Page 13 - Quarles

Life and Accidental Death and
Dismemberment Insurance

Life Insurance is an important part of your financial security, especially if others depend on you for support.
Accidental Death and Dismemberment (AD&D) Insurance provides an additional death benefit for your
beneficiary and benefits to you if you are severely injured. All regular full-time associates are eligible for
Company-paid Basic Life and AD&D Insurance and to elect Supplemental Life and AD&D Insurance.

Basic Term Life Insurance and AD&D Benefits

You are automatically enrolled in Basic Term Life and Basic AD&D Insurance at no cost to you. Coverage
equals one times your annual salary up to $50,000 and is payable to your beneficiary.

Supplemental Term Life and AD&D Benefits

You may elect additional Term Life Insurance as follows:

? For yourself, the lesser of $200,000 or five time your annual base salary without providing

proof of good health. You can elect up to $500,000 with proof of good health. Elections must be made

in $10,000 increments. When to Provide Evidence of
? For your spouse, up to $50,000 without proof of good Insurability

health, but not to exceed 50% of your supplemental life When you elect Supplemental Life
insurance benefit amount. You may elect up to $100,000 Insurance coverage, the carrier will require
with proof of good health. Elections must be made in you to complete an Evidence of Insurability
$5,000 increments. (EOI) form if you:
? For your dependent children, up to $10,000 in $1,000
increments (newborn coverage begins 15 days from birth). ? Enroll after you had previously waived
You can elect up to $10,000* without providing proof of
good health. coverage when it was available to you
as a newly hired associate or
*For additional coverage amounts, you will need to complete an Evidence of
Insurability form for the insurance carrier to approve before that part of your ? Increase your current coverage amount
coverage can begin.
during annual Open Enrollment or
If you elect Supplemental Life Insurance coverage for yourself, following a qualified status change.
you will automatically receive the same amount for your AD&D
benefit. AD&D insurance is not available to your dependents. If you are newly hired, you can request

coverage up to the Guarantee Issue amount
during your 30-day enrollment period:

? For you: the lesser of $200,000 or five

times your annual base salary

? For your spouse: $50,000, not to

The following key features apply to both your Basic and exceed 50% of your supplemental life
Supplemental Life Insurance coverage: election amount

? Up to 75% of your Life Insurance benefits can be paid to ? For your children: $10,000

you if you request an accelerated death benefit after your

physician certifies that your life expectancy is 12

months or less.

? At age 65, your benefit amount will be reduced by

35% and at age 70 by 50%.

? Coverage terminates at retirement.

? If your employment with Quarles Petroleum ends,

you may convert your coverage to an individual

policy.

? You may also continue your Supplemental Life

Insurance for 31 days after your coverage ends.

12 2016-2017 Benefits Guide