LIFE INSURANCE

Voluntary Term Life Insurance

You may purchase coverage in addition to the basic life insurance through the Valassis Voluntary Term Life Insurance program. You pay for this coverage through payroll deductions.

Coverage is available in increments of 1-5 times your salary and may not exceed $1,000,000. Coverage over $400,000, 3-times your salary or whichever is less is subject to evidence of insurability.

Cost

The following table reflects the cost of voluntary life insurance, which is based on your age and salary.

Example:

If you are age 32 and your salary is $29,300 and electing 1 times your salary for voluntary life insurance.
Amount of additional insurance desired (1-5 times salary, rounded up to nearest thousand)	A	$30,000
Divide "A" by 1000	B	$30.00
Determine rate/cost per thousand by age band and multiply it by "B"	C	Represents monthly cost: $2.40
To determine the weekly or bi-weekly cost:
Multiply "C" by 12 and divide by 52 (weekly)		Represents weekly cost: $0.55
Multiply "C" by 12 and divide by 26 (bi-weekly)		Represents bi-weekly cost: $1.11

Evidence of Insurability
If you do not elect voluntary life insurance within 31 days of your date of hire or eligibility, you must provide evidence of insurability to enroll for this coverage. Evidence of insurability is required for benefit increases of more than one level. Evidence of insurability is required for benefit amounts that exceed $400,000 – for any coverage level.

Changes (other than for a family status change) may only be made during open enrollment. During the enrollment period, associates will be sent a letter with instructions on how to apply for Evidence of Insurabilty (EOI). An EOI is required for Voluntary and Dependent Life..

Qualified Change in Status
If you have a qualified change in status, you may be able to enroll for Voluntary Life Insurance within 31 days of the event, but evidence of insurability will be required if you are not newly eligible or you increase your coverage more than one level. You may be able to decrease coverage depending on the life status event. Qualified changes in status generally include changes in:

• Your marital status, including marriage, civil union, divorce, legal separation, annulment or death of a spouse;
• The number of your dependents, including birth, adoption, placement for adoption or death or a dependent;
• Employment status for you, your spouse or dependent, such as starting a new job or stopping employment;
• Work schedule, such as a reduction or increase in hours, a switch between part-time and full-time employment or the start of, or return from, unpaid leave; or
• Dependent status (for example, your dependent child over age 19 is no longer a full-time student)
• You get married;
• You and your spouse divorce;
• Your child is born or you adopt or become the legal guardian of a child;
• Your spouse dies;
• Your child is no longer financially dependent on you or dies;
• Your spouse is no longer employed, which results in a loss of group insurance; or
• You have a change in classification from part-time to full-time or from full-time to part-time.

Any forms must be completed and received by the Human Resources Representative