Member Eligibility Definition
Optional Term Life All active members in good standing and who are under age 65
Effective Date Of Coverage
First day of the month following enrollment
Guarantee Issue Amounts
Optional Life: Up to $50,000 Member Only
Waiver of Premium (Life Plan)
Does not apply
Accelerated Benefit Option (Life)
90% up to $100 Optional Life, Life expectancy 6 Months. Applies to Active Members Only.
2 year suicide exclusion applies
Exposure and Disappearance Benefit**
% of Principal sum consistent with type of loss
Termination of Coverage
Does not apply
Optional Term Life: Applies (member and dependent)
Effective Date of Benefit reductions, Termination, Changes in Age Band rates due to Member or Dependent Aging
This product may not be available in all states.
1. Within the last 12 months, have you used tobacco or nicotine in any form?
2. Do you currently have any known disorder, condition, or disease or are you currently taking prescription medication for any disorder, condition, or disease (other than: acid reflux; allergies; cold; cough; herniated disc; high cholesterol; non rheumatoid arthritis; overactive or underactive thyroid; or pregnancy)?
3. Within the last five years have you been treated for, had any symptoms of, been in a hospital or health care facility for, or diagnosed with any of the following:
• circulatory or respiratory disease or disorder;
• coronary artery or heart disease, chest pain; heart attack, stroke, or high blood pressure;
• cancer, leukemia or tumors; • diabetes; disease or disorder of the lungs, kidneys, liver, pancreas, or genitourinary system;
• arthritis or other musculoskeletal condition;
• alcoholism; drug addiction, mental or nervous disorder;
• Acquired Immune Deficiency Syndrome (AIDS) or AIDS-Related Complex (ARC)?
• Multiple sclerosis, epilepsy, seizure, stroke;
• Chronic pain, rheumatoid arthritis, lupus
If you answered “Yes” to any questions 2-3 please provide full details.