Apply For Coverage Up to $1,000,000
If you’re a member of the American Society of Mechanical Engineers (ASME), under age 70, and a resident of the United States (excluding VT and territories) Puerto Rico and Canada (except Quebec), you are eligible to apply for $100,000 up to $500,000 (in multiples of $100,000) of ASME Term Life Insurance Plan.
Amounts greater than $500,000 are available without the ABI feature (see description of ABI below). To apply for an amount greater than $500,000 please call the administrator.
You may also apply for coverage for your lawful spouse in the same amount as yourself. The amount of spouse coverage requested cannot exceed 100 percent of yours. Each unmarried, dependent child from age 14 days through 22 years (24 for full-time students) may also be insured for $10,000. Children’s coverage is not available for ABI.
A dependent who is also an ASME member is eligible for either member or dependent coverage, but not both.
* See "Choose the Amount You Need" and "Amounts of Insurance at Ages 61-100" for details.
Automatic Benefit Increase Benefit (ABI) Option
Automatic Benefit Increase automatically increases your coverage, to help you keep pace with inflation. The Automatic Benefit Increase option increases your level of coverage by 10 percent a year…every year…for up to 10 full years. That means your benefits initial coverage amount can gradually double over 10 years. To receive each automatic increase, you must be less than age 60 and not totally disabled. Regardless of your health at the time, you will not need to reapply or requalify for this benefit increase. Of course, it's your decision to accept or decline the additional 10 percent each year but once declined, it cannot be resumed. Because member and spouse coverage is considered as one unit, you accept or decline the offer for both member and spouse at the same time. Your total premium increases annually to reflect your 10 percent higher benefit amount at the then current age of the insured. Please see your Certificate of Insurance for details. The ABI option does not apply to children’s insurance.
Premium Discounts May Reduce Your Cost
A money-saving feature of the ASME Term Life Insurance Plan is the opportunity to receive a premium discount. Premium discounts reduce the total cost of insurance. A 25 percent premium discount will be applied to semiannual premium contributions due through April 30, 2012. And in the future, if plan experience warrants, the Trustee may grant premium discounts that can reduce your cost to renew coverage. Although not promised or guaranteed, premium discounts and/or credits have been granted every year since 1965.
Compare For Yourself the Value of Our Plan
Life insurance policies are issued by insurance companies in varying amounts (e.g. $15,000, $25,000, $100,000). An easy way to compare premiums is to calculate the annual cost per $1,000 of coverage. What’s more, ASME premium discounts, when available, further reduce the cost of coverage.
How Much Coverage Do You Need?
Many independent insurance planners recommend anywhere from five to nine times your annual salary as an adequate amount of insurance. To estimate a coverage level that’s right for you, consider your present living expenses, your estate and the future plans of your family. Be sure to include educational plans, mortgage amounts, and daily expenses. Remember, the financial needs of your family will continue even after your death.
Choose the Amount You Need
| For Member |
Options of $100,000 to $500,000 (in multiples of $100,000) with the ABI option. To apply for options of $500,000 to $1,000,000 without the ABI feature please call the administrator. |
| For Lawful Spouse |
Options of $100,000 to $500,000 (in multiples of $100,000) with the ABI option. To apply for options of $500,000 to $1,000,000 without the ABI feature please call the administrator.
May not exceed member coverage |
| For Each Unmarried Dependent Child |
From 14 days through 22 years (or 24 if a full-time student) --$10,000 |
* Coverage decreases starting at member age 61. See "Amounts of Insurance at Ages 61-100."
Please note that the total amount of coverage for an individual insured by more than one group policy issued by New York Life Insurance Company to the Trustee of the Life Insurance Plan for Members of the ASME may not exceed the maximum benefit option. The total amount of coverage an individual may request under all engineering group life insurance plans underwritten by New York Life Insurance Company cannot exceed $2,000,000.
CURRENT 2012 SEMIANNUAL PREMIUM
CONTRIBUTIONS
The initial cost of insurance for you (the member) and your lawful spouse is based on your age on the day your insurance becomes effective. The cost increases as you grow older. All eligible children can be insured for $3.30 ($2.48 with the premium discount*), regardless of number or your age.
Ontario, Canada Residents: Please see tax notice under HOW TO APPLY section.
|
|
Member $10,000 Option |
Spouse $10,000 Option |
Member’s
Age |
No
Premium Discount |
With 25%
Premium Discount* |
No
Premium Discount |
With 25%
Premium Discount* |
| Under 30 |
2.50 |
1.88 |
2.00 |
1.50 |
| 30-34 |
2.95 |
2.22 |
2.20 |
1.65 |
| 35-39 |
4.00 |
3.00 |
2.80 |
2.10 |
| 40-44 |
6.25 |
4.69 |
4.20 |
3.15 |
| 45-49 |
10.15 |
7.62 |
6.40 |
4.80 |
| 50-54 |
15.75 |
11.82 |
9.90 |
7.43 |
| 55-59 |
24.40 |
18.30 |
15.30 |
11.48 |
| 60-64** |
33.75 |
25.32 |
21.50 |
16.13 |
| 65-69** |
37.00 |
27.75 |
23.80 |
17.85 |
* The 25 percent premium discount is effective through April 30, 2012.
** Amounts of coverage decrease with age. See "Amounts of Insurance at Ages 61-100." Coverage terminates at member’s age 100. See Conversion Privilege.
Contact the administrator for renewal rates at ages 70-100.
The premium contributions shown reflect the current rates and benefit structure. Premium contributions may be changed by New York Life Insurance Company on any premium due date, but not more than once in any 12-month period, and on any date on which benefits are changed. However, your rates may change only if they are changed for all others in the same class of insureds under this group policy. For example, a class of insureds is a group of people all with the same issue age and tobacco/nicotine usage. Benefit option amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the Trustee.
AMOUNTS OF INSURANCE AT AGES 61-100*
The amount of life insurance for you and your spouse is based on your age at last birthday, and decreases on the semiannual premium due date on or immediately after you enter a new age category. After age 61, coverage decreases for each $10,000 member option of insurance. Spouse coverage also decreases for each $10,000 option. Full premiums continue to be payable. (The amount of children’s insurance does not decrease.)
| Member’s Age |
Each Member/Spouse
$10,000 Option |
| Under 61 |
$10,000 |
| 61 |
9,200 |
| 62 |
8,500 |
| 63 |
7,800 |
| 64 |
7,200 |
| 65 |
6,700 |
| 66 |
6,200 |
| 67 |
5,700 |
| 68 |
5,200 |
| 69 |
4,800 |
| 70 |
4,400 |
| 71 |
4,000 |
| 72 |
3,700 |
| 73 |
3,400 |
| 74 |
3,200 |
| 75 |
3,000 |
| 76 |
2,800 |
| 77 |
2,600 |
| 78 |
2,400 |
| 79 |
2,200 |
| 80** |
2,000 |
* Based on each $10,000 option of member coverage and $10,000 option of spouse coverage.
**Coverage terminates at age 100. See Conversion Privilege.
Benefit amounts are not guaranteed and are subject to change by agreement between New York Life Insurance Company and the Trustee.
PLAN FEATURES
Living Benefit Provision "Accelerated Death Benefit"
A Living Benefit or "accelerated death benefit" option is available to help terminally ill insureds and their families during a difficult, and often financially challenging time. Under this provision the member may request one advance payment equal to 50%percent of his or her (or an insured dependent’s) in force life insurance to be paid while that person is still alive. The request must be made at least 12 months prior to the insured person’s scheduled coverage termination age and the amount of insurance payable after the insured’s death will be reduced by this payment. (Premium contributions will not be reduced.) If a scheduled reduction in coverage will occur within one year of the date the Accelerated Death Benefit will be paid, the benefit payable will be 50 percent of the reduced coverage amount.
This money can be used to help cover high prescription drug costs...medical bills...outstanding debts...to help pay for experimental treatments...the cost of modifications to your home...or for a family vacation--the choice is yours.
To qualify, a terminally ill insured must provide the insurance company with proof of terminal illness and anticipated life expectancy (12 months or less), as well as any other necessary medical information requested. For additional details and limitations, please see the Certificate of Insurance.
Please note that receipt of accelerated death benefits may affect your eligibility for public assistance programs and may be taxable. Prior to applying to receive such benefits, you should consult with the appropriate social services agency and seek the advice of a qualified tax advisor.
Note: This benefit is not available to residents of Massachusetts.
Premiums Waived If You’re Disabled
If you become totally disabled before age 60 and the disability continues for at least nine months, your life insurance (and any dependent coverage) can be continued at no cost to you, subject to certain conditions. Please see the Certificate of Insurance for additional details.
No Exclusions
Benefits are paid for death from any cause, at any time, anywhere in the world (subject to government regulations on restricted countries). The validity of any amount of your life insurance which has been in force for two years during your lifetime will not be contested except for non-payment of premium contributions and plan provisions relating to eligibility.
Your Choice of Beneficiary
You may select any person, persons, trust or other legal entity as your beneficiary. If, at the time of your death, there are no surviving beneficiaries, benefits will be paid to the executor or administrator of your estate, or at the option of New York Life, to the surviving relatives in the following order of survival: spouse; children equally; parents equally; or brothers and sisters equally.
Conversion Privilege
The Plan provides conversion privileges under certain circumstances of involuntary termination as described in the Certificate of Insurance.
ADDITIONAL PLAN PROVISIONS
Effective Date
You and your dependents will become insured on the date specified by New York Life Insurance Company provided the first premium contribution has been paid, satisfactory evidence of insurability has been submitted, and you and your dependents are alive on that date. Coverage for any dependent who is confined at home, in a hospital or other medical institution or incapacitated so as to be unable to perform his or her normal activities on the date coverage would otherwise become effective until the date he or she is no longer so confined or incapacitated provided you are insured on that date and the dependent is still eligible for insurance. (Payment of a premium contribution for insurance does not mean there is any coverage in force before the effective date as specified by New York Life Insurance Company.)
When Coverage Ends
Your insurance can remain in force until you reach age 100, and for your insured dependents as long as they remain eligible, provided you remain a member of ASME, you continue to pay premium contributions when due, and the group policy is not terminated by the Trustee or New York Life Insurance Company. Even if you change jobs, retire, or your health declines, you can continue your ASME life insurance coverage. Upon your death, coverage for your insured dependents may continue as described in the Certificate of Insurance.
Renewal Payments and Claims
Once you are accepted into the Plan, you will have a 31-day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the administrator for claim forms.
Certificate of Insurance
This information is only a brief description of the principal provisions and features of the Plan. The complete terms and conditions are set forth in the group policy issued by New York Life Insurance Company to the Trustee of the Life Insurance Plan for Members of the American Society of Mechanical Engineers.
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the Plan.
Underwritten by New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010 under Group Policy No. G-8700-1 on Policy Form GMR-FACE/G-8700-1.
Want More Information?
Visit the Forms section and download a no–obligation application and brochure containing detailed plan information and plan provisions, including costs, exclusions, limitations, and terms of coverage.
HOW TO APPLY
Consider Your Eligibility
Before you request coverage, you must be a member in good standing of ASME. Please wait until your application for membership is accepted before initiating your insurance requests. If you have any questions regarding membership, see the ASME home page.
Get Quicker, Easier Service When You Apply
The information provided when you fill out your application can make the medical underwriting process quicker and easier. By providing complete and accurate information, you avoid delays that may occur while we wait for missing information to be received and shorten the time needed for underwriting decisions and approvals.
New York Life Insurance Company relies on your answers and statements. Misstatements or failures to report information on your application may be used as the basis for rescinding your insurance.
"30–Day Free Look"
If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will receive a full refund– –no questions asked!
The Group Term Life Insurance Plan is medically underwritten based on the information provided by you on the application. It is important that you complete the form truthfully and completely. Your request is subject to New York Life Insurance Company’s approval and more medical information may be requested. A physical exam, EKG, blood test or other information may be required. If so, we will arrange for a professional paramedic to contact you to perform these simple tests at your convenience, free of charge.
To Apply:
Truthfully complete and sign the application. Be sure to indicate whether you are requesting coverage for your dependents.
Make your check for the total premium contribution payable to: Administrator, ASME Insurance Program.
IMPORTANT TAX INFORMATION FOR RESIDENTS OF ONTARIO, CANADA: Ontario has enacted a law requiring, taxation of all group insurance purchased by individuals. An 8% tax will be added to the amount of any premium contributions due (in U.S. dollars).
Mail both your completed application and your check to:
Administrator,
ASME Insurance Program
12421 Meredith Drive
Urbandale, IA 50398
Residents of Puerto Rico:
Please send your completed application to:
Global Insurance Agency, Inc.
P.O. Box 9023918
San Juan, PR 00902-3918
If you have questions about your eligibility or the features of this Plan, call a Customer Service Representative toll-free at 1-800-289-ASME (2763).
IMPORTANT NOTICE
How New York Life Obtains Information and Underwrites Your Request for Group Term Life Insurance
Information regarding insurability will be treated as confidential. In considering your request for insurance, we will rely on the medical information you provide, and on the information you authorize us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, Inc. (formerly known as Medical Information Bureau).
New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. We may make a brief report to MIB; however, we will not disclose our underwriting decision. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a “need to know” basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. When you apply for insurance or submit a claim for benefits to a MIB member company, medical or non-medical information may be given to the Bureau, which may then be furnished to member companies.
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is: MIB, Inc., 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone (866) 692-6901 (TTY 866-346-3642). For Canadian residents, the address is: MIB Information Office, 330 University Avenue, Suite 501, Toronto, Ontario, Canada M5G 1R7, telephone (416) 597-0590. Information for consumers about MIB may be obtained on its website at www.mib.com.
For NM Residents: PROTECTED PERSONS 1have a right of access to certain CONFIDENTIAL ABUSE
INFORMATION 2we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
1PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured person or prospective insured person.
2CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured as family member, employer or associate or a victim of domestic abuse or a person with whom an applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
New York Life Insurance Company 2.09ed.