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Plan Description
ING Reliastar > Basic Life Plan
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Note: This page contains a brief summary of coverage. It does not
state all provisions and limitations of the plan. The terms and provisions of
each plan, as outlined in the plan document, will determine coverage and
eligibility.
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Broker Name:
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Blue Cross Blue Shield of Georgia
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Policy Number:
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34512435
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Original Plan Effective Date:
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12/11/2002
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Rate Guarantee Expiration Date:
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12/11/2002
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Plan Anniversary Date:
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12/11/2202
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Billing Cut-off Day of the Month:
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1
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Retroactive Termination Limit:
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30
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Divisions:
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All Divisions
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Locations:
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California
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Employee Classes:
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Full Time
Manager
Officer
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Validation Method:
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Automatic
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General Plan Information
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Base Plan Benefit
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1 x Salary
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Base Maximum Benefit
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$300,000.00
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Base Minimum Benefit
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$10,000.00
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Buy-up Benefit
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1 x Salary
2 x Salary
3 x Salary
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Buy-up Maximum Benefit
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$500,000.00
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Guarantee Issue
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$300,000.00
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Accelerated Benefit
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Included: up to a maximum of $250,000 or 75% of the insured person's life coverage, whichever is less
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Portability
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Included
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Airbag Benefit
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Included
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Seabelt Benefit
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Included
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Reduction of Benefits Schedule
Age Reduction percentages are Cumulative.
Age Reduction percentages are a percentage of the original benefit.
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Years of Age
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Reduction (%)
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Reduction 1
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65
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35%
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Reduction 2
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70
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40%
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Reduction 3
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75
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35%
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Reduction 4
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80
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30%
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Reduction 5
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85
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25%
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Reduction 6
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90
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10%
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Other examples
Waiting Period Information
Eligible employees are eligible as of the 1st of the month following the employee's hire date.
Termination of Coverage Information
When a plan participant is terminated from the company, the plan coverage ends on the last day of the month following the employee's termination date.
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(per month)
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Base Plan Rate:
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$0.15
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Base Plan Rate Type:
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Per $1,000 of benefit
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Base Plan Contribution:
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Employee contributes 0% per month.
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Other examples
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Plan Name HMO
http://www.bluesss.com
Member Services
John Carpet
600 Lafayette East
Detroit, MI 48226
(313) 225-5890
Fax (313) 225-3453
Claims Services
Jennifer Pattern
600 Lafayette East
Detroit, MI 48226
(313) 225-3445
Fax (313) 225-3435
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Enrollment Related Form)