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University Group Term Life Insurance Plans (PDF)

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					University Group Term
Life Insurance Plans
University Plan • Optional Plan • Dependent Plan
FOr eligible University OF michigan FacUlty anD staFF
     Benefits Information by Phone                                                                                Contents
     The HR/Payroll Service Center can answer your benefits
     questions. Call 734-615-2000 or 866-647-7657 (toll free for                                                  Section 1: Life Insurance Plans
     off campus long-distance calling within the U.S.). Service                                                   Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1
     Center Representatives are available from 8:00 a.m.- 5:00                                                    Life Insurance Plan Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
     p.m., Monday – Friday, to assist you. Have your UMID                                                         Faculty and Staff Member Monthly Rates
     number available when you call.                                                                                 for the Optional Life Insurance Plan . . . . . . . . . . . . . . . . . . . . . . .4
                                                                                                                  What You Pay for Your Optional Plan Insurance . . . . . . . . . . . . . . . .5
     Office Hours and Locations                                                                                   Your Coverage in Retirement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
     You can meet with a benefits consultant on a walk-in basis.                                                  When Changes Occur . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
     U-M Ann Arbor                                                                                                How Benefits Are Paid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .8
     HR Service Center
     Wolverine Tower—Low Rise 250 (Ground Floor)                                                                  Section 2: Dependent Life Insurance Plan
     3003 South State Street                                                                                      Spouse or Other Qualified Adult . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
     Ann Arbor, MI 48109-1278                                                                                     Dependent Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
     8:00 a.m. – 5:00 p.m., Monday – Friday                                                                       Dependent Life Insurance Plan Options . . . . . . . . . . . . . . . . . . . . . .9
     734-763-0363, fax                                                                                            Beneficiary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
                                                                                                                  Continuation of Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
     U-M Flint                                                                                                    Terminating Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
     UHR-Flint
     213 University Pavilion                                                                                      Section 3: Certificate of Coverage
     303 East Kearsley                                                                                            Certificate of Group Coverage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
     Flint, MI 48502-1950                                                                                         Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
     810-762-3150                                                                                                 Employee Group Term Life Insurance . . . . . . . . . . . . . . . . . . . . . . .10
     8:00 a.m. – 5:00 p.m., Monday – Friday                                                                       Mode of Settlement Provisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
                                                                                                                  Conversion Privilege. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
                                                                                                                  Incontestability of Life Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . .11
                                                                                                                  Beneficiary Provisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Resources                                                                                                         Option to Accelerate Payment of Death Benefits . . . . . . . . . . . . . .11
                                                                                                                  Modification of the Group Life Coverage Provisions . . . . . . . . . . .12
HR/Payroll Service Center  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .734-615-2000                    Assignments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .12
  Toll Free . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 866-647-7657
  Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . AskHR.umich.edu
Benefits Office Website  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . benefits .umich .edu
  Life Insurance Information . . . . . . . benefits.umich.edu/plans/life
  Forms . . . . . . . . . . . . . . . . . . . . . benefits.umich.edu/forms/life.html
                                                                                                                  Limitations
MetLife Website  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .www .metlife .com/mybenefits                       the university in its sole discretion may modify, amend, or terminate the
     For beneficiary designations                                                                                 benefits provided in this booklet with respect to any individual receiving
                                                                                                                  benefits, including active employees, retirees, and their dependents. although
Hyatt Legal Plans  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . 800-821-6400      the university has elected to provide these benefits this year, no individual has
     Provides simple will preparation services if you are enrolled in Optional Life or Retiree Life.              a vested right to any of the benefits provided. nothing in these materials gives
     Website  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  . www .legalplans .com   any individual the right to continued benefits beyond the time the university
     Web Password . . . . . . . . . . . . .Member only . . . . . . . . . . . . 2100010                            modifies, amends, or terminates the benefit. anyone seeking or accepting
                                                                                                                  any of the benefits provided will be deemed to have accepted the terms of
     . . . . . . . . . . . . . . . . . . . . . . . . . .Member and family . . . . . . 2110010
                                                                                                                  the benefits programs and the university’s right to modify, amend or terminate
                                                                                                                  them.
Telephone Services for People who are Deaf,
Hard of Hearing, or have Speech Impairments
TTY/TDD phone service is available to you through the Michigan                                                    every effort has been made to ensure the accuracy of this book. however,
Relay Center. Call 800-649-3777 and ask the operator to connect                                                   if statements in this book differ from applicable contracts, certificates, and
you to the HR/Payroll Service Center at 734-615-2000 or 866-647-                                                  riders, then the terms of those documents will prevail. all benefits are
7657 (toll free). Service Center Representatives will be happy to                                                 subject to change.
assist you.
Section 1: Life Insurance Plans

The University of Michigan offers three group term life insur-        •	 The	Optional	Plan	gives	you	the	flexibility	of	setting	your	own	
ance plans to eligible active faculty and staff:                         level	of	coverage.		There	is	a	$1	million	maximum	of	coverage	
•	 a	university-paid	plan	of	$30,000,	called	the	University	Life	        available. You must be enrolled in the University Plan to
   Insurance Plan (University Plan),                                     enroll in the Optional Plan. If you are a nonsmoker, you get a
                                                                         discount on the Optional premium. A nonsmoker is defined
•	 an	optional	plan	of	$5,000,	$50,000,	or	one	to	six	times	annual	      as a person who has not smoked for 12 months. If you do not
   salary, called the Optional Life Insurance Plan (Optional             indicate your nonsmoker status on the application, you will be
   Plan), and                                                            defaulted to the smoker rate.
•	 a	Dependent	Life	Insurance	Plan	(Dependent	Plan).                  •	 Under	the	Optional	Plan,	the	amount	of	coverage	you	choose	
All plans are administered by MetLife.                                   and its cost will increase when your salary increases if your
                                                                         coverage is based on your salary. Your cost will increase simi-
The University and the Optional plans offer coverage for you
                                                                         larly when you move into the next higher age bracket.
only. The Dependent Plan offers coverage for your spouse or
OQA and/or dependent children (see page 9). Retired faculty           •	 If	your	salary	increase	results	in	your	coverage	increasing	
and staff who were participating in the University or Optional           above	$500,000,	your	coverage	will	be	capped	at	a	flat	$500,000	
Life Insurance Plans on the date of their retirement will be             until you furnish evidence of insurability that is satisfactory to
transferred to the Retiree Life Insurance Plan.                          MetLife.


Plan Highlights                                                       Who is eligible to participate in the plan?
•	 The	University	Plan	of	$30,000	is	paid	for	by	the	university.		    Regular, nonbargained-for university faculty and staff members
   There are no employee contributions.                               who:
•	 These	term	life	plans	have	neither	cash	value	nor	provision	       •	 have	at	least	a	50%	appointment,	and	
   for loans, which means you must be enrolled when you die
                                                                      •	 have	departmental	funding	for	a	minimum	of	
   in order for your beneficiary to receive benefits.
                                                                         four continuous months, and
•		 Enrollment	is	not	automatic	for	the	Optional	Plan.		You	must	
                                                                      •	 GSRAs	who	have	at	least	a	25%	appointment	and	department	
    enroll to participate.
                                                                         funding for a minimum of four continuos months.
•		 New	hires	or	newly	eligible	staff	members	hired	after	
                                                                      •	 Research	Fellows	who	have	more	than	a	0%	appointment	and	
    1/1/2001	will	be	enrolled	automatically	in	the	$30,000				
                                                                         university funding. Stipend money is not eligible.
    university-paid plan.
                                                                      Regular, bargained-for University staff members who are
•	 Both	the	University	Plan	and	the	Optional	Plan	have	a	“Living	
                                                                      members of:
   Needs	Benefit”	option—or	accelerated	payment	of	death	
   benefit—which is an advance payment of life insurance              •	 the	Michigan	Nurses	Association	(MNA);
   proceeds when you are terminally ill and have a life expec-        •	 the	Police	Officers	Association	of	Michigan	(POAM);
   tancy of six months or less.
                                                                      •	 the	University	of	Michigan	Skilled	Trades	(Trades);
•	 If	you	are	enrolled	in	the	Optional	Plan	or	have	Retiree	Life	
   Insurance, you are eligible for will preparation services          •	 the	House	Officers	Association	(HOA);
   provided by attorneys who participate in the Hyatt Legal Plan      •	 the	International	Union	of	Operating	Engineers	(IUOE);
   Network.		Hyatt	Legal	Plans	is	a	wholly	owned	subsidiary	of	       •	 the	American	Federation	of	State,	County,	and	Municipal	
   MetLife and is the administrator of the Universities Group            Employees	(AFSCME);
   Legal Plan.
                                                                      •	 Graduate	Employees	Organization	(GEO),	or
                                                                      •	 Lecturers	Employee	Organization	(LEO).
                                                                      Temporary hourly wage staff are not eligible.




                                  benefits.umich.edu
                                                                                                     liFe insUrance Plans                     1
     How do I enroll?                                                              Application Form .
     New	enrollment	is	not	automatic for the Optional Plan. There                  The application form is available from any Benefits Office, the
     are three ways you can enroll.                                                Benefits Office website: benefits.umich.edu/forms. Complete
                                                                                   the form and return it to the HRRIS Benefits Transaction Team,
     1 . As a new hire to the university . You have 30 days to enroll.             either by U.S. mail, Campus Mail, or by fax to: 734-763-0363.
         If you enroll as a new hire, you will not be required to provide
         evidence of insurability (a health statement) as long as
         Optional	coverage	is	less	than	$500,000.		Obviously,	this	is	to	          Health Statement .
         your advantage and will save you time and effort.                         If you enroll within 30 days of the date you become eligible
     2 . As a newly eligible faculty or staff member . As you                      and	choose	less	than	$500,000	of	coverage,	you	will	not	need	to	
         become newly eligible for life insurance due to a promotion               provide a satisfactory health statement as proof of insurability.
         or job change that qualifies you for life insurance benefits,             Therefore, it is to your advantage to enroll in life insurance at
         you will receive an application form. If you enroll within the            the time you become eligible, either when you are a new faculty
         30 days allowed, you will not be required to provide evidence             or staff member at the university or when you become newly
         of insurability (a health statement) as long as coverage is               eligible for this benefit (as the result of a change in appointment,
         less	than	$500,000.                                                       etc.).
     3 . At any time . After the 30 days provided for (1) and (2) above            The type of statement you need depends on the amount of
         expires, you can apply to enroll at any time you choose, but              coverage you purchase, as shown in the chart below. You may
         you will be required to furnish evidence of insurability that is          enroll in the University Plan first and then add the Optional Plan
         satisfactory to MetLife may also require a physical examina-              at a later date.
         tion.




     Which Type of Health Statement Do You Need?
     Both long-form and short-form health statements are available from any HR Service Center or the Benefits Office website:
     benefits.umich.edu/forms.

         If You:                                                                                       Long Form                  Short Form

         Enroll	in	or	increase	Optional	Plan	coverage	less	than	$500,0001                                                               U
         Elect	Optional	Plan	coverage	above	$500,000                                                         U
         Request	increased	Optional	Plan	coverage	above	$500,000                                             U
         Enroll in the University Plan after the 60-day deadline                                             U
     A long-form health statement may be required if you do not successfully pass the short form.
     1




2   yOUr beneFits
Effective Date .                                                      You can choose different beneficiaries for each of the different
                                                                      life insurance plans.
If you are newly eligible, your insurance will become effective on
your service date or first day you are newly eligible if you enroll   If you enroll in the plan and you change the amount of your
within 30 days. If you are not actively at work on the day your       coverage at a future date, the beneficiary you designate now will
insurance would otherwise become effective, you will become           remain your beneficiary until you make a change. If you wish to
insured on the day you return to active work. If proof of insur-      change your beneficiary, go to the MetLife website, www.metlife.
ability is required, your insurance will become effective on the      com/mybenefits.
day the health statement is approved by MetLife, the Benefits
Office has been notified, and you are actively at work.
                                                                      Is this booklet the same as a contract?
                                                                      No,	this	booklet	describes	your	Group	Term	Life	Insurance	plans,	
Your Beneficiary .                                                    but it is not a contract of insurance. Likewise, possession of this
When you elect life insurance coverage for the first time, you        booklet does not constitute coverage. The complete terms of the
must complete the beneficiary designation on the MetLife              Group Term Life Insurance coverage are set forth in the Group
website, www.metlife.com/mybenefits. You may choose any               Term Life Insurance policy issued to the University of Michigan
beneficiary you wish, such as a family member, a friend, a trust,     by MetLife.
or	an	organization.		You	can	name	a	single	beneficiary	or	you	
can name two or more joint beneficiaries to receive the insur-
ance payment. You may change your beneficiary at any time. If
you do not designate a beneficiary, or if none of the beneficiaries
you name survives you, death benefits will be paid to the first of
the following:
•	 your	surviving	spouse/OQA;
•	 surviving	children	in	equal	shares;
•	 surviving	parents	in	equal	shares;
•	 surviving	siblings	in	equal	shares;	or
•	 your	estate.		




                                                                                                     liFe insUrance Plans                   3
     Life Insurance Plan Benefits


        University Life Insurance Plan                                            Optional Life Insurance
        If	you	are	enrolled	in	the	University	Plan,	$30,000	of	group	            Faculty and Staff Member
        term life insurance coverage is provided at no cost to you.
                                                                                 Monthly Rates Per $1,000

        Optional Life Insurance Plan                                           Age         Standard    Nonsmoker
        Benefits for Active Faculty                                                                     Discount
        and Staff Members                                                	     <	30	        	$0.025	     	$0.012
        Optional Plan Coverage Options .
                                                                         	    30	-	34	      	$0.027	     	$0.025
        If you are enrolled in the University Plan and want addi-
                                                                         	    35	-	39	      	$0.034	     	$0.031
        tional coverage, these are your coverage options. You can
        choose from nine different coverage options:*                    	    40	-	44	      	$0.052	     	$0.043
        •	 no	coverage                                                   	    45	-	49	      	$0.088	     	$0.076
        •	 $5,000	(minimum)                                              	    50	-	54	      	$0.146	     	$0.125
        •	 $50,000                                                       	    55	-	59	      	$0.229	     	$0.195
        •	 1	times	salary
                                                                         	    60	-	64	      	$0.356	     	$0.323
        •	 2	times	salary
                                                                         	    65	-	69	      	$0.639	     	$0.539
        •	 3	times	salary
        •	 4	times	salary                                                	   70	&	older	    	$1.145	     	$0.746

        •	 5	times	salary
        •	 6	times	salary	(to	a	maximum	of	$1	million).


        * If the coverage option you elect results in coverage over
          $500,000,	your	coverage	will	be	capped	at	$500,000	until	
          you furnish evidence of insurability that is satisfactory to
          MetLife.




4   yOUr beneFits
What You Pay for Your Optional Plan Insurance

The university pays the full amount of the University Plan. You          Use the worksheet below to determine your monthly premiums
pay for your Optional Plan.                                              for your Optional Plan. If you are paid monthly, your premiums
                                                                         will	be	deducted	from	your	monthly	paycheck;	if	you	are	paid	
The cost of your Optional Plan depends on the coverage you
                                                                         bi-weekly, your premiums will be deducted from your first and
select, your age, your smoking status, and your salary. The
                                                                         second paycheck of the month.
amount of coverage you choose and its cost will increase when
your salary increases if your coverage is based on your salary.          Your premium will be deducted on an aftertax basis.
Your cost will increase similarly when you move into the next
higher age bracket.




Optional Life Insurance Premium Worksheet
   1 . Box A .
   	 	 From	the	Faculty	and	Staff	Member	Monthly	Rates	Per	$1,000	chart	on	the	previous	page,	find	your	age	and	smoker	status.		
       This is your rate. Write the figure in Box A below.


   2 . Box B .
   	 	 If	you	wish	basic	coverage	of	$5,000	or	$50,000,	enter	5	or	50	in	Box	B	below.		If	you	select	a	salary-based	option,	to	find	the	
       level	of	coverage	(1-6	times	your	salary),	multiply	your	annual	salary	by	1-6.		For	example,	$12,000	x	3	=	$36,000.		Drop	the	
       last	three	zeros	and	write	the	figure	in	Box	B	below.


   3 . Box C .
        Multiply the rate, Box A, by the coverage level, Box B, and enter the result in Box C below.


                                              A                      B                    C

                                                          X                    =

                                             Rate                 Coverage       Your Monthly Cost




                                                                                                        liFe insUrance Plans               5
     Your Coverage in Retirement


     What if I enter the phased retirement program?                     In any event, during retirement the amount of insurance will
                                                                        decrease as your age increases until you reach age 66, at which
     Your coverage amount will not change because you enter the         time	coverage	at	$2,000	becomes	effective	and	will	remain	in	
     university’s Phased Retirement Program unless other factors        effect for the rest of your life.
     change	such	as	age	and	salary.		See	page	7,		“What	if	my	salary	
     is	reduced?”                                                       Under present policy, which is subject to change, the entire cost
                                                                        of the continued life insurance protection during retirement is
     How does retirement affect my life insurance                       paid by the university.
     program?
                                                                        Amounts of Insurance .
     When you retire, you will be covered under the university’s
     Retiree Life Insurance Plan. Your amount of life insurance will    The table below applies to faculty and staff members who were
     be the lesser of:                                                  hired after October 1, 1983. Faculty and staff hired prior to
                                                                        October 1, 1983, only need five (5) continuous years of service
     •	 the	amount	for	which	you	were	insured	on	your	date	             at age 60 and above. Your insurance coverage amount is based
        of retirement from the university, and                          on	your	age	as	of	January	1.
     •	 the	amount	applicable	to	your	age	as	of	January	1	and	your	
                                                                        Note: 	Retirees	with	a	date	of	service	on	or	after	July	1,	1988,	will	
        completed years of continuous service (find the age and years
                                                                        pay the full cost of benefits up to the month they turn age 62.
        of service that apply to you in the table below).




                                                       Amounts of Insurance
                Your Age On and After                                                                          Amount of
                     Retirement                                                                                Insurance

      50	years	or	less	       	                                           	                                       $15,000
      51 years but less than 52 years                                                                              15,000
      52 years but less than 53 years                                                                              15,000
      53 years but less than 54 years                                                                              15,000
      54 years but less than 55 years                                                                              15,000
      55 years but less than 56 years                                                                              15,000
      56 years but less than 57 years                                                                              14,000
      57 years but less than 58 years                                                                              13,000
      58 years but less than 59 years                                                                              12,000
      59 years but less than 60 years                                                                              11,000
      60 years but less than 61 years                                                                              10,000
      61 years but less than 62 years                                                                               8,000
      62 years but less than 63 years                                                                               6,000
      63 years but less than 64 years                                                                               5,000
      64 years but less than 65 years                                                                               4,000
      65 years but less than 66 years                                                                               3,000
      66 years and over                                                                                             2,000



6   yOUr beneFits
When Changes Occur


If I become ineligible to participate in the                          Consult the University of Michigan Standard Practice Guide
University Life Insurance Plan or Optional Life                       (SPG) for the most up-to-date rules regarding leaves (SPG
Insurance Plan, do I lose my life insurance?                          Sections 201.30-0 and 201.30-1) and layoffs (SPG Sections
                                                                      201.72-0 and 201.72-1).
Your insurance will terminate if:
•	 you	become	ineligible	for	the	insurance;		
•	 you	discontinue	your	contributions;		
                                                                      How will changes in salary or age affect my cost
                                                                      for the Optional Life Insurance Plan?
•	 your	employment	terminates;	or
                                                                      If you selected a multiple of your salary for your Optional
•	 either	the	University	or	Optional	Plans	are	terminated	by	         coverage, the amount of coverage selected and its cost will
   the university.                                                    increase automatically when your salary increases. Your cost
However, if your coverage terminates for any reason, your             will increase similarly when you move into the next higher age
University Life and Optional Life insurance benefits will be paid     bracket.		See	below,		“What	if	my	salary	is	reduced?”
in the event your death occurs during the next 31 days after one
of the events above or during the remainder of the period for
which you have already paid the premium—whichever occurs              What if my salary is reduced?
later. If your coverage at the university has been in effect for at
least five years, you may convert to a MetLife individual policy.     In the event of a reduction in base annual salary, your insurance
See	“Conversion	Privilege”	on	page	10.                                coverage and contributions will be reduced to reflect your actual
                                                                      salary. However, if you should die within two years of your salary
                                                                      reduction, your life insurance will be paid at the higher amount.
                                                                      If you have questions about this provision, contact the HR/Payroll
What if I take a leave of absence or I am tempo-
                                                                      Service Center at: 734-615-2000 or 866-647-7657 (toll free).
rarily laid off?
•	 If you are granted an official leave of absence by the univer-
   sity, your insurance can be continued for the duration of the      What if I terminate my employment at the
   leave, provided you make arrangements with the Benefits            University?
   Office prior to the start of your leave to pay the premiums
   during your leave.                                                 If you are enrolled in either life insurance plan and your employ-
                                                                      ment terminates for any reason, your life insurance coverage will
•	 If you are temporarily laid off for any reason, your insurance     cease 31 days from the last day of the month in which you leave
   can be continued during the layoff for up to 12 months,            the	university.		See	“Conversion	Privilege,”	page	10.
   provided you make arrangements prior to the layoff with the
   Benefits Office for the payment of premiums. If you request
   and	qualify	for	“extended	layoff,”	coverage	can	be	continued	      What happens if I become totally disabled?
   an additional six months.
                                                                      If you become disabled, you are in the university’s Long-Term
•	 If you choose not to continue coverage during a leave of
                                                                      Disability Plan, and you are approved for benefits, your life insur-
   absence or layoff, and you return to work at the University
                                                                      ance will remain in force, paid for by the university.
   with an eligible appointment, your coverage will be rein-
   stated at the same level you were enrolled for prior to your
   leave or layoff. You must contact the Benefits Office within
   30 days of your return to work if you need to make allowable
   changes to your coverage.




                                                                                                      liFe insUrance Plans                   7
     How Benefits Are Paid


     What happens to my life insurance when I die?                       Does the plan offer an accelerated payment of
                                                                         death benefits or “Living Needs Benefit” option
     If you die while your insurance is in force, regardless of how,
                                                                         and how does it work?
     when, or where death occurs, the full amount of your insurance
     will be paid to your beneficiaries when MetLife receives written    The	accelerated	payment	of	death	benefit	or	“Living	Needs	
     proof of your death. A certified copy of the death certificate is   Benefit”	option	is	an	advance	payment	of	life	insurance	proceeds	
     required.                                                           for terminally ill persons, and is available under this plan.
                                                                         Under this option, a plan participant whose life expectancy
                                                                         is			six	months	or	less	may	receive,	in	advance,	up	to	80%	of	
     How will the insurance proceeds be paid?                            life insurance benefits that would otherwise be payable only at
                                                                         death	(with	a	maximum	of	$24,000	for	the	University	Plan	and	
     The beneficiary may choose a lump-sum payment. Beneficiaries        $500,000	for	the	Optional	Plan).		A	$10,000	policy,	for	example,	
     of active university employees can open an interest-bearing         would	pay	a	benefit	of	$8,000.		Faculty	and	staff	members	can	
     checking account immediately when the claim is processed,           choose to have the benefit paid out in one lump sum or three
     in lieu of a lump-sum distribution.                                 equal monthly payments. The money can be used at the discre-
                                                                         tion of the insured. Benefits not paid in advance remain payable
                                                                         to the named beneficiaries at the death of the insured.
     When will payment be made to my beneficiary?
     Payment to your beneficiary will be made within ten (10)
     business days after all documentation is received by MetLife.       How do I file a claim?
     Whenever there is a claim, your family, beneficiary, or other       Notify	the	HR/Payroll	Service	Center	promptly	when	you	have	a	
     designated person should notify the HR/Payroll Service Center       claim. Written proof of death (a certified death certificate) must
     immediately.                                                        be furnished to MetLife before a claim can be paid. MetLife will
                                                                         process all claim forms.




8   yOUr beneFits
Section 2: Dependent Life Insurance Plan


The group term Dependent Life Insurance Plan, also referred to                 Continuation of Coverage .
as	the	“Dependent	Plan,”	is	available	for	your	spouse	or	OQA	and	
any eligible children—even if you do not wish to insure yourself.              If your dependent has been enrolled in the Dependent Life
                                                                               Insurance plan for at least five years, you have the option to
                                                                               convert life insurance for your dependent when coverage ends
                                                                               because:
Spouse or Other Qualified Adult .
                                                                               •	 you	cease	to	be	in	an	eligible	class;
Your spouse or OQA can enroll in the Dependent Plan at any
time. He or she will need to provide satisfactory evidence of                 •	 your	employment	ends;
insurability (health statement). Coverage will go into effect                 •	 the	group	policy	ends;	or
when (1) the Dependent Plan application is received in the
Benefits Office and (2) satisfactory evidence of insurability has             •	 the	dependent	ceases	ceases	to	qualify	as	an	eligible	depen-
been received and approved.                                                      dent.
                                                                              See Conversion Privilege, page 10.

Dependent Children .
                                                                               Terminating Coverage .
No	health	statement	is	required	to	enroll	children	in	the	
Dependent Plan. Children may be enrolled in the Dependent                     You can terminate dependent coverage at any time. To do so,
Plan at any time.                                                             complete	a	“Group	Life	Insurance	Withdrawal	Form”	available	
                                                                              from any HR Service Center or the Benefits Office Web site:
Dependent Plan coverage for newborns will go into effect at age               www.umich.edu/~benefits/forms.
15 days or when the Dependent Plan application is received,
whichever is later.                                                           Dependent Spouse/OQA Plan coverage terminates when the
                                                                              faculty or staff member retires, terminates employment with
                                                                              the University for any reason, or dies. Dependent Spouse Plan
Beneficiary .                                                                 coverage will terminate the date the faculty or staff member’s
                                                                              divorce is final.
When you enroll in the Dependent Plan, you do not need to desig-
nate a beneficiary. You are automatically the beneficiary. If you             Coverage for your eligible dependent child or children ends at the
and your dependent die within a 24-hour period, both benefits                 end of the month in which the child turns age 26.
will be paid to the beneficiary of your life insurance policy or to           You must notify the Benefits Office in writing when you no
your estate.                                                                  longer have a child eligible for benefits.




                                      Dependent Life Insurance Plan Options
          You Can Choose                                                                                             Health Statement
        Insurance For Your:              In These Amounts                       Cost Per Month                            Needed

    Spouse	or	OQA		                               $10,000	                              $0.84	                            short	form1
    	                                             $25,000	                              $2.10	                            short	form1
    	                                             $50,000	                              $4.20	                            long	form
    Children2	                                  $2,000/child	                           $0.073                               none
    	                                           $5,000/child	                           $0.173                               none

1
 A long form Health Statement may be required if you do not successfully pass the short form statement.
2
 Coverage for all your eligible dependent children from age 15 days through the end of the month they turn age 26.
3
 Composite rate covers all your eligible children.



                                                                                                                 liFe insUrance Plans              9
     Section 3: Certificate of Coverage


      Certificate of Group Coverage .                                       Conversion Privilege .
      This Certificate of Group Coverage certifies that subject to the      If your or your dependent’s Group Life Insurance ends because
      terms and conditions of the Group Policy, the insurance referred      you terminate your employment or transfer out of an eligible
      to herein is provided for certain faculty and staff members of        class, you can convert all or part of it to an individual life insur-
      The Regents of the University of Michigan, herein called the          ance policy. To do so, contact the Benefits Office and make the
      Policyholder.                                                         first premium payment within the next 31 days, or, if later, within
                                                                            the	period	through	which	you	have	made	contributions.		No	
                                                                            evidence of insurability is required.
      Benefits .                                                            You may obtain any type of individual policy that MetLife then
      The MetLife benefits for which you are insured are described in       customarily issues in an amount up to the amount you had at
      this booklet in the sections preceding this Certificate of Group      termination. The only exceptions are term insurance or a policy
      Coverage. The benefits and all the provisions applicable to you       that contains disability or other supplementary benefits. The
      are described in the booklet and are effective only if you are        policy will become effective when your coverage at U-M ends.
      eligible for insurance, become insured, and remain insured in         Premiums will be based on your age and class of risk at that time.
      accordance with the provisions of the Group Policy.
                                                                            You or your dependent may be able to convert to an individual
      This certificate, which is merely evidence of insurance provided      policy even if your Group Life Insurance ends because the Group
      under the Group Policy, is furnished in accordance with, and          Policy terminates (or because such insurance terminates for
      subject in every respect to, the Group Policy, which alone consti-    your class). You can convert, as described above, only if you
      tutes the agreement under which payments are made. This               were insured for the Group Life Insurance for at least five years.
      certificate replaces any certificates previously issued to you with   Your dependent must also have been enrolled for at least 5 years
      respect to the group coverage described herein.                       to convert to an individual policy. The amount you can convert is
                                                                            the amount for which you are enrolled when you terminate your
                                                                            university employment minus any group life insurance for which
      Employee Group Term Life Insurance .                                  you become eligible during the conversion period, but not more
                                                                            than	$2,000.
      Upon receipt of written proof of your death, the amount of
      Employee Group Term Life Insurance for which you are insured          If you die within 31 days after your employment terminates
      under the Group Policy shall be payable to the beneficiary desig-     or you become ineligible, or, if later, you die within the period
      nated by you in accordance with the terms of the Group Policy.        through which you have made contributions, the amount of
      Any part of such insurance for which no beneficiary is designated     Group Life Insurance you were entitled to convert will be paid
      or surviving at your death will be payable in accordance with the     to your beneficiary whether or not you applied for conversion,
      terms of the Group Policy.                                            when MetLife receives due written proof of death (a certified
                                                                            death certificate).
                                                                            The individual policy will be in place of all Group Life Insurance
      Mode of Settlement Provisions .                                       benefits. You (or, after your death, your beneficiary under the
      Your life insurance will be paid to your beneficiary in a lump        individual policy) may, however, still establish rights under the
      sum. However, other methods of payment may be arranged                Extended Death Benefit if its requirements are satisfied. If this
      with MetLife. Information about the available methods may be          is done, those rights will be in exchange for all benefits under
      obtained from MetLife.                                                the individual policy. In that case, any premiums paid for the
                                                                            individual policy will be refunded.




10   yOUr beneFits
Incontestability of Life Insurance .                                    Option to Accelerate Payment of Death Benefits .
All statements made by an insured person with respect to the life       Accelerated Payment of Death Benefits is an option which
insurance under this plan shall be deemed representations and           provides early payment of life insurance proceeds when you
not warranties. With respect to each amount of life insurance           are terminally ill or totally and permanently disabled with a life
for which a person is insured, no such statement shall be used          expectancy of six months or less. It is not intended or designed
in any contest of such insurance unless a copy of the instrument        to provide health, nursing home, or long-term care insurance.
containing the statement is or has been furnished to him/her or
                                                                        When you elect this option, the total amount of Employee Term
to	his/her	beneficiary.		No	statement	made	by	an	insured	person	
                                                                        Life Insurance otherwise payable on your death, including any
relating to his/her insurability for such insurance shall be used
                                                                        amount under the extended death benefit, will be reduced by the
in contesting the validity of the insurance with respect to which
                                                                        accelerated proceeds. Also, any amount you could otherwise have
the statement was made after such insurance has been in force
                                                                        converted to an individual contract will be reduced by the accel-
prior to the contest for a period of two years during his/her life-
                                                                        erated proceeds. In other words, this benefit is in lieu of the
time.		Nor	can	such	statement	be	used	unless	it	is	contained	in	a	
                                                                        benefits that would have been paid on your death with respect to
written instrument signed by him/her.
                                                                        the accelerated proceeds.
                                                                        You are totally and permanently disabled for the purposes of this
Beneficiary Provisions .                                                option when you furnish proof, including a certification by a
                                                                        doctor, that satisfies MetLife that your life expectancy is six (6)
These provisions apply to any coverage which pays a benefit on          months or less.
account of your death. Any such benefit is payable to the benefi-
ciary you designate on a form satisfactory to MetLife. You may          The	terminal	illness	proceeds	are	equal	to	80%	of	the	amount	of	
change your beneficiary at any time without your present benefi-        life insurance in force on your life on the date MetLife receives
ciary’s consent. To do this, go to the MetLife website, www.            proof that you are totally and permanently disabled, but not more
metlife.com/mybenefits. The new designation will take effect on         than	$24,000	for	the	University	Plan	or	$500,000	for	the	Optional	
the date your change is completed.                                      Plan. However, the accelerated proceeds may be reduced if,
                                                                        within six (6) months after the date MetLife receives such proof,
If you designate more than one beneficiary but do not specify           a reduction on account of age would have applied to the amount
their shares, they will share equally. If a beneficiary dies before     of your Employee Term Life insurance. In that case, the amount
you, his interest will terminate and will be shared equally by any      of terminal illness proceeds may not exceed the amount of such
remaining beneficiaries, unless you specify otherwise in your           insurance after applying the reduction.
beneficiary designation. Any amount of insurance for which
there is no beneficiary at your death will be payable to the first of   If you elect this option, MetLife will make the accelerated
the following:                                                          proceeds payable to you either in a lump sum or in three (3)
                                                                        monthly installments.
•	 your	surviving	spouse/OQA;
                                                                        Your rights to be paid under this option are subject to the
•	 surviving	children	in	equal	shares;
                                                                        following terms:
•	 surviving	parents	in	equal	shares;
                                                                        1. you must choose this option in writing in a form that satisfies
•	 surviving	siblings	in	equal	shares;	or                                  MetLife;	and		
•	 your	estate.                                                         2. your Employee Term Life Insurance must not be assigned.
Your beneficiary designation will be maintained by MetLife and
will not be contained or updated in this Certificate.




                                                                                                       liFe insUrance Plans                   11
      3. Accelerated proceeds will be made available
         to you on a voluntary basis only. Therefore:

           (a)   If you are required by law to use this option to meet
                 the claims of creditors, whether in bankruptcy or
                 otherwise, you are not eligible for this benefit.
           (b)   If you are required by a government agency to use
                 this option in order to apply for, receive, or maintain
                 a government benefit or entitlement, you are not
                 eligible for this benefit.

      Modification of the Group Life Coverage
      Provisions .
      The	meaning	of	“Form”	for	an	individual	life	insurance	contract	
      which appears in the Conversion Privilege of the Group Life
      Coverage provisions is replaced by:
      “Form:		Any	form	of	a	life	insurance	contract	that:
      1. conforms to Title VII of the Civil Rights Act of 1964, as
         amended,	having	no	distinction	based	on	sex;	and
      2. is one that MetLife usually issues at the age and amount
         applied	for.”
      This does not include term insurance or a contract with disability
      or supplementary benefits.


      Assignments .
      Irrevocable assignments to an individual or a trust are permitted
      for the Optional Plan only.




12   yOUr beneFits
Published by                                    Board of Regents of the University of Michigan:
Benefits Office                                 Julia	Donovan	Darlow,	Ann	Arbor
University of Michigan                          Laurence B. Deitch, Bingham Farms
Wolverine Tower—Low Rise G405                   Denise Ilitch, Bingham Farms
3003 South State Street                         Olivia P. Maynard, Goodrich
Ann Arbor, MI 48109-1278                        Andrea	Fischer	Newman,	Ann	Arbor
                                                Andrew C. Richner, Grosse Pointe Park
PHONE	 734-615-2000	or	                         S. Martin Taylor, Grosse Pointe Farms
       866-647-7657 (toll free for off-campus   Katherine E. White, Ann Arbor
       long-distance calling within the U.S.)   Mary Sue Coleman, ex officio
FAX    734-763-0363
WEB    benefits.umich.edu                       Nondiscrimination Policy Statement
       AskHR.umich.edu                          The University of Michigan, as an equal opportunity/affirmative
                                                action employer, complies with all applicable federal and state laws
                                                regarding nondiscrimination and affirmative action. The University
                                                of Michigan is committed to a policy of equal opportunity for all
April 2012                 pdf                  persons and does not discriminate on the basis of race, color,
                                                national origin, age, marital status, sex, sexual orientation, gender
The Benefits Office is a unit of                identity, gender expression, disability, religion, height, weight, or
University Human Resources (UHR).               veteran status in employment, educational programs and activities,
                                                and admissions. Inquiries or complaints may be addressed to the
Laurita Thomas                                  Senior Director for Institutional Equity, and Title IX/Section 504/
Associate Vice President for Human Resources    ADA Coordinator, Office of Institutional Equity, 2072 Administrative
                                                Services Building, Ann Arbor, Michigan 48109-1432, 734-763-0235,
Ted Makowiec                                    TTY 734-647-1388. For other University of Michigan information
Senior Director for Benefits                    call 734-764-1817.




MC 120194
U-M Ann Arbor
Benefits Office
Wolverine Tower—Low Rise G405
 (Ground Floor)
3003 South State Street
Ann Arbor, MI 48109-1278

U-M Flint
Office of Human Resources
213 University Pavilion
303 East Kearsley
Flint, MI 48502-1950
810-762-3150
810-766-6711, fax

				
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