The time to buy life insurance is when you are in good health. Each year many applicants are declined for life insurance because of health or physical impairments. You won’t regret having life insurance—only not having enough of it.
The Group Term Life Insurance Plan is designed to help provide you and your family sound financial protection at reasonable group rates.
Review your cost of living regularly to be sure your life insurance is adequate. With the Group Term Life Insurance Plan it's easy to update your coverage. Application subject to approval by the underwriting company.
Plan Details
LIFE INSURANCE IS IMPORTANT PROTECTION TO HELP MEET YOUR FAMILY'S NEEDS
You certainly understand the importance of having sufficient life insurance.Now, you have the opportunity to help make sure you have that protection. Your loved ones will appreciate the added peace of mind this Plan can provide, with benefits up to $500,000 that will help them go on with less of a financial concern.
ABOUT THIS PLAN
You may select from $25,000 to $500,000 in term life insurance benefits (in $25,000 increments).
TERMINATION
As long as you remain an active member of the Illinois CPA Society, pay your premium when due, and the master policy remains in force, you can keep your coverage until you turn age 70. Your dependent's coverage will remain in effect as long as your coverage is active, premiums are paid, and they meet the eligibility requirements.
WHO MAY APPLY
All Illinois CPA Society members and their spouses under age 60 and are Actively-at-Work at least 30 hours a week are eligible to apply for this Plan. Unmarried, dependent children under age 19 (23 if a full-time student) are also eligible for $5,000 of coverage ($500 if age 15 days to six months). This coverage is available for citizens or legal residents of the United States. This coverage is not available in all states.
IMPORTANT FEATURES
Accidental Death Benefit
If death should occur as the result of a covered accidental Injury and within 90 days from the date of the accident, your beneficiary will receive an additional amount equal to your selected benefit (not to exceed $250,000).
Injury means bodily injury resulting directly from an accident; and independent of disease or bodily infirmity; which occurs while You are covered under The Policy. Loss resulting from sickness or disease; or medical or surgical treatment of a sickness or disease; is not considered as resulting from Injury.
Nonsmoker Rates
You are eligible for a nonsmoker rate, if you have not smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine chewing gum or snuff in the last 12 months.
Waiver of Premium for Disability
If you become Totally Disabled prior to age 60 and the disability continues for six consecutive months, premiums will be waived as long as the disability continues as long as you provide such proof within one year of the date you first became disabled, up to age 70 or provide proof that you have been diagnosed with a life expectancy of 24 months or less. When your disability ends, premium payments resume.
Disabled means You are wholly and continuously prevented from: performing any work or occupation for wage or profit for which You are reasonably qualified or trained; or if not employed, engaging in the normal activities of a person of like age and gender in good health; as a result of injury or sickness.
If You are in an occupation that requires You to maintain a license, Your failure to pass a physical examination required to maintain that license does not alone mean that You are disabled.
Accelerated Death Benefit
In the event of a Terminal Illness, you may receive up to 50% of the life insurance benefit before death to a maximum of $100,000 upon being diagnosed by a physician as having less than 24 months to live. Member must be covered with at least $50,000 life insurance and be under age 70 to be eligible for these benefits. The face amount of your term life coverage is then reduced by the accelerated benefit paid out.
Receipt of accelerated benefits may be taxable. Seek assistance from your personal tax advisor for more information.
Accelerated benefits may be taxable. These materials are not intended to provide tax, accounting or legal advice and cannot be relied upon for any such purpose. You should consult your own tax or legal counsel for advice. We recommend that you consult with a qualified tax advisor. Accelerated benefits may affect your or your family's initial or continued eligibility for public assistance, such as medical assistance (Medicaid), Aid to Families with Dependent Children (AFDC), supplementary social security income (SSI), we recommend that you consult with social service agencies with any questions regarding eligibility for public assistance.
Satisfaction Guaranteed
You may return your Certificate of Insurance within 30 days if you are not completely satisfied with the coverage this Plan provides. Any premiums paid will be fully refunded, minus any claims paid.
Convenient Payment Options
Automatic Monthly Check Withdrawal:
Choose to have your premiums automatically deducted from your checking account on a monthly basis.
Semiannual Direct Bill:
Choose to have your premiums billed to you directly on a semiannual basis.
Beneficiary Selection
You may name anyone you wish as the beneficiary of this Plan, and you may change your beneficiary by contacting the Insurance Administrator in writing and advising them of the change. Your beneficiary may choose to receive benefits in a lump sum, monthly installments or a combination of both. If you do not name a beneficiary the insurance amount will be paid to your survivors, in equal shares, to first your spouse; children; parents; or to your estate.
Conversion Privileges
You and your covered family members may convert your group term life insurance into an individual insurance policy, subject to the policy provisions offered by the insurance company if coverage ends for any reason except nonpayment of premiums. You will not be required to provide any physical proof of insurability for this conversion to an individual life insurance policy. Your Certificate of Insurance contains more details on this conversion privilege.
MONTHLY PREMIUMS
| Non-Smoker Rates | ||||||
| Insured's Age | $25,000 | $50,000 | $75,000 | $100,000 | $125,000 | $150,000 |
| Under 30 | $2.25 | $4.51 | $6.76 | $9.01 | $8.63 | $10.35 |
| 30-34 | 2.30 | 4.60 | 6.90 | 9.20 | 8.63 | 10.35 |
| 35-39 | 3.12 | 6.23 | 9.34 | 12.46 | 12.46 | 14.95 |
| 40-44 | 5.03 | 10.06 | 15.09 | 20.13 | 20.13 | 24.15 |
| 45-49 | 8.05 | 16.10 | 24.15 | 32.20 | 34.74 | 41.69 |
| 50-54 | 12.22 | 24.44 | 36.66 | 48.88 | 56.78 | 68.14 |
| 55-59 | 25.16 | 50.31 | 75.47 | 100.63 | 125.78 | 150.94 |
| 60-64* | 38.91 | 77.82 | 116.73 | 155.63 | 194.54 | 233.45 |
| 65-69* | 63.35 | 126.69 | 190.04 | 253.38 | 316.73 | 380.08 |
| Smoker Rates | ||||||
| Insured's Age | $25,000 | $50,000 | $75,000 | $100,000 | $125,000 | $150,000 |
| Under 30 | $2.78 | $5.56 | $8.34 | $11.12 | $11.26 | $13.51 |
| 30-34 | 2.97 | 5.94 | 8.91 | 11.88 | 11.98 | 14.38 |
| 35-39 | 4.36 | 8.72 | 13.08 | 17.44 | 18.69 | 22.43 |
| 40-44 | 7.00 | 13.99 | 20.99 | 27.98 | 29.95 | 35.94 |
| 45-49 | 11.36 | 22.71 | 34.07 | 45.43 | 51.27 | 61.53 |
| 50-54 | 17.11 | 34.21 | 51.32 | 68.43 | 81.22 | 97.46 |
| 55-59 | 25.92 | 51.85 | 77.77 | 103.69 | 129.62 | 155.54 |
| 60-64* | 38.91 | 77.82 | 116.73 | 155.63 | 194.54 | 233.45 |
| 65-69* | 63.35 | 126.69 | 190.04 | 253.38 | 316.73 | 380.08 |
*For renewal purposes only.
Rates are based on the attained age of the Insured person and increase as you enter each new age category. Rates and/or benefits may be changed on a class basis.
For the other benefit levels not listed, please contact the administrator.
You are considered a non-smoker if you have not smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine chewing gum or snuff in the last 12 months. Premiums are based on applicant's age at the date of issue and on attained age at renewal dates. This rate table should not be used to calculate your premium beyond your attained age when coverage becomes effective. Rates and/or benefits may be changed on a class basis. Coverage is renewable to age 70. For Children's coverage: Add $1.15 to your monthly premium (for semi-annual, add $6.90) for children 6 months to 19 years of age (23 if full time student) for a benefit of $5,000 ($500 for age 15 days to 6 months).
If paying by Semiannual Direct Bill, here is how you would compute your premium: find the appropriate monthly rate above and multiply by 6. Multiply that amount by the number of $25,000 units you are applying for.
If applicable, an additional $2 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.
Acceptance into this Plan is subject to medical evidence of insurability as determined by The Hartford. As a part of the evidence of insurability process, a medical examination medical test(s), or other evidence of good health may be required. Any exams/tests requested by the company will be conducted at your convenience at no expense to you.
Effective Date:
Coverage will become effective upon the first of the month following approval of your application and receipt of your premium check.
Exclusions:
If You or Your Dependent commit suicide, while sane or insane: 1) during the first two years of coverage under The Policy, We will only pay the deceased person's Life Insurance Benefit in an amount equal to the premium paid for coverage to the date of death; or 2) during the two years immediately following an increase in coverage under The Policy, We will only pay the deceased person's Life Insurance Benefit in an amount equal to the amount of Life Insurance in force prior to the increase, plus an amount equal to the premium paid for the increase to the date of death. The full Life Insurance Benefit amount for the deceased person is payable if he or she is covered under The Policy and commits suicide after the two year period.
Download a no-obligation application and brochure containing detailed plan information including costs, exclusions, limitations and terms of coverage.
The Hartford Life and Accident Company respects your right to privacy and values your trust. This Notice explains how we collect, use and protect your personal information and your rights regarding that information.
Information We Collect
While your application for insurance is our primary source of information about you, we may also need to collect or verify information from other sources such as physicians and other medical and health care providers and professionals, health facilities such as hospitals, clinics, pharmacies, employers, consumer reporting agencies, and insurance-support organizations, which may provide us with an investigative consumer report about you. Organizations that provide us with consumer reports about you may disclose the contents of the report to others for which such organization performs such services. We may collect personal information about you that is necessary to determine your eligibility for insurance, to service your insurance policy, and otherwise as permitted by law; the information may include information from which judgments can be made about your age, health and medical history, occupation, avocations, finances, credit, character, habits, general reputation, or any other personal characteristics. We also collect information about your transactions with us, such as the products you buy from us; the amount you paid for those products; your account balances; and your payment and claims history.
Personal History Interview
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.
Medical Information Bureau (MIB) Pre-Notice
Information regarding your insurability will be treated as confidential. Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite Model 400, Braintree, Massachusetts 02184-8734. Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.
Disclosure of Personal Information
We will not disclose your personal information to third parties without your authorization except in connection with our business or as otherwise permitted or required by law. For example, in connection with our general business practices, we may disclose personal information we collect to: companies performing services or functions on our behalf, including other insurers, agents or insurance support organizations, including for the purpose of determining your eligibility for insurance benefits or payments; detect or prevent fraud or criminal activity in connection with insurance transactions; medical care institutions or medical professionals for the purposes of verifying coverage or benefits; insurance regulatory authorities or law enforcement of other governmental authorities to prevent or prosecute the perpetration of fraud; the policyholder of a group insurance policy (for example an employer who provides group insurance) for purposes of reporting claims experience, conducting an audit of our operations or services, risk mitigation or other permissible purposes; third parties who collect data regarding claims for purposes of underwriting and claims handling, or to a third party as otherwise permitted or required by law; or reinsurers.
How We Protect Your Information
We employ administrative, technical and physical safeguards to protect the security, confidentiality and integrity of personal information. We will continue to protect your information even when a business relationship no longer exists between us.
Right to Access and Right to Correct/Amend/Delete
You have the right to learn what personal, including medical, information we have in our files about you, to whom it has been recently disclosed, to have access to the information, to correct the information, and to receive a copy. We are not required to provide you access to information that is collected when we evaluate a claim or when the possibility of a lawsuit exists.
Please contact us if you would like access to your information from your files. There may be a reasonable charge for copies of records. If you think your file contains incorrect information, notify us indicating what you believe is incorrect and your reasons. We will investigate the matter and either correct our records or place a statement from you in our files explaining why you believe the information is incorrect. We will also notify persons or organizations to whom we previously disclosed the information of the change or your statement.
If you request access to medical record information that was supplied to us by a medical care institution or medical professional, we may choose to provide it to a medical professional designated by you.
Rights Relating to Adverse Underwriting Decision
You have the right to certain information relating to adverse underwriting decisions we may make about You, including the reason for such decision. In the event we make an adverse underwriting decision relating to You, we will provide You with information regarding such decision and Your rights.
How to make a request: If you wish to exercise your rights as provided in this notice, please provide us with your full name, complete address, your policy number or other identifying information and a reasonable description of the information you wish to access or correct. Please send your written request to: The Hartford, Attn: Medical Underwriting, PO Box 2999, Hartford, CT 06104-2999
PA-10210 (2018)
NOTICE OF INSURANCE INFORMATION PRACTICES
To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning your insurability. You are our most important source of information, but we may also contact other sources such as medical professionals and institutions, employers and other insurance companies. While all information regarding your insurability will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items of information to third parties without your specific authorization.
INVESTIGATIVE CONSUMER REPORTS – NOT APPLICABLE TO RESIDENTS OF NEW YORK
As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside insurance reporting organization. Personal information may be collected from others regarding your general reputation and lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in connection with the preparation of the investigative consumer report. You have the right to send a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.
PERSONAL HISTORY INTERVIEW
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.
MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite Model 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.
ACCESS, CORRECTION AND DISCLOSURE
You can obtain access to personal information about you contained in our policy files by sending us a written request. You may also request any necessary corrections, amendments or deletion of any information in our files which you believe to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice providing further description of the circumstances under which information about you may be disclosed and the types of persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further information or access to your personal information, please send your written request to: Hartford Life Insurance Company or Hartford Life and Accident Insurance Company, 200 Hopmeadow St., Simsbury, CT 06089.
PA-9369
The Hartford Financial Services Group, Inc. (NYSE: HIG) operates through its subsidiaries under the brand name, The Hartford, and is headquartered in Hartford, Connecticut. For additional details, please read The Hartford’s legal notice at www.thehartford.com.
These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.
Important: The Hartford does not offer Replacement policies.
Simplified Issue Applications & Brochures - apply for $25,000 minimum up to $150,000 maximum in $25,000 increments
Where available |
This program may vary and is not available in all states. |
Notes |
All Illinois CPA Society members and their spouses under age 60 and Actively-at-Work at least 30 hours a week are eligible to apply for this Plan. Unmarried, dependent children at least 15 days old and under age 19 (23 if full-time student) are also eligible for $5,000 of coverage ($500 if age 15 days to six months). This coverage is available for citizens or legal residents of the United States. |
|
Summary* |
Type of Insurance |
Group Term Life Insurance |
Designed for |
Illinois CPA Society members and dependents |
Underwritten by |
Hartford Life & Accident Insurance Company |
Issue Ages |
Through age 59 |
Coverage Amounts |
$25,000 to $500,000 (in $25,000 increments) |
Rate Schedule |
Premiums are based on applicant’s age at date of issue and on attained age at renewal dates. Rates are not guaranteed and may be subject to change. |
Nonsmoker Rates |
If you have not smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine chewing gum or snuff in the last 12 months. |
Policy form number |
Life Form Series includes GBD-1000, GBD-1100 or state equivalent |
Group Policy Number |
AGL-1934 |
Spouse coverage amounts |
$25,000 to $500,000 (in 25,000 increments) |
Children's Insurance |
$5,000 ($500 if age 15 days to six months) |
*This is a listing of highlights for the above insurance plan. Be sure to refer to the brochure for details about exclusions, limitations, reduction of benefits and policy terms.
Important Notes:
This website explains the general purpose of the insurance described, but in no way changes or affects the policy as actually issued. In the event of a discrepancy between this brochure and the policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the policyholder. This program may vary and may not be available to residents of all states.
We're here to help! Please contact us in whatever manner is most convenient for you.
| Address AMBA 4050 114th Street Urbandale, Iowa 50322 |
|---|
| Phone 1-800-842-ICPA (4272) |
| Hours M-F 7a-5p CT |
| Email [email protected] |
Underwritten by:
| Hartford Life and Accident Insurance Company One Hartford Plaza Hartford, CT 06155 |
|---|
Who is eligible for this insurance?
How much insurance can I request through this program?
Are non-tobacco rates available?
Do I have to meet with an insurance agent?
What if I have second thoughts after I apply?
How do I apply?