Underwritten by New York Life Insurance Company

WHAT IS 20-YEAR LEVEL TERM INSURANCE?

Term coverage is the purest kind of life insurance, with no costly savings features. Here is term life insurance you can depend on for a full twenty years, for premiums that will not go up and benefit options that will not go down. You can renew coverage up to age 75, subject to all termination of coverage provisions.

Available to ASME members and spouses under age 55, the Group 20-Year Level Term Life Insurance Plan helps you protect your family from the financial burdens of your or your spouse’s premature death. Your renewal is guaranteed until age 75, provided you pay premiums when due, remain a member of ASME, and the group policy remains in force.

You can select a coverage amount to help meet your needs, from $100,000 up to $2,000,000 (in $10,000 units). The Plan features “Preferred” and "Select" Nonsmoker Rates and you can benefit from volume discounts when you apply for higher amounts of insurance. Plus, send no money until you are approved.

ELIGIBILITY

ASME members under age 55 may request coverage for themselves, their lawful spouse under age 55 and all unmarried dependent children ages 14 days through 23 years (25 if a full-time student). In order to become insured, individuals must provide satisfactory evidence of insurability and the required premium must be paid.

A dependent who is also a member is eligible for either member or dependent coverage, but not both. If both the member and spouse are covered as members, neither may insure the other as spouse and only one may insure any eligible children.

This coverage is available only for residents of the United States (except WA and territories) Puerto Rico and Canada (except Quebec). Note: This coverage is available to residents of Canada through Marsh Canada Limited. Stephen Fretwell, an employee of Marsh Canada Limited, acts as broker with respect to residents of Canada.

APPLY FOR UP TO $2,000,000 OF COVERAGE

Choose the amount of 20-Year Level Term Life Insurance you need to help protect you and your family for the next twenty years—without the worry of premiums that could go up or benefits that could go down.

Amounts of Insurance:

Members–$100,000 to $2,000,000 in $10,000 multiples.

Spouse–$100,000 to $2,000,000 in $10,000 multiples, not to exceed 100 percent of member’s coverage.

Child(ren)–$10,000

The total amount of coverage an individual may have under all group life insurance plans underwritten by New York Life Insurance Company may not exceed $2,000,000. In addition, the total amount of coverage an individual may have under all group policies issued by New York Life Insurance Company to the Trustee of the ASME Life Insurance Plan may not exceed the maximum benefit option for any insured person.

PLAN FEATURES

Pay Less If You’re a Qualified Nonsmoker Nonsmokers meeting the highest underwriting standards may qualify for “Preferred” (the Plan’s best) rates. Other nonsmokers may qualify for “Select” (higher, but still very competitive) or “Standard” (the Plan’s highest) rates.

Save with Volume Discounts on Higher Amounts of Insurance If you or your spouse becomes insured for coverage amounts of $250,000 through $490,000, you’ll receive a volume discount; and for amounts of $500,000 through $2,000,000 of coverage, you’ll receive an even bigger discount.

Continuing Insurance After the 20-Year Term Ends Premiums are guaranteed to remain level for the first twenty years of coverage. At the end of the 20-year period, you may elect to reapply for 20-year level term rates then in effect for a subsequent 20-year period, provided the insured person is under age 55 and otherwise eligible. If your application for a subsequent 20-year term of guaranteed rates is approved, your premium contribution will be based on your age, health and tobacco/nicotine use at the time coverage becomes effective and will be guaranteed for a new 20-year term.

If you and your spouse are not approved for a subsequent 20-year term of guaranteed rates, or you do not apply for a subsequent 20-year term, coverage will continue in force on non-guaranteed rate basis, under which premium contributions increase as the insured ages.

Help Keep Your Cost Manageable Rates have been provided on an annual basis per $1,000 of coverage to make it easier for you to compare this Plan to other insurance plans on the market today. Two modes of payment are available to suit your budget: semiannual billing and our semiannual or monthly Electronic Funds Transfer (EFT) option (your cost would be approximately one-half or one-twelfth, respectively, the amount you calculate from the rate chart).

OTHER IMPORTANT INFORMATION

Valuable Living Benefit Provision “Accelerated Death Benefit” The “Accelerated Death Benefit” option is available to help terminally ill insureds during a difficult and often financially challenging time. Under this provision you may request one advance payment equal to 50 percent of your (or an insured dependent’s) in force life insurance to be paid while the terminally ill 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.)

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 New York Life 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: The Accelerated Death Benefit is not available to residents of Massachusetts.

No Exclusions

Benefits are paid for death from any cause, at any time, anywhere in the world. The validity of any amount of your life insurance which has been in force for two years during an insured’s lifetime will not be contested except for insurance eligibility provisions and non-payment of premium contributions.

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.

Ownership of Insurance “Owner” means the person or entity with rights of ownership of this insurance as described in the Certificate of Insurance. If a transfer of ownership has been recorded by or on behalf of New York Life Insurance Company, or if initial ownership is by other than the member according to the information provided on the application, references throughout this Plan Information to “you” or “member” will mean “owner,” as applicable.

Effective Date

Insurance will take effect on the date your application is approved by New York Life Insurance Company provided the initial contribution is paid within 31 days after the date you are billed (send no money now) and any person to be insured is actively performing the normal activities of a person in good health of like age [Note:  Residents of MD and NC: Any reference to "performing normal activities of a person in good health of like age" is replaced by the requirement that the health status of any proposed insured person remain the same as stated in your application.] on the date of approval..

Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities, provided such date is within three months of the date insurance would have been effective and the person is still eligible.

When Coverage Ends

Coverage will end when the insured person reaches age 75 (23 for children, or 25 for children who are full-time students) or earlier if: (a) premium contributions are not paid when due, (b) ASME membership ends, (c) the group plan is terminated or modified by the Policyholder to end insurance for the group of insured’s to which the member belongs, and (d) if the insured requests to terminate insurance. In addition, dependent child coverage will terminate when the dependent spouse or child ceases to be an eligible dependent. 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.

YOUR COST

The cost of this life insurance is based upon the member and spouse’s gender, amount of insurance requested, usage of tobacco/nicotine products, health status, and attained age on the date coverage is issued. Premium contributions will vary depending on the option chosen.

Only nonsmokers meeting the highest underwriting standards will qualify for “Preferred” rates. Other nonsmokers may qualify for the higher “Select” or “Standard” rates. (Note: Smokers may only qualify for Standard Rates only.) Upon approval of your application, you will be notified of the rate classification for each approved person.

†Payable semiannually, or via the monthly Electronic Funds Transfer (EFT) option as described previously.

††As previously noted, member and spouse benefits under this Plan are available in $10,000 multiples.

*Male rates apply to all coverage issued to Montana residents, regardless of a person’s sex.

The current annual premium for all eligible children is $6.60 for $10,000 of life insurance.

YOUR COST

The cost of this life insurance is based upon the member and spouse’s gender, amount of insurance requested, usage of tobacco/nicotine products, health status, and attained age on the date coverage is issued. Premium contributions will vary depending upon the options chosen.

Only nonsmokers meeting the highest underwriting standards will qualify for “Preferred” rates.

Other nonsmokers may qualify for the higher “Select” or “Standard” rates. (Note: Smokers may only qualify for Standard Rates.) Upon approval of your application, you will be notified of the rate classification for each approved person.

†Payable semiannually, or via the monthly Electronic Funds Transfer (EFT) option as described previously.

††As previously noted, member and spouse benefits under this Plan are available in $10,000 multiples.

*Male rates apply to all coverage issued to Montana residents, regardless of a person’s sex.

The current annual premium for all eligible children is $6.60 for $10,000 of life insurance.

YOUR COST

The cost of this life insurance is based upon the member and spouse’s gender, amount of insurance requested, usage of tobacco/nicotine products, health status, and attained age on the date coverage is issued. Premium contributions will vary depending upon the options chosen.

Only nonsmokers meeting the highest underwriting standards will qualify for “Preferred” rates.

Other nonsmokers may qualify for the higher “Select” or “Standard” rates. (Note: Smokers may only qualify for Standard Rates.) Upon approval of your application, you will be notified of the rate classification for each approved person.

†Payable semiannually, or via the monthly Electronic Funds Transfer (EFT) option as described previously.

††As previously noted, member and spouse benefits under this Plan are available in $10,000 multiples.

*Male rates apply to all coverage issued to Montana residents, regardless of a person’s sex.

The current annual premium for all eligible children is $6.60 for $10,000 of life insurance.

Note: Premiums are guaranteed to remain level for the first 20 years of coverage. Then, if still eligible, you may reapply for the 20-year level rates then in effect for a subsequent 20-year term; rates for subsequent term would be determined based on your then current age, health and tobacco/nicotine use and would be guaranteed for 20 years. If you or your spouse are not approved for a subsequent 20-year term of guaranteed rates, or do not apply for a subsequent 20-year term, coverage will continue in force on non-guaranteed rate basis with increasing premiums as the insured ages.

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, please call ASME directly at 1–800–289–2763.

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.

The 20-Year Level 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 application 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 an independent professional paramedic to contact you to perform these simple tests at your convenience. The exam and blood test will be paid for by the Plan.

1. Truthfully complete and sign the application. Be sure to indicate whether you are requesting coverage for your dependents.

2. Do not send any money until New York Life Insurance Company has approved your application and notifies you of the premium contribution due, based on the information you have provided.

3. Mail your completed application to
Administrator,
ASME Insurance Program
P.O. BOX 10374
Des Moines, IA 50306

Residents of Puerto Rico:
Please submit your completed application to:
Global Insurance Agency, Inc.
P.O. Box 9023918
San Juan, PR 00902–3918

IMPORTANT NOTICE:

How New York Life Insurance Company Underwrites Your Request For Group 20-Year Level 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). MIB and other insurance companies may also furnish New York Life, its subsidiaries or the plan administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other application for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying the Administrator in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.

New York Life may release this information to the plan administrator, MIB, other insurance companies to whom you may apply for insurance, or to whom a claim for benefits may be submitted and to others whom you authorize in writing. However, this will not be done in connection with information concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV).

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 0218408734, 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 PERSONS¹ have a right of access to certain CONFIDENTIAL ABUSE INFORMATION² we 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.

¹ PROTECTED 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.

² CONFIDENTIAL 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.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life.

New York Life Insurance Company 2/09 ed.

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 policy issued by New York Life Insurance Company to the Trustee of the Life Insurance Plan for Member 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.

30–DAY FREE LOOK

If you’re 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 be sent a full refund, no questions asked!

ASME is compensated in connection with this sponsored group plan to provide and maintain this valuable membership benefit.

New York Life Insurance Company 2/09 ed.