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Group Basic Life and AD&D Insurance

Eligibility

Each Active Full‐Time Employee of a participating Employer working 30 or more hours per week, except any person working on a temporary or seasonal basis.

Benefit Amount

Basic Life and AD&D: A choice of $15,000 $20,000 or $25,000

Guaranteed Issue

Employee: $25,000

Contribution Requirements

Coverage is employer-paid

AgeOriginal Benefit Reduced To
6566%
7050%
7534%
8024%

Features

  • Living Benefit Rider (expressed as Accelerated Death
  • Benefit in some states and Imminent Death Benefit in PA)
  • Air Bag Benefit
  • Conversion Privilege
  • FMLA/MSLA Continuation
  • Seat Belt Benefit
  • Waiver of Premium

Value-Added Services

  • Bereavement Counseling Service
  • Travel Assistance Service
For Accidental Loss of:Amount Payable
Life100%
Both hands or both feet100%
Sight of both eyes100%
One hand and one foot100%
One hand and sight of one eye100%
One foot and sight of one eye100%
Speech and hearing100%
One hand or one foot50%
Sight of one eye50%
Speech or hearing50%

Exclusions

AD&D Exclusions

AD&D benefits will not be payable for a loss: caused by suicide or intentionally self‐inflicted injuries; caused by or resulting from war or any act of war, declared or undeclared; to which sickness, disease or myocardial infarction, including medical or surgical treatment thereof, is a contributing factor; sustained during an insured’s commission or attempted commission of an assault or felony; to which the insured’s acute or chronic intoxication is a contributing factor; or to which the insured’s voluntary consumption of an illegal or controlled substance or a non‐prescribed narcotic or drug is a contributing factor. For a comprehensive list of exclusions and limitations, please refer to the Certificate of Insurance. The Certificate also provides all requirements necessary to be eligible for coverage and benefits. This Plan Highlights is a brief description of the key features of the RSL insurance plan. The availability of the benefits and features described may vary by state. It is not a certificate of insurance or evidence of coverage. Insurance is provided under group policy form LRS‐6422, et al.

Basic Life and AD&D Insurance Premium Table

Plan Holder: Professional Insurance Agents of Wisconsin

Scheduled Benefit: Each eligible employee may elect an amount of insurance shown in the table below.
Benefit amounts are reduced according to the age-based reduction chart shown in the Life/AD&D brochure.

Employee Premiums

  • Determine the age band: Employee age = Employee age at their last birthday.
  • Select a benefit amount.
  • Rates change as insured moves from one age bracket to the next
Benefit AmountAge 18-34Age 35-39Age 40-44Age 45-49Age 50-54Age 55-59Age 60-64Age 65-69Age 70+
$15,000$1.80$2.25$3.75$5.55$8.25$12.30$18.00$32.25$127.50
$20,000$2.40$3.00$5.00$7.40$11.00$16.40$24.00$43.00$170.00
$25,000$3.00$3.75$6.25$9.25$13.75$20.50$30.00$53.75$212.50

Rates are subject to change

Questions?

Please contact Heidi Hodel-Faris at hhodel@piaw.org or by phone at 608-274-8188.