If you are an Eligible Employee, coverage is available for you and your Spouse/Domestic Partner (if he or she is under age 70).

 

Your dependent children are also eligible from live birth to 26 years of age (or dependent children 26 years of age or older who are primarily supported by you and incapable of self-sustaining employment because of a mental or physical disability).

 

No one can be covered more than once under this plan. If you are covered as an Eligible Employee, you cannot also be covered as a dependent.

Coverage for you

If you are an Eligible Employee, you may purchase coverage in the following amounts:

• Select from 1-6 times your Covered Earnings rounded to the next higher $1,000, if not already an even multiple.
• The maximum coverage amount is $2,500,000, or 6 times your Covered Earnings, whichever is less.

 

Coverage for your family

Each family member’s coverage is a percentage of the benefit amount you select. It will depend on who your insured family members are at the time of a covered accidental loss.

• If you select family coverage for you and your Spouse/Domestic Partner and you have no children, your Spouse/Domestic Partner will be covered for 60% of your benefit amount.
• If you have dependent children but no Spouse/Domestic Partner, your dependent children will be covered for 15% of your benefit amount.
• If you select family coverage and have a Spouse/Domestic Partner and dependent children, your Spouse/Domestic Partner will be covered for 50% and your children for 10% of your benefit amount.
• The premium is the same, regardless of the number of dependent children covered.
• The maximum benefit for a Spouse/Domestic Partner is $1,500,000; for dependent children, the maximum benefit amount is $50,000 per covered child.

When the covered employee reaches age 70, benefits will be reduced to 70% of the benefit amount selected; at age 75, 45%, at age 80, 30% and at age 85, 15%.

 

Coverage for your Spouse/Domestic Partner ends when they attain age 70.

Use this chart to help you figure out the cost of monthly AD&D insurance coverage. You pay your premiums through payroll deduction unless you are on an unpaid leave of absence, in which case you will be required to pay via check. The total depends on how much coverage you select.

Monthly Cost of Insurance
Employee only	$0.016 per $1,000 of coverage
Employee and Family	$0.026 per $1,000 of coverage

Note:

AD&D is paid for with after-tax dollars. Rates are subject to change.

 

We will pay benefits if you, or an insured family member, are seriously injured in a covered accident that results in dismemberment, loss of eyesight, speech and hearing, and paralysis. 

 

If you suffer multiple covered losses in one covered accident, you’ll receive only one benefit—the largest benefit to which you’re entitled. See your plan’s Schedule of Covered Losses below for details.

Schedule for Covered Losses

If, within 365 days of covered accident, bodily injures result in:	NYL GBS will pay this % of benefit amount:
	You and Your Spouse/ domestic partner	Your Children
Loss of life	100%	100%
Dismemberment
Loss of two or more hands or feet	100%	200%
Loss of one hand or one foot and sight in one eye	100%	200%
Loss of one hand or foot	50%	100%
Loss of thumb or index finger of the same hand	25%	50%
Loss of four fingers of the same hand	25%	50%
Sensory loss
Loss of sight of both eyes	100%	200%
Loss of speech and hearing (in both ears)	100%	200%
Loss of sight in one eye	50%	100%
Loss of speech	50%	100%
Loss of hearing (in both ears)	50%	100%
Paralysis
Quadriplegia	100%	200%
Paraplegia	50%	100%
Hemiplegia	50%	100%
Note: Only one benefit (the largest) will be paid for losses from the same accident.

Some accidents could seriously affect your finances—especially if extensive rehabilitation is needed. That’s why AD&D insurance gives you these additional benefits to help meet special needs.

 

Child-care center benefit

We will pay a benefit to help pay for each of your children’s daycare expenses if you, or your insured Spouse/Domestic Partner, dies because of an accident. We’ll pay up to 3% of your total coverage each year but not more than $3,000 a year, until the child turns 13. We’ll send the payments to the dependent child’s surviving custodial parent or legal guardian.

 

There are certain limitations:

• Your surviving child must be under age 13.
• Your surviving child must be enrolled in a licensed day care center at the time of your covered accident, or within 90 days of your accidental death.

 

Increase accidental injury benefit for children
We will pay double the dependent child’s coverage amount if your insured dependent child suffers an accidental injury. The maximum payment amount is $100,000. Restrictions apply. If the dependent child dies within 90 days of the accident, you will receive the death benefit only.

 

Seat belt and air bag benefits
We will automatically increase the benefit amount by 10% if you, or an insured family member, die in a motor vehicle accident while wearing a seat belt. Maximum benefit is $25,000.

We will automatically increase the benefit amount by 5% if you, or an insured family member, die in an accident while positioned in a seat protected by an air bag that properly inflated on impact. Maximum benefit is $12,500.

We will pay $1,000 if it isn’t clear whether the Insured had been wearing a seat belt, and/or if the air bag inflated properly upon impact.

Restrictions, limitations and exclusions apply as outlined in the Certificate.

 

Education benefit
If you die in a covered accident, we will provide benefits for training or education, as follows:

For your children. If you die in a covered accident, we will pay an extra benefit for each insured dependent child who is enrolled in college or is in the 12th grade and enrolls in college within one year of the accident. To help pay college expenses, we will increase your benefit amount by actual charges up to 5% or $5,000 (whichever is less), for each qualifying child. This benefit is payable each year for four consecutive years, as long as your dependent children continue their college education.

For your Spouse/Domestic Partner. If, within one year of your death in a covered accident, your Spouse/Domestic Partner enrolls in an accredited school to gain skills needed for employment, we will pay the actual cost of this education or training program for up to one year after enrollment begins, up to $5,000. If your Spouse/Domestic Partner doesn’t elect this education program and you have no dependent children, we will pay an additional $1,000 to your beneficiary.

 

Exposure and disappearance benefit Benefits are payable if you suffer a covered loss due to unavoidable exposure to the elements as a result of a covered accident. If your body is not found within one year of the disappearance, wrecking or sinking of the conveyance in which you were riding, on a trip otherwise covered, it will be presumed that you sustained loss of life as a result of a covered accident.

 

Coma Benefit
If you, your Spouse/Domestic Partner, or your children are in a coma as a result of a covered accident, we will pay a Coma benefit as long as the insured person entered the coma within 31 days of the accident. We will make 11 monthly payments, provided the person remains in a coma during this period. If the person recovers, the payments will stop.

If the insured person dies while the monthly Coma benefit payments are being made, or if the insured person remains in a coma after the 11 monthly payments have been made, he or she will be entitled to a lump-sum payment equal to the full benefit amount.

Coverage for You (and your Dependents, if applicable,) will start on the date we receive your completed and signed application form.

 

If you are not actively at work on the date coverage would become effective, coverage will become effective on the first day the employee returns to Active Service.

 

Your coverage will end on whichever comes first:

• Insperity cancels the group policy.
• You are no longer an Eligible Employee.
• You don’t pay the premiums.

 

Spouse/Domestic Partner or dependent children coverage will end on whichever comes first:

• Your coverage ends.
• Their premiums are not paid.
• They’re no longer eligible.

 

Changing from the Group Plan to Individual Coverage
If your coverage ends before you reach age 70, for any reason except nonpayment of premium, you can convert to an individual policy. Proof of good health is not required.

To continue your coverage, you must apply for the conversion policy and pay the first premium within 31 days after your group coverage ends. Family members may convert their coverage as long as they have not reached the maximum age limitation.

Converted policies are subject to certain benefits and limits, as outlined in your policy. Contact NYL GBS directly for additional information at 800.231.1193

Plan benefits are not payable if:

• An injury or a loss results, directly or indirectly, from or is caused by, self-inflicted injuries or suicide while sane or insane;
• There is a commission or attempt to commit a felony or an assault;
• There is any act of war, declared or undeclared;
• An injury or a loss results from sickness, disease, physical or mental impairment, or surgical or medical treatment thereof, or bacterial or viral infection, regardless of how contracted. (This does not include bacterial infection that is the natural and foreseeable result of an accidental external cut or wound or accidental food poisoning.)
• The loss occurs while the covered person is voluntarily using any drug, narcotic, poison, gas or fumes except one prescribed by a licensed physician and taken as prescribed (Accidental ingestion of a poisonous substance is not excluded.);
• Injuries are sustained while you are on full-time active duty in the armed forces for more than 30 days;
• Traveling in an aircraft that is owned, leased or controlled by Insperity (an aircraft will be deemed to be ‘’controlled’’ by Insperity if the aircraft may be used as Insperity wishes for more than 10 straight days, or more than 15 days in any year);
• Flying in, boarding or alighting from an aircraft or any craft designed to fly above the earth’s surface, (except as a passenger on a regularly scheduled commercial airline) that is:
• An ultra-light or glider, designed to be used in outer space;
• Being used by any military authority, except the Air Mobility Command or its foreign equivalent;
• Being flown by the covered person or in which the covered person is a member of the crew;
• Being used for any operation that requires a special permit from the FAA, even if it is granted (this does not apply if the permit is required only because of the territory flown over or landed on)

You can designate your beneficiaries during the enrollment process and maintain your beneficiaries online once your coverage is issued by clicking on My Account.

If the listed beneficiary is a trustee or a trust, you will need to enter the trustee's name, the name of the trust and the date of the trust agreement. The trust document must be presented in order for the claim to be processed.

 

Need To Access Or Designate Your Beneficiaries?

Below are steps to access your beneficiary designations online:

• Click on the My Account.
• Click on one of the coverages from the list displayed.
• Click on Beneficiary Information link.
• Click on “Edit” for whichever coverage you want to designate a beneficiary.
• Read the agreement, check the box and click “Continue” to the Beneficiary Designation page.
• Complete the information on the Beneficiary Designation page.
• Print the confirmation for your records.

 

You can also designate and/or change beneficiaries using the Beneficiary Designation form.

Understanding these words and phrases may be helpful as you read through the information about AD&D insurance.

 

Active Service

An Employee will be considered in Active Service on a day which is a scheduled workday if any of the following conditions are met:

1. The Employee is actively at work performing his or her regular occupation.
2. The Employee is on a holiday, vacation day, or a day which is not a scheduled workday and was performing his or her regular occupation on the preceding scheduled workday.
3. The Employee is on an approved leave of absence for a period of no longer than 12 weeks (or any longer period by state or federal law).

 

Employees of a new Client Company who fall into one of the categories above (as of the effective date of the co-employment agreement between Employer and a Client Company) will be treated as being in Active Service for purposes of this Policy.

 

Affordable Care Act (ACA)

The federal health care reform legislation that was enacted in 2010, as amended.

 

Applicable Large Employer (ALE)

An employer that employed, on average, at least 50 full-time employees (including full-time equivalent employees), as defined by the ACA, on business days during the preceding calendar year. Contact Insperity if you have questions concerning ALE determinations and whether you are an employee subject to these rules.

 

Benefits Eligibility Date

The first date you are eligible to become covered following satisfaction of any required waiting period (as provided in your enrollment materials).

 

Covered Earnings

For Full-time Employees, Covered Earnings means an Employee's base annual salary, plus actual earnings for the previous 12 months derived from (i) commissions, (ii) piece work, (iii) fee-based work, and (iv) for ordained, commissioned, or licensed ministers only, any housing allowance paid by the Employer, as reported by the Employer to New York Life on the eligibility file. Amounts attributable to actual earnings will be annualized if the Employee has been employed by the Employer for less than 12 months. In no event will Covered Earnings include bonuses, overtime pay, special pay or any other form of extra compensation.

For part-time Employees, Covered Earnings means actual earnings for the previous 12 months derived from (i) salary (including hourly wages), (ii) commissions, (iii) piece work, (iv) fee-based work, and (v) for ordained commissioned or licensed ministers only, any housing allowance paid by the Employer, as reported by the Employer to New York Life on the eligibility file. Any such amount will be annualized if the Employee has been employed by the Employer for less than 12 months. In no event will Covered Earnings include bonuses, overtime pay, special pay or any other form of extra compensation.

For Employees on a Leave of Absence (whether paid or unpaid), Covered Earnings will be the amount in effect (as calculated above) immediately prior to going on an approved Leave of Absence. The Covered Earnings amount will remain frozen until the Employee returns to work.

 

Domestic Partner

Domestic Partner means any of the following:

1. A person with whom the Employee or Former Employee has a registered civil union or domestic partnership under state law which imposes legal obligations on the parties substantially similar to marriage.
   
   Such person will continue to be recognized as a Domestic Partner unless and until: (1) the civil union or domestic partnership is dissolved under applicable law; or (2) either the Employee or Former Employee or the Domestic Partner marries another person.


2. A person meeting all of the following requirements, with respect to an Employee or Former Employee:
   1. Shares a permanent residence with the Employee or Former Employee;
   2. Has resided with the Employee or Former Employee for at least 12 months.
   3. Has not been legally married to any other person within the previous 12 months, and has no Domestic Partner other than the Employee or Former Employee during the previous 12 months, and is the Employee’s or Former Employee sole Domestic Partner;
   4. Is interdependent with the Employee or Former Employee in two of the following ways:
      1. Both partners are registered under any municipal ordinance as domestic partners.
      2. Both partners are jointly parties to a lease, mortgage or deed.
      3. Both partners jointly own one or more motor vehicles.
      4. Both partners jointly own one or more bank or credit accounts.
      5. The Employee or Former Employee has named the Domestic Partner as attorney-in-fact under a durable power of attorney with authority over health care decisions.
      6. The Employee or Former Employee has designated the Domestic Partner as a beneficiary under a retirement plan or a life insurance policy.
      7. The Employee or Former Employee has designated the Domestic Partner as a beneficiary of the Employee’s will.
      
      
   5. Is not so closely related by blood to the Employee or Former Employee as to prohibit legal marriage in their state of residence.
   6. Is no less than 18 years of age.

All references in the policy to “Spouse” shall be changed to read “Spouse and Domestic Partner" except as follows:

1. The definition of “Spouse” remains unchanged.
2. A child of a Domestic Partner may only be eligible to be insured if:
   1. the child is primarily dependent on the Employee for financial support; or
   2. the Employee has a legal obligation of support of the child; or
   3. the Employee is the child’s legal guardian.

 

Important Note: In order to file a claim for benefits, proof of the domestic partnership as indicated above must be furnished the same as proof of a marriage.

 

Eligible Employees

The Plan administers two sets of eligibility rules – one for employees of a non-ALE company and one for employees of an ALE company, as described below and in the SPD.

 

Employees of a Non-ALE Company

You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and you are:

• A Full-Time Employee. A full-time employee of Insperity who is working 30 hours or more per week (20 hours in Hawaii) on average.
• A Full-Time Employee on a Leave of Absence. A full-time employee of Insperity who meets the requirements for continuing eligibility during an approved leave of absence.

 

Employees of an ALE Client Company

You are an Eligible Employee if your benefits package from Insperity includes coverage under the Plan and if you are:

• A Full-Time Employee. A full-time employee of Insperity who is working 30 hours or more per week (20 hours in Hawaii) on average.
• A Part-Time or Seasonal Benefits Eligible Employee. A part-time or seasonal employee of Insperity who is also employed by an ALE Client Company and has been determined to be eligible for benefits as described below.
• An Employee on a Leave of Absence. An employee in either of the two categories described above, who meets the requirements for continuing eligibility during an approved leave of absence.

 

Eligibility for employees of an ALE Client Company will be determined based on hours worked during the employee’s Measurement Period. Once the employee is determined by Insperity to be eligible for benefits, eligibility will be retained during the Stability Period associated with that Measurement Period (regardless of any changes in hours worked during the Stability Period).

 

Certain exclusions may apply. Please see the Certificate for more information.

You can apply for Accidental Death & Dismemberment Insurance Online by using the "Apply Now" button to the right. Or, you can Complete An Application and submit to NYL GBS.

 

Important Tips For Applying For Coverage With NYL GBS Trusted Advisor

• Online applications for each voluntary benefits program will open in separate browser windows.
• Online applications for each voluntary benefits program will need to be completed, electronically signed and submitted individually.
• Once an application has been submitted, close the application window and start the next application by clicking “Apply Now” below.
• For your protection, an online application will time out after 30 minutes of inactivity; any un-submitted applications will NOT be saved.
• Do not use the “Back” button in your browser; you will have the option to edit your application when you see the “Edit Application” button before each application is completed.
• In the event you need to access Insperity Premier^TM, it will remain open in a separate Internet browser window (you may be asked to log in again, depending upon the length of inactivity).

No. You do not need to provide proof of good health regardless of the coverage amount you are applying for.

Yes - NYL GBS Secure Travel can arrange and cover the cost of transportation to get you to a different hospital or medical facility or to be repatriated to your place of residence for treatment. And, in the event of a fatality, we’ll arrange and cover the cost of transporting remains back to the country of origin

Yes. Our Accidental Death & Dismemberment (AD&D) insurance plan includes many value-added programs, offered at no additional cost, to help you and your family maintain your health, well-being and sense of security throughout your lifetime. To see which programs are available to you select "Value-Added Programs" from the menu above.