Life / AD&D

Benefit Description

The Plan provides death benefits for Employees and dependents, and accidental death and dismemberment benefits for Employees only.

To file a claim for death benefits or Accidental Death or Dismemberment Insurance, call the Trust Fund Office at (408) 288-4500.

Life Insurance

Insurance Classes
Class 1 All Active Full-Time Employees
Class 2 Retired Employees under age 65.
Class 3 Retired Employees age 65 and over.
Retiree Life Insurance Benefit
Class 1 Flat $20,000
Class 2 Flat $20,000
Class 3 Flat $6,000
Retiree AD&D Insurance Benefit
Matches Basic Life Benefit
Dependent Life Insurance
Spouse $3,000
Child – Age:

-From birth through 5 months

-6 months but under 19 years

-Full-time students 19 years but under 24 years

$200

$3,000

$3,000

 Note: This chart is only a summary. Please see the evidence of coverage or disclosure form for the selected plan for a thorough description of its benefits, limitations, exclusions and conditions of coverage.

Limitation

The amount of life insurance for each of your dependents will not be more than 50% of the amount of your life insurance. If the amount shown above for a dependent is more than 50% of your life insurance amount, it will be reduced to 50% of your life insurance amount.

Accidental Death And Dismemberment

LOSS OF BENEFIT
Life Full Benefit
Both Hands Full Benefit
Both Feet Full Benefit
Both Eyes Full Benefit
A Hand and a Foot Full Benefit
A Hand and an Eye Full Benefit
A Foot and an Eye Full Benefit
A Hand Half the Full Benefit
A Foot Half the Full Benefit
An Eye Half the Full Benefit

Note: Loss of a hand or foot means the complete and permanent severance of the hand or foot at or above the wrist or ankle joint. Loss of an eye means the entire and permanent loss of the sight of that eye.

To file a life or AD&D insurance claim, please contact us at 408 288 4511