This is a valuable plan designed to provide a $15,000 benefit to your survivors in the event of your death. This plan also provides a $15,000 benefit if you die as a result of an accident (within 90 days) or if you suffer one of the losses below:
Life
100% Both Hands, Both Feet or Both Eyes
100% One Hand and One Foot
100% One foot and Sight in One Eye
100% Speech and Hearing in Both Ears
100% One Hand or One Foot
50% Sight of One Eye
50% Speech or Hearing on Both Ears
50% Hearing in One Ear
25% Thumb and Index Finger of Same Hand 25%
TO ENROLL: Complete the Basic Term Life Insurance Enrollment Form. Your Life Insurance is NOT in effect unless you complete the Enrollment Form. You also do not have additional life (buy up for additional coverage), unless you complete the Enrollment Form and Heath Questionnaire for Additional Term Life. You may fax the Employee Benefit Request Form to Simple HR at 1-850-650-9396, however you MUST mail in any Life Insurance Enrollment Forms. All applications for additional coverage must pass through Underwriting prior to approval.
