
Group Accidental Death & Dismemberment Insurance


INFO CENTER
CCPOA Retired Chapter dues paying members are eligible to enroll, also
your spouse under age 75, and unmarried dependent children under age
21.
Unmarried children who are full time students and primarily dependent on
you for support are also eligible to age 23.
Forms:
No claim form available.
Contact the Trust for help with a
claim.
Applications:
Documents:
Summary Plan Description - Active
Summary Plan Description - Retired
Brochures:
AD&D BrochureWHAT DOES IT COST?
Active Starting Monthly at $1.25
Retired Starting Monthly at $1.60
ADDITIONAL LINKS & RESOURCES
Complete benefit information can be found in our Catalog of Benefits.
Catalog of BenefitsWhat Is It?
AD&D helps bridge the financial gap that occurs when a breadwinner meets accidental death, or an accident results in loss of sight or loss of limbs. In addition, it provides financial assistance to train or retrain you or a loved one for a new career.
Who Can Apply?
Rank & File; Supervisor; Retired
What Does It Cover?
AD&D pays a dollar amount on accidental death or loss of limbs.
Additional benefits include an education benefit for a surviving spouse, funds to help with day-care for young children and funds for adaptive home and vehicle alterations.
How Does It Work?
You pick an amount of coverage to buy (Principle Sum.) Your monthly payment remains constant, but the amount of coverage does reduce as you age. When a claim is paid-out it is based on a percentage of the Principle Sum, the type of injury, and your age.
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.
Extended Coverage
Includes additional benefits like Day Care, Adaptive Vehicle and Spouse Education.
Rates Current: January 2020
rank & file | supervisor | retired | |||||||
Principle Sum | Member Only | Family Plan | Member Only | Family Plan | |||||
$25,000 | $1.25 | $1.50 | $1.60 | $2.13 | |||||
$50,000 | $2.50 | $3.00 | $3.16 | $4.25 | |||||
$75,000 | $3.75 | $4.50 | $4.79 | $6.38 | |||||
$100,000 | $5.00 | $6.00 | $6.38 | $8.50 | |||||
$125,000 | $6.25 | $7.50 | |||||||
$150,000 | $7.50 | $9.00 | |||||||
$175,000 | $8.75 | $10.50 | |||||||
$200,000 | $10.00 | $12.00 | |||||||
$225,000 | $11.25 | $13.50 | |||||||
$250,000 | $12.50 | $15.00 |
Underwritten by: New York Life Insurance Company
51 Madison Avenue, NY NY
10010
Bates #: 1710192
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