Accidental Death and Dismemberment

February 2010 2APRIL 2010

1x,2x,3x,4x,5x,6x,7x, 8x or 9x Benefit Salary

Maximum $500,000 (If you are 75 or older, the value of your

coverage is reduced)

Covers the employee only

Covered Accident Benefits

Dismemberment

Permanent Total Disability

No Medical Underwriting required

AD&D INSURANCE

February 2010 3APRIL 2010

% of Eligible Coverage

ACCIDENTAL DEATH & DISMEMBERMENT

PERMANENT TOTAL DISABILITY

LESS THAN 75 100% 100%

75 BUT LESS THAN 80

50% 20%

80 OR MORE 25% 10%

*Age as of Benefit Calculation Date

February 2010 4APRIL 2010

If accidental bodily injury occurs in any one

of the specific losses within one year from

the date of a covered accident, Minnesota

Life will pay the benefit specified

Only one benefit will be paid for more than

one loss resulting from any one covered

accident

Loss of Life, Limb, Sight, Speech or Hearing

February 2010 5APRIL 2010

Dismemberment chart

LOSS OF LIFE COVERAGE AMOUNT

LOSS OF TWO OR MORE MEMBERS

COVERAGE AMOUNT

LOSS OF SPEECH AND HEARING COVERAGE AMOUNT

LOSS OF ONE MEMBER ½ THE COVERAGE AMOUNT

LOSS OF SPEECH OR HEARING ½ THE COVERAGE AMOUNT

LOSS OF THUMB & INDEX FINGER ON THE SAME HAND

¼ THE COVERAGE AMOUNT

February 2010 6APRIL 2010

Definitions

“Member” means hand, foot, or eye

“Loss” means with regard to: Hand or foot, actual severance through or above the

wrist or ankle joint, without reattachment Eye, entire or irrevocable loss of sight Speech, entire and irrevocable loss of function Hearing, entire and irrevocable loss of function Thumb & index finger, actual severance through or

above the metacarpophalangeal joint, without reattachment

February 2010 7APRIL 2010

Permanent Total Disability

“Total Disability” means a person is unable, due to accidental bodily injury, to perform all of the material duties of your occupation for twelve continuous months

After twelve months, the total disability is means the same as “Permanent Total Disability”

February 2010 8APRIL 2010

Permanent Total Disability

If approved as Permanently or Totally Disabled, the employee will be paid monthly 1% of the Coverage Amount

Eligibility requirements: Became totally disabled within 180 of the covered

accident Total Disability continued for 12 months after onset Medical authorization after the 12 months that the

disability is continuous, permanent, and presumably lasting for life

February 2010 9APRIL 2010

Exclusion Examples

Caused by or resulting from war or an act of war (declared or undeclared)

Caused by intentionally self-inflicted injuries

Caused by suicide

Committing or attempting to commit a felony

Caused by motor vehicle accident where you are the operator and meet or exceed the specific state’s level of intoxication