Common use of GROUP LONG-TERM DISABILITY AND GROUP TERM LIFE Clause in Contracts

GROUP LONG-TERM DISABILITY AND GROUP TERM LIFE. Group Long-Term Disability (Choose one) : Option 1 (60% of the monthly rate of basic earnings less other benefits up to $6,000 per month) Option 2 (60% of the monthly rate of basic earnings less other benefits up to $10,000 per month) Group Term Life–Choose one: Option 1 (one times annual earnings up to $50,000) Option 2 (two times annual earnings up to $100,000) NOTE: Group Long-Term Disability and Group Term Life requires 100% participation of all active, regular, full-time (working at least 30 hours per week) Employees.

GROUP LONG-TERM DISABILITY AND GROUP TERM LIFE. Group Long-Term Disability (Disability–Choose one) one : Option 1 (60% of the monthly rate of basic earnings less other benefits up to $6,000 per month) Option 2 (60% of the monthly rate of basic earnings less other benefits up to $10,000 per month) Group Term Life–Choose one: Option 1 (one times annual earnings up to $50,000) Option 2 (two times annual earnings up to $100,000) NOTE: Group Long-Term Disability and Group Term Life requires 100% participation of all active, regular, full-time (working at least 30 hours per week) Employees. Employee Enrollment Form‌ To be completed by each employee becoming a member of a medical, dental or vision plan, applying for COBRA coverage, or waiving coverage.