Employer-Paid Accidental Death and Dismemberment Benefits Overview

Offered by Life Insurance Company of North America Employer-Paid Accidental Death and Dismemberment Summary of Benefits Prepared for: Elkhart Community Schools Class 1 Eligibility: All active Employees of the Employer classified as Administrator or Executive Secretary, regularly working a minimum of 30 hours per week in the United States, who are citizens or permanent resident aliens of the United States. Employee: You will be eligible for coverage the first of the month following date of hire. Available Coverage: Benefit Amount* Maximum Employee 2 Times Annual Compensation 2 Times Annual Compensation or $500,000 * Amount will be rounded to the next higher $1,000, if not already a multiple thereof Benefit Details: If, within 365 days of a Covered Accident, bodily injuries result in: We'll pay this % of the Benefit Amount: Loss of life; Quadriplegia; Loss of two or more hands or feet; Loss of sight in both eyes; Loss of one hand or one foot and sight in one 100% eye; Loss of speech and hearing (both ears) Paraplegia 75% Hemiplegia; Loss of one hand or foot; Loss of sight in one eye; Loss of speech; Loss of hearing (both ears); Severance & Reattachment 50% of one hand or foot Uniplegia; Loss of all four fingers of the same hand; Loss of thumb & 25% index finger of the same hand Loss of all toes of the same foot 20% For Comas – You will receive 1% of the full benefit amount each month, for up to a maximum of 11 months, if you or an insured family member are in a coma for 30 days or more as a result of a Covered Accident. If the covered person is still in a coma after 11 months, or dies, the full benefit amount will be paid. Additional Features: For Wearing a Seatbelt & Protection by an Airbag – You will receive an additional 10% benefit but not more than $25,000 if the covered person dies in a Covered Automobile Accident and law enforcement-certified to be wearing a seatbelt or approved child restraint. We will increase the benefit by an additional 5% but not more than $10,000 if the insured person was also positioned in a seat protected by a properly-functioning and properly deployed Supplemental Restraint System (Airbag). For Exposure & Disappearance – Benefits are payable if you or an insured family member suffer a covered loss due to unavoidable exposure to the elements as a result of a Covered Accident. If you or an insured family member's body is not found within one year of the disappearance, wrecking or sinking of the conveyance in which you or an insured family member were riding, on a trip otherwise covered, it will be presumed that you sustained loss of life as a result of a Covered Accident. For a Loss Resulting from a Common Carrier – If you or an insured family member suffer a covered loss while riding as a passenger in, or being struck by, a common carrier, we will pay an additional 100% of the benefit amount, to a maximum of $500,000. Conversion – If group accident coverage ends (except due to nonpayment of premium), your employment is terminated, membership in an eligible class is terminated, or insurance coverage is reduced based on attained age,