 8% taxation of all group insurance purchased by individuals. This tax will be added to the amount of any premium contributions due (in U.S. dollars), which is then reported and remitted to the province.
<a src="http://www.ieeeinsurance.com/portals/1/Images/adobe_75w.png" href="<p> </p>
<p><img alt="> Click here to review YOUR COST
OTHER IMPORTANT INFORMATION
Amounts of Insurance at Member Ages 69 through 99
The amount of life insurance for you and your spouse is based on your age at last birthday. After age 68, coverage decreases for each $10,000 member and spouse option of insurance on the premium due date on or immediately after you enter a new age category. Premiums do not reduce.
(The amount of children's insurance does not decrease.)
||Each $10,000 Member
and Spouse Option
|Under age 69
|*Coverage terminates at member's age 100. See Group Conversion Privilege.
Benefit option amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the Trustee of the IEEE-sponsored Life Insurance Plan.
Valuable Living Benefit Provision "Accelerated Death Benefit"
The "Accelerated Death Benefit" option is available to help terminally ill insureds during a difficult, and often financially challenging time. Under this provision you may request one advance payment equal to 50% of a qualified terminally ill person's in force life insurance to be paid while that person is still alive.
The request must be made at least 12 months prior to the insured person's scheduled coverage termination age and the amount of insurance payable after the insured's death will be reduced by this payment. (Premium contributions will not be reduced.) If a scheduled reduction in coverage will occur within one year of the date the Accelerated Death Benefit will be paid, the benefit payable will be 50% of the reduced coverage amount.
This money can be used to help cover high prescription drug costs...medical bills...outstanding debts...to help pay for experimental treatments...the cost of modifications to your home...or for a family vacation—the choice is yours.
To qualify, a terminally ill insured must provide the New York Life Insurance Company with proof of terminal illness and anticipated life expectancy (12 months or less), as well as any other necessary medical information requested. For additional details and limitations, please see the Certificate of Insurance.
Please note that receipt of Accelerated Death Benefits may affect your eligibility for public assistance programs and may be taxable. Prior to applying to receive such benefits, you should consult with the appropriate social services agency and seek the advice of a qualified tax advisor.
NOTE: The Accelerated Death Benefit is not available to residents of Massachusetts.
Premiums Waived If You're Totally Disabled
If you become totally disabled before age 60, and remain so disabled for nine months or longer, your insurance will be continued as long as you remain totally disabled—for both you and your insured family members—without additional premium contributions until coverage terminates when you reach age 100. The amount continued will be based on the options under which you and your dependents were insured at the time your disability began, subject to the scheduled decreases shown in "Amounts of Insurance At Member Ages 69 through 99." You may be asked to provide evidence of your continued total disability from time to time.
Benefits are paid for death from any cause, at any time, anywhere in the world. The validity of any amount of your life insurance which has been in force for two years during an insured's lifetime will not be contested except for insurance eligibility provisions and non-payment of premium contributions.
Your Choice of Beneficiary
You may select any person, persons, trust or other legal entity as your beneficiary. If, at the time of your death, there are no surviving beneficiaries, benefits will be paid to the executor or administrator of your estate, or at the option of New York Life, to the surviving relatives in the following order of survival: spouse; children equally; parents equally; or brothers and sisters equally.
Group Conversion Privilege
The Plan provides conversion privileges under certain circumstances of involuntary termination as described in the Certificate of Insurance.
ADDITIONAL PLAN PROVISIONS
You and your eligible dependents will become insured on the date specified by
New York Life Insurance Company provided the first premium contribution has
been paid, satisfactory evidence of insurability has been submitted and you
and your dependents are alive on that date. Coverage for any dependent who is
confined at home, in a hospital or other medical institution, or is incapacitated
so as to be unable to perform his or her normal activities on the date coverage
would otherwise become effective, will not become effective until the date he
or she is no longer so confined or incapacitated provided you are insured on
that date and the dependent is still eligible for insurance. Payment of a premium
contribution for insurance does not mean there is any coverage in force before
the effective date as specified by New York Life Insurance Company.
When Coverage Ends
Your insurance can remain in force until you reach age 100, and for your insured family members as long as they remain eligible, provided:(a) you remain a member of IEEE;(b) you continue to pay premium contributions when due; and (c) the group plan is not terminated or modified by the Policyholder or New York Life Insurance Company to end insurance for the group of insureds to which you belong. Upon your death, coverage for your insured dependents may continue as described in the Certificate of Insurance.
Renewal Payments And Claims
Once you are accepted into the Plan, you will have a 31-day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.
Certificate Of Insurance
This information is only a brief description of the principal provisions and features of the Plan. The complete terms and conditions are set forth in the group policy issued by New York Life to the Trustee of the Institute of Electrical and Electronics Engineers Life Insurance Plan.
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the Plan.
"30-Day Free Look"
If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will be sent a full refund—no questions asked!
|How New York Life Obtains Information and Underwrites
Your Request for
Group Term Life Insurance
|In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance, we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage or a claim for benefits is submitted to an MIB member company, medical or non-medical information may be given to MIB and such information may then be furnished by MIB, upon request, to a member company.
|Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.
|MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other application for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.
|New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing. However, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.
|New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a “need to know” basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
|If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is: MIB, Inc. 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866-692-6901 (TTY 866 346-3642). For Canadian residents the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone 416-597-0590. Information for consumers about MIB may be obtained on its Web site at www.mib.com.
|For NM Residents: PROTECTED PERSONS1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION 2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
|1PROTECTED PERSON means a victim of domestic abuse; who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured person.
|2 CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured family member, employer or associate of a victim of domestic abuse or a person with whom the applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
|New York Life Insurance Company
IEEE is compensated in connection with this sponsored group plan to provide and maintain this valuable membership benefit.
Underwritten by New York Life Insurance Company, under Group Policy No. G-8100-1, on Policy Form GMR-FACE /G-8100-1.
About New York Life Insurance Company
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