To support consistent presentation and comparison of plans across carriers, values for the following benefits will be streamlined where applicable. Exact adjustments may vary based on carrier, product and plan source, and have been reviewed/approved by our carrier partners.
Basic Life
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| AD&D | Principal | $X benefit Coverage for employees on and off the job. Coverage is not included for retirees. | $X Ex: $50,000 |
| Accelerated Benefit | Principal | Terminally ill employees can receive up to X% of their life insurance benefit, up to $Y, if their life expectancy is 12 months or less (as diagnosed by a physician) and the death benefit is at least $Z. When an employee uses the accelerated benefit, the death benefit is reduced by the accelerated benefit payment. There are possible tax consequences to receiving an accelerated benefit payment and the employee should contact a tax advisor for details. Receipt of accelerated benefits could also affect eligibility for public assistance. | Terminally ill employees can receive up to X% of their life insurance benefit, up to $Y Ex: Terminally ill employees can receive up to 75% of their life insurance benefit, up to $250,000 |
| Benefit Amount | Principal | $X benefit | $X EX: 200,000 |
| Benefit Amount | Principal | 100% of annual salary to a maximum of $200,000 and a minimum of $10,000. Benefits are rounded to the next higher $1,000. | 100% of your annual salary plus $1000, rounded to the next higher $1,000 |
| Benefit Reduction | Principal | 35% reduction at age 65 and an additional 15% reduction at age 70 Upon retirement, benefits will reduce to 50% of the amount in force prior to age 65. Age reductions apply to the benefit amount after proof of good health. |
X% reduction at age 65 and an additional Y% reduction at age 70 Ex:35% reduction at age 65 and an additional 15% reduction at age 70 |
| Participation Requirement | Principal | • 100% participation for all non-contributory coverages. • 50% participation for all contributory coverages. |
5 standalone or 2 if multi-coverage |
| Portability | Principal | "-" | NA |
| Rate Guarantee | Principal | two years, unless volume increases or decreases by more than 25% | X years EX: 2 years |
| Waiver of Premium | Principal | If an employee becomes totally disabled before age 60, coverage will continue and premium will be waived | Total Disability; to age 65 |
Dental
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Major Waiting Period | All | No Waiting Period | None |
| Major Waiting Period | All | NO WAIT | None |
| Major Waiting Period | All | No | None |
| Major Waiting Period | All | 12 mos | 12 months |
| Major Waiting Period | Metlife | Benefits are payable immediately from the start date of an individual’s benefits | None |
| OON Reimbursement | All | Based on Maximum Allowable Charge Standard schedule (for location of service rendered). | MAC |
| OON Reimbursement | All | Xth R&C | Xth Percentile |
| OON Reimbursement | All | Xth Percentile of Submitted Charges | Xth Percentile |
| Ortho Coinsurance | All | If Orthodontia = "No Benefit","NA","N/A","Not Covered" | Not covered |
| Ortho Lifetime Max | All | If Orthodontia = "No Benefit","NA","N/A","Not Covered" | Not covered |
| Ortho Waiting Period | All | If Orthodontia = "No Benefit","NA","N/A","Not Covered" | Not covered |
| Ortho Waiting Period | Metlife | Benefits are payable immediately from the start date of an individual’s benefits | None |
| Participation Requirement | Principal | • If the employer contributes less than 50% of the employee cost for both plans, combined participation of 20% or 10 lives, whichever is greater, is required between choice offerings. • If the employer contributes 50-99% of the employee cost for either choice plan, 50% combined employee participation is required between choice offerings. • If the employer contributes 100% of the employee cost for either choice plan, 100% combined employee participation is required between choice offerings. |
2 lives |
| Participation Requirement (Vol) | Principal | • If the employer contributes less than 50% of the employee cost for both plans, combined participation of 20% or 10 lives, whichever is greater, is required between choice offerings. • If the employer contributes 50-99% of the employee cost for either choice plan, 50% combined employee participation is required between choice offerings. • If the employer contributes 100% of the employee cost for either choice plan, 100% combined employee participation is required between choice offerings. |
Greater of 5 enrolled or 20% participation |
| Rate Guarantee | Principal | two years or "-" |
X years (i.e. 2 years) or if missing API value (1 year) |
| Rollover Account Limit | Principal | four times the carry over amount | no more than four times the carry over amount |
| Rollover Amount | Principal | If qualification is met, 50% of the threshold will be carried over to next year's maximum benefit | 50% of the threshold |
| Rollover Threshold | Principal | The threshold is equal to the lesser of 50% of the maximum benefit or $1000 | lesser of 50% of the maximum benefit or $1000 |
LTD
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Definition of Disability | Principal | An employee will be considered disabled if, because of sickness, injury or pregnancy, during the elimination period and own occupation period, one of the following applies: • Unable to perform a majority of the substantial and material duties of his/her own occupation; OR • Unable to earn 80% of his/her indexed predisability income while working in his/her own occupation in a modified capacity or any occupation. An employee will be considered disabled if, after completing the elimination period and own occupation period, one of the following applies: • Unable to perform a majority of the substantial and material duties of any occupation for which he/she is or may reasonably become qualified based on education, training or experience; OR • Unable to earn 80% of his/her indexed predisability income while working in his/her own occupation or any occupation in a modified capacity. |
Own occupation with residual, own occupation period=2 years |
| Earnings Definition | Principal | Base wage Compensation for business owners covers the net profits plus salary, averaged over the prior two calendar years. or Base wage, including commissions and bonus Compensation for business owners covers the net profits plus salary, averaged over the prior two calendar years. |
Base wage |
| Guaranteed Issue | Principal | "-" | Yes |
| Max Benefit Duration | Principal | To Social Security normal retirement age or To age 65 (reducing benefit duration) |
To age 65 |
| Mental & Nervous | Principal | 24 month benefit limit | 24 months |
| Partial Benefit | Principal | "-" | May be reduced by amounts the employee receives or is entitled to receive from deductible sources of income (offsets) and disability earnings. |
| Participation Requirement | Principal | "-" | 5 standalone or 2 if multi-coverage |
| Rate Guarantee | Principal | two years | X years EX: 2 years |
STD
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Covered Disability | Principal | No | Non-occupational |
| Covered Disability | Principal | Yes | 24 hour |
| Covered Weekly Benefit | Unum | Carrier file indicates Volume per $10 of weekly benefit | Multiplied carrier file Volume by 10 to calculate Covered Weekly Benefit displayed in app |
| Definition of Disability | Principal | An employee will be considered disabled if, because of sickness, injury or pregnancy, one of the following applies: • Unable to perform a majority of the substantial and material duties of his/her own job; OR • Unable to earn 80% of his/her predisability income while working in his/her own job in a modified capacity or any job. |
Own occupation with residual |
| Guaranteed Issue | Principal | "-" | Yes |
| Participation Requirement | Principal | "-" | 5 standalone or 2 if multi-coverage |
| Rate Guarantee | Principal | two years | X years (i.e. 2 years) |
Vision
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Contact Lenses Allowance | Principal | Up to $60 copay for standard and premium elective contact lens exams (fitting and evaluation) $150 allowance for elective contacts |
$X allowance for elective contacts EX: $150 allowance for elective contacts |
| Contact Lenses Frequency | Principal | 1 per X months Instead of lens and frames benefit | Once every X months |
| Exams Frequency | Principal | 1 per X months | One exam every X months |
| Frames Frequency | Principal | 1 set per X months | One set every X months |
| Lenses Frequency | Principal | 1 pair per X months | Two lenses (one pair) every X months |
| Participation Requirement | Principal | 50% employee participation assumed | 5 standalone or 2 if multi-coverage |
| Participation Requirement (Vol) | Principal | 20% or 5 lives, whichever is greater | Greater of 5 enrolled or 20% participation |
| Rate Guarantee | Principal | two years | X years (i.e. 2 years) |
Vol STD
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Participation Requirement | Principal | 20% or 5 lives, whichever is greater | Greater of 5 enrolled or 20% participation |
| Rate Guarantee | Principal | two years | X years (i.e. 2 years) |
Vol LTD
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Participation Requirement | Principal | 20% or 5 lives, whichever is greater | Greater of 5 enrolled or 20% participation |
| Rate Guarantee | Principal | two years | X years (i.e. 2 years) |
Vol Life
| Benefit | Carrier | Example of Original Value | Adjusted Value |
| Accelerated Benefit | Principal | Terminally ill employees can receive up to 75% of their life insurance benefit, up to $250,000, if their life expectancy is 12 months or less (as diagnosed by a physician) and the death benefit is at least $10,000. When an employee uses the accelerated benefit, the death benefit is reduced by the accelerated benefit payment. There are possible tax consequences to receiving an accelerated benefit payment and the employee should contact a tax advisor for details. Receipt of accelerated benefits could also affect eligibility for public assistance. | EX: Terminally ill employees can receive up to 75% of their life insurance benefit, up to $250,000 |
| Age Reduction | Principal | 35% reduction of benefits at age 65 and an additional 15% reduction at age 70 Age reductions apply to the benefit amount after proof of good health. | EX: 35% reduction at age 70 with an additional 20% reduction at age 75 |
| Benefit Amount | Principal | Employees choose to purchase benefits in $10,000 increments. Minimum amount: $10,000 Maximum amount: $300,000 | EX: Select a benefit in increments of $10,000 |
| Dependent AD&D | Principal | "-" | Included Not Included |
| Employee AD&D | Principal | Included. Benefit equal to the base voluntary term coverage. This is automatically included for employees electing voluntary term life insurance. | Included Not Included |
| Employee GI | Principal | Required for life insurance amounts greater than: Under age 70: $150,000 Age 70 and over: $10,000 Guaranteed coverage may be limited to the amount insured under the prior carrier based upon the method of enrollment. | EX: If you're under 70: $150,000 If you're 70 or older: $10,000 |
| Participation Requirement | Principal | 20% or 5 lives, whichever is greater. All eligible employees may enroll for coverage. | Greater of 5 enrolled or 20% participation |
| Portability | Principal | Employees may continue coverage for themselves and any covered dependents until age 70 if the employee ceases to qualify as a member. The employee or spouse must enroll within 60 days from the date they cease to qualify as a member. Maximum age requirements apply. Portability is not available if: coverage is continued during disability / the employee has received accelerated benefits / individual purchase rights have been exercised / the employee dies / a dependent no longer meets the eligibility requirements. | To age 70 |
| Rate Guarantee | Principal | two years | X years (i.e. 2 years) |
| Spouse AD&D | Principal | Included. Benefit equal to the base voluntary term coverage. This is automatically included for employees electing voluntary term life insurance. | Included Not Included |
| Spouse GI | Principal | Required for life insurance amounts greater than: Under age 70: $30,000 Age 70 and over: $10,000 Guaranteed coverage may be limited to the amount insured under the prior carrier based upon the method of enrollment. | EX: If your spouse is under 70: $30,000 If your spouse is 70 or older: $10,000 |
| Waiver of Premium | Principal | If an employee becomes totally disabled before age 60, coverage will continue and premium will be waived for the employee and any covered dependents | Total Disability; to age 65 |
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