Voluntary

Current Underwriter (2020) - SSQ Insurance Company Inc.
Policy Number: 1FX50

ELIGIBILITY

Subject to eligibility guidelines, NLTA members and employees residing in Canada are eligible to participate in this plan. Spouses and eligible dependent children are also eligible to be insured under this plan option.

COVERAGE

Enrollment forms for this benefit are available by contacting the Plan Administrator, Johnson Inc. Coverage is effective on the date the completed enrollment form is received by the Plan Administrator, Johnson Inc. If a member is not presently insured or wishes to increase the benefit level, an application is required. The application can be obtained by contacting the Plan Administrator, Johnson Inc.

  1. Member/Employee Only Plan
    The member or employee, under age 75, may apply for coverage from a minimum of $10,000 to a maximum of $500,000 in units of $10,000. Maximum coverage from age 70-74 is $100,000.
  2. Family Plan
    The member or employee, under age 70, may apply for coverage from a minimum of $10,000 to a maximum of $500,000 in units of $10,000. Coverage terminates at age 75. Maximum coverage from age 70-74 is $100,000.
    The member or employee’s family is insured for the following:

    1. Spousal Coverage: The spouse is insured for 50% of the member coverage if there are dependent children, or 60% of the member coverage if there are no dependent children.
    2. Each Dependent Child: Each dependent child is insured for 15% of member coverage if there is an insured spouse, or 20% of member coverage if there is no spouse.

EXCLUSIONS

No benefit will be paid for any loss, fatal or non-fatal, caused or contributed to by:

  1. self-inflicted injuries, suicide or attempted suicide, whether the Insured Person was sane or insane;
  2. war whether declared or undeclared, and whether or not the Insured Person was actually participating therein;
  3. civil commotion, riot, insurrection, armed conflict if the Insured Person was participating therein;
  4. the Insured Person’s service, whether as a combatant or noncombatant, in the armed forces of any country;
  5. the Insured Person riding as a passenger or otherwise in any vehicle or device for aerial navigation, other than as provided in the section of this booklet entitled “Aircraft Coverage”;
  6. medical treatment or surgery on the Insured Person, except if the medical treatment or surgery was needed because of an Accident.

CLAIMS PROCEDURE

To make a claim, the insured or insured’s beneficiary should notify the Plan Administrator, Johnson Inc., immediately after an accident. The Plan Administrator, Johnson Inc., must provide written notice of claim to the underwriter within thirty (30) days from the date of the accident and written proof of loss must be submitted to the underwriter within ninety (90) days after the date of such loss. Failure to submit such proof within the time required shall not invalidate nor reduce any claim if it was not reasonably possible to give proof within such time, provided such proof is furnished as soon as reasonably possible; but in no event later than one (1) year after the date of accident.

In the event of accidental death, the Accidental Death benefit shall be payable to the beneficiary or beneficiaries designated by the insured on the most recent enrollment form under this policy. If there is no such beneficiary designation, the benefit shall be payable to the beneficiary or beneficiaries designated under the Basic Group Life Insurance. In the event that there is no beneficiary designation under this policy and the NLTA Group Insurance Program Basic Group Life policy, the Accidental Death benefit shall be payable to the estate. All other benefits payable other than “Education Benefit” and “Day-Care Benefit” are payable to the insured.

Conversion to an Individual Insurance Contract

In the event your coverage is terminated because:

  1. you cease to be an active person of the Policyholder on account of resignation, dismissal, retirement or failure to return to work for the Policyholder following a period of total disability; or
  2. you cease to be an eligible person under the Policy.

The benefits provided will be set out in a Specific Loss Accident Indemnity schedule available from the Insurer at the time of conversion, and the amount of insurance that may be converted will not exceed the lesser of:

  1. the amount of insurance then in effect on the date of termination; or
  2. a total aggregate amount of five hundred thousand dollars ($500,000) for all such conversions by any insured person. Premiums for such an individual accident policy being issued in compliance with the aforementioned condition will be calculated at the Insurer’s rates then in force for your attained age at the date of conversion.

Premiums will be payable annually in advance and the accident policy will be issued on an annually renewable basis.

Termination of Voluntary Death and Dismemberment Insurance

Insurance for the Insured Person will cease on the earliest of the following events:

  1. Termination of employment, other than retirement under the provisions of the eligibility guidelines.
  2. On the date of death.
  3. On the day the Insured Person enters the armed forces of any country on a full-time basis.
  4. Termination of policy on eligibility of coverage or termination of eligibility of dependent spouse or child.
  5. On the date the Insured Person no longer pays the required premium towards the cost of insurance, where applicable.
  6. On the date the Insured Person reaches age 75.
  7. For substitute teachers, on November 30th of the following school year if, during the preceding three months, the substitute teacher has not taught at least one day, and has not taught at least 10 days in the previous school year.
  8. For private school teachers, coverage terminates upon termination of the teaching contract.

SCHEDULE OF BENEFITS

The insurance includes benefits for Accidental Death, Dismemberment, Loss of Speech and/or Hearing, Paralysis and Loss of Use, any of which are caused by accident.

Specific Loss Accident Indemnity
If within one year from the date of the accident, injury results in any of the following specific losses, the underwriter pays the percentage set opposite such loss for injury resulting from an accident. Each sum is calculated based on the amount of insurance.

For Loss of:

Percentage of Amount of Insurance

Life
100%
Entire Sight of Both Eyes
100%
One Hand and Entire Sight of One Eye
100%
One Foot and Entire Sight of One Eye
100%
Speech and Hearing in Both Ears
100%
Entire Sight of One Eye
100%
Speech or Hearing in Both Ears
100%
Hearing in One Ear
66⅔%
All Toes of One Foot
33⅓%

For Loss of or Loss of Use of:

Both Arms, Both Hands, or Both Feet
100%
One Hand and One Foot
100%
One Arm or One Leg
100%
One Hand or One Foot
100%
Thumb and Index Finger of the Same Hand or Four Fingers of One Hand
66⅔%

For Paralysis of:

All Four Limbs QUADRIPLEGIA
200%
Both Lower Limbs PARAPLEGIA
200%
One Arm and One Leg on the Same Side of the Body HEMIPLEGIA
200%

Additional Benefits...

For Loss of:

Percentage of Amount of Insurance

Life
100%
Entire Sight of Both Eyes
100%
One Hand and Entire Sight of One Eye
100%
One Foot and Entire Sight of One Eye
100%
Speech and Hearing in Both Ears
100%
Entire Sight of One Eye
100%
Speech or Hearing in Both Ears
100%
Hearing in One Ear
66⅔%
All Toes of One Foot
33⅓%

For Loss of or Loss of Use of:

Both Arms, Both Hands, or Both Feet
100%
One Hand and One Foot
100%
One Arm or One Leg
100%
One Hand or One Foot
100%
Thumb and Index Finger of the Same Hand or Four Fingers of One Hand
66⅔%

For Paralysis of:

All Four Limbs QUADRIPLEGIA
200%
Both Lower Limbs PARAPLEGIA
200%
One Arm and One Leg on the Same Side of the Body HEMIPLEGIA
200%