2013 Life Insurance Guide

Transcription

2013
Life
Insurance
Guide
WAEPA
Worldwide Assurance for Employees of Public Agencies
www.waepa.org
WAEPA Guide – 2013 Life Insurance Guide
2013 Life Insurance Guide
Published by WAEPA, Worldwide Assurance for Employees of Public Agencies
________________________________________________________________________
Copyright © 2009-2013. Worldwide Assurance for Employees of Public Agencies (WAEPA), 433 Park Avenue, Falls
Church, Virginia 22046. Telephone: 703-790-8010. Website: http://www.waepa.org. All rights reserved. No part of
this book may be reproduced in any form or by any means without prior written permission from the Publisher.
Printed in the U.S.A.
“This publication is designed to provide accurate and authoritative information in regard to the subject matter covered.
It is published with the understanding that the publisher is not engaged in rendering legal, accounting or other
professional service. If legal advice or other expert assistance is required, the services of a competent professional
person should be sought.”– From a Declaration of Principles jointly adopted by a committee of the American Bar
Association and a committee of publishers and associations.
Go to http://www.waepa.org to sign up for addition free WAEPA Guides!
WAEPA – Better Insurance. Better Prices. Better Value.®
2
Contents
Introduction ......................................................................................................................................................... 4
Coverage Options ............................................................................................................................................... 5
Basic Insurance ............................................................................................................................................ 5
Option A ....................................................................................................................................................... 6
Option B ....................................................................................................................................................... 6
Option C ....................................................................................................................................................... 6
Accidental Death and Dismemberment ....................................................................................................... 8
Travel Accident Insurance ........................................................................................................................... 9
Living and Terminal Illness Benefits ........................................................................................................... 9
Coverage in Retirement .............................................................................................................................. 10
Changing Insurance Coverage .......................................................................................................................... 12
Rates ................................................................................................................................................................. 14
Basic Insurance .......................................................................................................................................... 14
Option A ..................................................................................................................................................... 14
Option B ..................................................................................................................................................... 15
Option C ..................................................................................................................................................... 15
Rates in Retirement .................................................................................................................................... 16
More Information About Waepa ...................................................................................................................... 18
A Brief History of WAEPA .............................................................................................................................. 18
Top 10 Reasons to Switch to WAEPA ............................................................................................................. 19
WAEPA Application ........................................................................................................................................ 20
3
Introduction
Life insurance usually brings protection and peace of mind for Federal families. And our primary goal, in bringing you
WAEPA’s 2013 Life Insurance Guide, was to help Federal families understand the basics of coverage within the
Federal Employees’ Group Life Insurance (FEGLI) program.
But we’d also like Federal Employees, like you, to become informed about what we believe is a better way to protect
your family, bring peace of mind, and keep more of your hard-earned dollars at the same time.
Since 1943, over 100,000 Federal Employees and their dependants have been insured by WAEPA (Worldwide
Assurance for Employees of Public Agencies.) WAEPA is a non-profit association (not an insurance company)
governed by a board of directors composed of senior level government officials, who serve without pay and at their
own expense. Today, over 42,000 Federal Employees and their dependants currently belong to WAEPA and life
insurance in force exceeds $10.1 billion.
We urge you to take a look at the differences between FEGLI benefits and costs versus WAEPA benefits and costs.
Just a few of the many reasons over 42,000 current Federal Employees and their dependants now use WAEPA:
•
Lower premiums for you, the civilian federal or U.S. postal service employee. If you are less than 65, you can
save money with WAEPA's life insurance plan compared to your current FEGLI coverage.
•
WAEPA's premiums for your spouse and dependent children are also significantly less than those charged by
FEGLI.
•
More coverage options for you the federal employee. WAEPA offers coverage from $25,000 up to $750,000.
You choose the right amount of coverage to meet your individual needs. Unlike FEGLI, you are not limited by
the amount of your annual salary.
•
More coverage options for your dependent spouse. WAEPA offers coverage from $10,000 up to $250,000 (the
current FEGLI maximum is $25,000).
•
As a non-profit association, WAEPA has instituted a premium refund policy. Since 1996, WAEPA has
declared eleven such annual refunds during which time WAEPA policy holders have received over
$65,000,000 in returned premiums (the Federal Program – FEGLI – has never declared a refund).
•
WAEPA also offers more coverage for your dependent children. WAEPA offers up to $25,000 of coverage
(the current FEGLI maximum is $12,500).
•
Coverage for you non-dependent adult children, a benefit not provided by FEGLI. Your non-dependent adult
children are eligible to apply for their own WAEPA coverage from $25,000 up to $750,000 (even if they are
not federal employees) once you become a member of WAEPA. It is easy for you to join WAEPA, just pay a
one-time $2.00 membership fee, and no insurance purchase is required on your part.
We hope that you find this 2013 Life Insurance Guide helpful. If you have any questions about WAEPA’s Life
Insurance coverage, please feel free to call us at 1-800-368-3484 or visit our website at www.waepa.org.
–
The WAEPA Staff
4
Coverage Options – Basic Insurance
FEGLI
WAEPA
Basic Insurance
Level Term Insurance
Based on Employee's annual basic pay after the
locality adjustment, rounded up to the nearest
$1,000, plus an additional $2,000. Rates are based
on the employee’s age, and they increase every five
years.
Coverage available in $25,000 increments from
$25,000 to $750,000. It is not based on salary or
wage scale. Any eligible employee can apply for
any coverage amount. Rates are based on the
employee’s age, and they increase every five years.
Example: an employee who makes $47,285/yr
would have basic coverage in the amount of
$50,000 ($47,285 rounded up to $48,000, plus an
additional $2,000).
Also, WAEPA’s associate member program offers
coverage from $25,000 up to $750,000 to your
spouse, domestic partner and non-dependent adult
children – even if they are not federal employees.
Your spouse and non-dependent adult children are
eligible to apply for associate member coverage
once you obtain WAEPA insurance, or become a
WAEPA member by paying the one-time $2.00
membership fee.
Extra Benefit
Free additional coverage offered to all employees
under 45 years of age. It is a multiple of the Basic
insurance only.
35 and under
36
37
38
39
40
41
42
43
44
45 and over
Extra Benefit
WAEPA does not offer an Extra Benefit.
2.0x
1.9x
1.8x
1.7x
1.6x
1.5x
1.4x
1.3x
1.2x
1.1x
1.0x
Take the Basic pay and multiply it by the multiplier
to obtain the total basic coverage offered to the
employee.
Example: 40 yr old employee with 50k of Basic
coverage has $50,000 x 1.5 = $75,000. This
employee has $75,000 of Basic coverage, but is
only paying for $50,000 of coverage.
5
Coverage Under Options A, B & C
FEGLI
WAEPA
Option A - Standard
Option A
Option A is an additional $10,000 added to the
Basic coverage. The rates for Option A change
every five years, just like the Basic coverage.
Option B - Additional
Option B is offered in 1, 2, 3, 4, or 5 multiples of
your pay. Round your Basic pay up to the nearest
$1,000 only, then apply the option B multiple. The
rates for Option B change every five years, just like
the Basic coverage.
WAEPA does not specifically offer Optional
coverage. Applicants can apply for as much
coverage as they want under the Level Term plan.
Option B
Option C (Family)
Dependent Coverage
Option C is offered in 1, 2, 3, 4, or 5 multiples of
the base coverage. The base coverage is described
as $5,000 for your spouse and $2,500 for each
child. The rates for Option C change every 5 years,
just like the Basic coverage.
Coverage available from $10,000 - $250,000 in
$10,000 increments for spouses, and $2,500 $25,000 for dependent children. Coverage for the
spouse is limited to no more than half of the
employee’s coverage. Rates increase every 5 years.
Rates for Option C are based on the federal
employee's age.
Rates for Dependent coverage are based on the
employee’s age. Coverage for children is based on
the amount of coverage selected for the
spouse/domestic partner.
Eligibility is defined as a spouse by marriage only,
children, step-children, foster children, or
grandchildren if the member has custody of the
grandchild.
Eligibility is defined as a spouse or Domestic
Partner, children, step-children, foster children, or
grandchildren if the employee has custody of the
grandchild.
Children must be unmarried and under 22 years of
age. Children 22 years or older may be covered if
they are incapable of self support because of a
mental or physical disability which was present
before the child's 22nd birthday.
Coverage for spouses/domestic partners continues
until the spouse/domestic partner reaches age 75.
Children must be unmarried full time students
under the age of 23. If a child is not a student,
coverage terminates at age 19.
A Domestic Partner is defined as an individual who is
at least 18 years of age; shares your permanent
residence, is financially interdependent with you, has
signed a domestic partner declaration with you (if you
reside within a jurisdiction that provides
declarations), and executes a domestic partner
affidavit attesting to the validity of the relationship.
6
FEGLI
WAEPA
Example: 43 year old making $66,479 has
Basic, Option A, Option B (4x), and Option
C (4x). The premium and coverage
amount is calculated as follows:
Example: 43 year old making $66,479 has
Basic, Option A, Option B (4x), and Option
C (4x). The premium and coverage
amount is calculated as follows:
Basic: $66,479 rounded up plus $2,000 equals
$69,000. Then apply the Extra Benefit (x1.2), so
$69,000x1.2=$82,800
Level Term: $375,000 is the closest coverage
amount WAEPA can offer, since coverage is not
based on salary
Option A: $10,000
Option B: $66,479 rounded up to the nearest
$1,000, then times 4, so $67,000x4=$268,000
Option C: $5,000 times 4 for the spouse, and
$2,500 times 4 for the children, so $20,000 for the
spouse and $10,000 on each child
Dependent Coverage: WAEPA can offer $20,000
of spousal coverage and $5,000 of coverage on
children
Basic + Option A + Option B + Option C =
69x3.9 + 10x1.56 + 268x1.30 + 20x2.18 =
Level Term + Dependent Coverage =
375x1.12 + 20x1.6 =
$676.70/yr for: $360,800 employee coverage,
$20,000 spousal coverage, and
$10,000 on each child
$452.00/yr for: $375,000 employee coverage,
$20,000 spousal coverage, and
$5,000 on each child
7
Accidental Death & Dismemberment
FEGLI
WAEPA
Accidental Death and Dismemberment
(AD&D) Coverage
Accidental Death and Dismemberment
(AD&D) Coverage
Member only coverage equal up to the Basic
insurance amount, and Option A only. It does not
include the Extra Benefit or Option B. No charge
for AD&D coverage. AD&D coverage terminates
upon retirement from federal service.
Member only coverage equal up to 20% of the face
value of the policy. No charge for AD&D
coverage. All AD&D coverage terminates at age
65, regardless of employment status.
AD&D Schedule of Losses:
AD&D Schedule of Losses:
Loss of Life
Full Basic Amount
Loss of Life
20% of Face Value
Loss of Two or More Members Full Basic Amount
Loss of Two or More Members 20% of Face Value
Loss of One Member
Loss of One Member
50% of Basic Amount
A member is defined as a hand, foot, or sight in
one eye.
AD&D does not cover:
10% of Face Value
A member is defined as a hand, foot, or sight in
one eye.
AD&D does not cover:
Physical or Mental Illness
Bodily or Mental Infirmity
Diagnosis of or Treatment of Mental Illness
Disease or Illness of any kind
Ptomaine or Bacterial Infection
Intentional Self Inflicted injury
A war (declared or undeclared), any act of war, or
any armed aggression against the United States,
in which nuclear weapons are actually being used
War, if declared or not, and act of war or service in
any military force of any country while such
country in engaged in war
A war (declared or undeclared), any act of war, or
any armed aggression or insurrection in which
you are in actual combat at the time bodily injuries
are sustained
Doing police duty as a member of a military
organization
Suicide or attempted suicide
Taking part in, or as a result of taking part in,
commission of a felony
Injuring ones self on purpose
A drug, unless taken as prescribed by a doctor
Driving a vehicle while you were intoxicated,
based on the law in the jurisdiction where you were
operating the vehicle
Poison, gas or fumes, taken, administered or
inhaled, except for an accident due to employment
with any employer or self employment and caused
by a risk related to that employment
8
Illegal or illegally obtained drugs that you
administer to yourself
Injury sustained in, or on, any vehicle or device for
aerial navigation, except as a passenger in a
previously tested and approved aircraft, other than
experimental or prototype aircraft
Common Carrier Coverage
FEGLI
WAEPA
FEGLI does not offer Common Carrier Coverage.
Employee only coverage equal up to 40% of the
face value of the policy. No charge for Common
Carrier coverage. All Common Carrier coverage
terminates at age 65, regardless of employment
status.
Common Carrier coverage is payable if loss of life
occurs while the employee is a fare paying
passenger on a mode of transportation which has a
fixed route and a regular schedule.
Living & Terminal Illness Benefits
FEGLI
WAEPA
Living Benefits
Terminal Illness Benefit
Living benefits are paid to you while you are still
alive. They can be elected only once, and are
limited to only your Basic insurance.
Terminal Illness benefits are paid while you are
still alive. They can be elected only once, and are
limited to 25% - 50% of the face value of the
policy.
You must have been diagnosed with a life
expectancy of 9 months or less, and you must
submit medical proof of the terminal illness.
You must have been diagnosed with a life
expectancy of 12 months or less, and you must
submit medical proof of the terminal illness.
If your Living benefit is approved, your Basic
coverage will be reduced by the amount of Living
benefit you received.
If your Terminal Illness benefit is approved, the
face value of your policy will be reduced by the
Terminal Illness benefit amount you received.
9
Insurance Coverage in Retirement
FEGLI
WAEPA
Retirement
Retirement
Retirement can drastically change the FEGLI
coverage. You must have FEGLI insurance for at
least 5 years before retirement in order to be
eligible to continue insurance after retirement.
Retirement does not affect the WAEPA policy in
any way. If an employee is paying their premium
via payroll deduction, they will need to change to a
direct bill basis or bank draft to continue their
premium payments.
Basic Insurance
Level Term Insurance
Three choices await at retirement, 75% Reduction,
50% Reduction, and No Reduction.
No change due to retirement, but coverage amounts
are limited beginning at age 60. An employee’s
coverage may or may not decrease depending on
their existing coverage.
75% Reduction: At retirement or age 65, whichever
is later, your basic insurance reduces by 2% each
month until 25% of your basic is left. Once your
basic begins to reduce you no longer have to pay
for any basic coverage for the rest of your life.
Coverage maximums are as follows: Age 60 $250,000, Age 65 - $125,000, Age 70 - $75,000,
Age 75 - $50,000, Age 80 - $25,000, Age 85 - No
Coverage
is later, your basic insurance reduces by 1% each
month until 50% of your basic is left. Once your
basic begins to reduce, you must pay $7.68/yr for
each $1000 of coverage you have remaining.
No Reduction: At retirement or age 65, whichever
is later, there is no reduction in your basic
coverage, and the premium is $23.28/yr for each
$1000 of coverage you have under the basic.
Option A - Standard
Only one option exists at retirement, 75%
reduction.
Option A
is later, your Option A will reduce by 2% each
month until 25% of Option A is left. Once Option
A begins to reduce you no longer have to pay for
any Option A coverage for the rest of your life.
10
Option B - Additional
Two options are available at retirement, Full
Reduction or No Reduction.
Option B
Full Reduction: At retirement or age 65, whichever
is later, your Option B will reduce by 2% each
month until all coverage is gone. Once Option B
begins to reduce, you no longer have to pay for any
Option B coverage.
is later, your Option B will remain the same and the
rates would remain as if you are still actively
employed. At any time you can choose to switch
to Full Reduction.
Option C (Family)
Two options are available at retirement, Full
reduction or No reduction.
Full Reduction: At retirement or age 65, whichever
is later, your Option C will reduce by 2% each
month until all coverage is gone. Once Option C
begins to reduce, you no longer have to pay for any
Option C coverage.
Dependent Coverage
No change due to retirement, but coverage amounts
are limited beginning at age 60. An employee’s
coverage may or may not decrease depending on
their existing coverage.
Coverage maximums are as follows: Age 60 $120,000, Age 65 - $60,000, Age 70 - $30,000,
Age 75 - No Coverage.
is later, your Option C will remain the same and the
rates would remain as if you are still actively
employed. At any time you can choose to switch
to Full Reduction.
11
Changing Insurance Coverage
FEGLI
WAEPA
Changing FEGLI Insurance
Changing WAEPA Insurance
FEGLI Basic can be cancelled at any time for any
reason. Option A, B, and C can be reduced or
cancelled at any time for any reason.
FEGLI coverage is reduced by completing form SF
2817, and returning it to OPM.
FEGLI Basic can be obtained, if you do not have it
already, by a federal Open Season or by waiting a
year and applying for the coverage. If you wait a
year to apply, you must have a physical exam
which the applicant must pay for.
WAEPA coverage can be decreased at any time for
any reason.
A decrease or cancellation of coverage is obtained
by sending WAEPA a written request of the
change.
WAEPA coverage can be increased up to age 65.
An increase in coverage requires completion of an
application and possibly a medical exam and/or
physician's statement. WAEPA will pay for the
medical exam, and pay up to $50 for the
physician's statement.
Option A can be obtained, if you do not have it
already, by a federal Open Season or by waiting a
year and applying for the coverage. If you wait a
year to apply, you must have a physical exam
which the applicant must pay for.
Option B can be obtained or increased by a federal
Open Season, by waiting a year and then applying,
or by experiencing a Qualified Life Event. If you
wait a year to apply, you must have a physical
exam which the applicant must pay for.
A Qualified Life Event is defined as: Marriage,
Divorce, Death of a Spouse, Birth or adoption of a
child. For each person involved in the life event
the multiple of Option B can be increased by that
same number, not to exceed 5x
A foster child does not count as a QLE for Option
B.
Option C can be obtained or increased only by a
federal Open Season or by experiencing a Qualified
Life Event.
For each person involved in the life event, the
multiple of Option C can be increased by that same
number, not to exceed 5x. A foster child does count
as a QLE for Option C purposes.
12
Changing Insurance Coverage (continued)
FEGLI
WAEPA
Conversion of Basic and Optional
Coverage
Conversion of Level Term and
Dependent Coverage
Conversion is offered to all covered individuals as
long as their FEGLI coverage is stopping due to the
policy provisions. Conversion is not allowed if an
employee waived coverage or voluntarily cancelled
their FEGLI coverage.
An individual policy is offered to the employee and
any other eligible family members by one of
FEGLI's underwriting companies.
Conversion is offered to all covered individuals as
long as they are currently covered by WAEPA.
An individual whole life policy is offered to the
employee and any other eligible family members
by CGLIC (Cigna Group Life Insurance
Company).
The policy does not require a medical examination.
The policy does not require a medical examination.
13
Coverage Rates
Actively Employed Rates – Basic
Employee Coverage
(Yearly Rates per $1,000 of Coverage)
Age
WAEPA
FEGLI
Basic
% Savings
Under 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
$0.48
0.60
0.68
0.80
1.12
1.60
2.44
3.72
6.28
15.24
35.40
57.00
99.00
N/A
$3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
3.90
88
85
83
79
71
59
37
5
(38)
(74)
(89)
(93)
(96)
N/A
Actively Employed Rates – Option A – Standard
Employee Coverage
Age
WAEPA
FEGLI
Option A
% Savings
Under 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
$0.48
0.60
0.68
0.80
1.12
1.60
2.44
3.72
6.28
15.24
35.40
57.00
99.00
N/A
$0.78
0.78
0.78
1.04
1.56
2.34
3.64
7.02
15.60
15.60
15.60
15.60
15.60
15.60
38
23
13
23
28
32
33
47
60
2
(56)
(73)
(84)
N/A
14
Actively Employed Rates – Option B – Additional
Employee Coverage
Age
WAEPA
FEGLI
Option B
Under 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
$0.48
0.60
0.68
0.80
1.12
1.60
2.44
3.72
6.28
15.24
35.40
57.00
99.00
N/A
$0.516
0.516
0.516
0.78
1.296
2.076
3.384
5.976
13.524
16.116
29.64
46.80
62.40
62.40
Actively Employed Rates – Option C – Family
Employee Coverage
Age
WAEPA
FEGLI
Option C
Under 25
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70-74
75-79
80-84
85+
$0.60
0.80
0.90
1.20
1.60
2.20
3.20
4.80
7.40
19.00
39.20
N/A
N/A
N/A
$5.76
5.76
5.76
7.56
10.92
16.44
24.48
39.48
70.20
81.60
93.60
124.80
171.6
171.60
15
Rates in Retirement
Basic Insurance - in Retirement
(Yearly Rates per $1000 of Coverage)
Age
WAEPA
FEGLI No
Reduction
FEGLI 50%
Reduction
60-64
65-69
70-74
75-79
80-84
85+
6.28
15.24
35.40
57.00
99.00
N/A
27.18
23.28
23.28
23.28
23.28
23.28
11.58
7.68
7.68
7.68
7.68
7.68
FEGLI
75%
Reduction
3.90
Free
Free
Free
Free
Free
Option A - in Retirement
Age
WAEPA
FEGLI 75%
Reduction
60-64
65-69
70-74
75-79
80-84
85+
6.28
15.24
35.40
57.00
99.00
N/A
156.00
Free
Free
Free
Free
Free
Option B – in Retirement
Age
WAEPA
FEGLI No
Reduction
FEGLI Full
Reduction
60-64
65-69
70-74
75-79
80-84
85+
6.28
15.24
35.40
57.00
99.00
N/A
13.52
16.12
29.64
46.80
62.40
62.40
13.524
Free
N/A
N/A
N/A
N/A
16
Option C – in Retirement
Age
WAEPA
FEGLI No
Reduction
FEGLI Full
Reduction
60-64
65-69
70-74
75-79
80-84
85+
7.40
19.00
39.20
N/A
N/A
N/A
70.20
81.60
93.60
124.80
171.60
171.60
70.20
Free
N/A
N/A
N/A
N/A
17
Better Insurance. Better Prices. Better Value.®
A Brief History of WAEPA
WAEPA was formed in 1943 during World War II to provide life insurance coverage for civilian employees of the
U.S. Government who were serving overseas. The original name, War Agencies Employees Protective Association,
was changed in 1961 to Worldwide Assurance for Employees of Public Agencies.
In May, 1973, membership was opened to all U.S. civilian government employees, regardless of duty assignment. In
January 1999, eligibility was extended to retired civilian federal employees. And in October 2000 non-dependent adult
children, parents, and parents-in-law of WAEPA members became eligible for membership. And in May 2006
Domestic Partners of WAEPA members became eligible for membership.
Over the years, WAEPA has insured over 100,000 federal employees and their dependents. In the past, members were
not able to retain their membership and insurance coverage after they retired or left government service. These
restrictions have now been eliminated.
Over 42,000 members now belong to WAEPA and life insurance in force exceeds $10.1 billion. During the past fiscal
year all members received a 25% return of premium. Plus, since 1996 WAEPA has refunded over 65 million dollars in
life insurance premiums to members.
WAEPA is a non-profit association (and not an insurance company) governed by a board of directors, composed of
senior level government officials, who serve without pay and at their own expense.
WAEPA’s offices are located in Falls Church, Virginia – a suburb of Washington, D.C.
18
Top 10 Reasons to Switch from FEGLI to WAEPA
1. Lower premiums for you, the civilian federal or U.S. postal service employee. If you are less than 65, you
can save money with WAEPA's life insurance plan compared to your current FEGLI coverage.
2. WAEPA's premiums for your spouse and dependent children are also significantly less than those charged
by FEGLI.
3. With WAEPA life insurance coverage you would be eligible to participate in any future premium refunds.
WAEPA has returned over $65,000,000 in insurance premiums to its members since 1996.
4. More coverage options for you the federal employee. WAEPA offers coverage from $25,000 up to
$750,000. You choose the right amount of coverage to meet your individual needs. Unlike FEGLI, you are
not limited by the amount of your annual salary.
5. More coverage options for your dependent spouse. WAEPA offers coverage up to $250,000 (the current
FEGLI maximum is $25,000).
6. Domestic partners of WAEPA members are now eligible for coverage.
7. WAEPA also offers more coverage for your dependent children. WAEPA offers up to $25,000 of
coverage (the current FEGLI maximum is $12,500).
8. Coverage for you non-dependent adult children, a benefit not provided by FEGLI. Your non-dependent
adult children are eligible to apply for their own WAEPA coverage from $25,000 up to $750,000 (even if
they are not federal employees) once you become a member of WAEPA. It is easy for you to join
WAEPA, just pay a one-time $2.00 membership fee, and no insurance purchase is required on your part.
9. You can apply for an increase in your WAEPA coverage at any time. You don't need a special Open
Season to do so.
10. WAEPA insurance coverage continues if you leave federal service. You retain your WAEPA coverage if
you retire or become employed in the private sector.
19
WAEPA Application for Life Insurance
Life Insurance
WAEPA
APPLICANT INFORMATION — PLEASE COMPLETE PAGES 7, 8 & 9 OF THIS APPLICATION AND SIGN.
APPLICANT NAME: (Please Print) ________________________________________________________________________________________
( First )
( M.I. )
( Last )
WAEPA
n I hereby make application for membership in WAEPA. If admitted to membership, I hereby make application for Group Insurance
for which I am eligible, and for the Accidental Death and Dismemberment benefits under the policies issued to WAEPA by The Life
Insurance Company of North America.
1. Amount of insurance coverage selected.
a. Basic Group Life Insurance (Amount of Member Life Insurance) $_________________ Level ___________
b. Dependent Group Life (DGL) Insurance (Amount of Spouse/Domestic Partner*/Children Life Insurance) $___________ Level ________
Note: Your spouse/domestic partner’s coverage may not be greater than one half (50%) of your coverage.
Full-time members of the Armed Forces are not eligible for member, associate member, or dependent coverage.
Note: To verify eligibility for dependent coverage, domestic partners must complete a Domestic Partner Affidavit and return the notarized
affidavit with their application. The affidavit is available at www.waepa.org or by calling 1-800-368-3484.
2. Your sex: n Male n Female
And Here’s How...
w
•WAEPA charges significantly lower premiums for
more life insurance coverage than FEGLI
Your spouse/domestic partner’s date of birth _________/___________/____________ Age ________ Occupation ____________________
(MM/DD/YY - Your spouse/domestic partner must be less than age 65)
4. I hereby certify the following: (complete a or b)
n a. I am a civilian employee of the U.S. Government actively at work. I have been employed
by _______________________________________________________ since ____________________________________________
(Department, Agency, or Bureau)
b. I am a retired civilian federal employee currently receiving a retirement annuity.
(Please attach a copy of your Standard Form 50 –
Notification of Personnel Action.)
5. I am a citizen of the United States of America and my Social Security Number is _______________________________________________
6. Spouse Social Security Number (ONLY if applying for spousal coverage) _____________________________________________________
7. I will pay premiums:
n Annually
n Semi-Annually
n Quarterly
8. Initial Premium Payment – Send No Money!
Once your application has been received and approved, we will advise you of the amount due. Your
coverage will be effective on the date you provide evidence of insurability satisfactory to the insurance
carrier, and you forward the first premium. Your payment must reach us within 30 days of the date of
notification. Your initial premium payment will also include your one-time $2.00 lifetime membership fee.
n Monthly
An authorization
form permitting us
to transfer funds
from your checking
account will be
mailed to you.
Life insurance secures your family against the financial
impact of your passing. It protects them against:
WAEPA enables federal employees (and their families)
to purchase better life insurance at far better prices.
As a superior alternative or supplement to FEGLI,
WAEPA gives its members:
• Funeral costs and other expenses
•WAEPA has returned more than $58 million in
premium refunds to its members since 1996
• Outstanding debts
See inside to learn how little piece of mind for your
loved ones can cost.
•WAEPA continues your coverage even if
you retire or leave government service
• More coverage
• More benefits
Your WAEPA benefit will see your family through
immediate difficulties if you die, and provide a
foundation for their long-term financial security.
•WAEPA provides more coverage for your
spouse and dependents than FEGLI
Information regarding
payroll deduction will be
mailed to you after your
application is approved.
• Greater flexibility
Yet, WAEPA coverage costs up to 89% less than FEGLI –
even though it includes higher coverage limits for you,
more coverage for your family, and benefits for relatives
FEGLI doesn’t even cover!
See page 2 to learn how WAEPA and FEGLI really
compare in cost and coverage.
Apply Now...
WAEPA Members:
• No Open Season required
Primary________________________________________________________________________Relationship ______________________
Contingent______________________________________________________________________Relationship ______________________
If you name a contingent beneficiary, the contingent beneficiary will receive the death benefit if your primary beneficiary is not living when
you die. If you name more than one person as a primary beneficiary or a contingent beneficiary, specify the percentage of benefit payable to
each beneficiary. The applicant/member will be the beneficiary of all dependent coverage.
10. Applicant Contact Information:
Street _________________________________________________________________________________________________________
City___________________________________________________________________________ State ____________ Zip Code________
Office Phone ______________________________ Home Phone ______________________________ E-mail ________________________
Cell Number ______________________________
*Domestic Partner Coverage is not availiable in Virginia.
What Makes
WAEPA Better...
n Payroll Deduction
9. I designate as my beneficiary (please list legal name, e.g., Mary White Jones not Mrs. John Jones).
Why You (Yes, You)
Need Insurance...
• The loss of your income
3. Your date of birth _________/___________/____________ Age _______ Occupation/Grade ______________________________________
(MM/DD/YY - You must be less than age 65)
Life Insurance
Life Insurance for Civilian Employees and their Families
Delivers Better Life
Insurance Value
n I am a member of WAEPA, presently insured under Certificate Number______________________, and wish to change my present
Group Insurance coverage to the Group Insurance coverage selected below:
Serving Federal
employees
Since 1943
Page 9
Worldwide Assurance
for Employees of
Public Agencies, Inc.
433 Park Avenue
Falls Church, VA 22046
Toll Free: 1-800-368-3484
www.waepa.org
Email: [email protected]
Page 10
Get Better Life Insurance.
Spend Far Less.
Scan the code above
with your smartphone
• Enjoy coverage levels of up to $750,000
•More coverage for your spouse and dependent children
The Bottom Line:
If you would like to reduce your insurance
costs, or if you need additional coverage due
to your changing family circumstances, now
is the perfect time to consider life insurance
from WAEPA. You will be glad you did!
WAEPA offers Better Insurance,
Better Prices, and Better Value®
WAEPA
Better Insurance.
Better Prices.
Better Value.®
Life Insurance
Underwritten by the following CIGNA companies: Life Insurance Company of North America (LINA), Connecticut General Life
Insurance Company (CG) and CIGNA Companies (herein called the Insurance Company)
WAEPA vs FEGLI: How They Stack Up...
LIST BELOW ONLY INDIVIDUALS APPLYING FOR COVERAGE
Better Rates
We think you should be able to purchase exactly the
amount of life insurance you need. This chart shows
you how we offer more coverage in simple increments.
There are no complicated options to calculate.
These charts show you the actual difference in premium
costs between WAEPA and FEGLI for every $1,000 of
coverage you purchase. It’s simple: if you’re under 60,
you will save money with WAEPA.
Member Coverage
$25,000 up to $750,000
(in $25,000 increments)
Your Basic coverage is
determined by your annual pay.
Option A is an additional
$10,000 of coverage.
Option B is one to five
times your annual pay.
Dependent Coverage
Spouse / Domestic Partner
$10,000 up to $250,000
Spouse*
Option C is $5,000 up to
$25,000 (in $5,000 increments)
*FEGLI does NOT provide domestic partner coverage.
Children
$1,000 up to $25,000
$2,500 up to $12,500
Associate Member Coverage
(Spouses and domestic partners, non-dependent adult children
and stepchildren, parents of WAEPA members, parents-in-law)
$25,000 up to $750,000
Not Available
Additional Benefits
Your non-dependent adult children are eligible for their own
WAEPA coverage, even if they’re not federal employees.
See WAEPA Associate Membership brochure for details...
www.waepa.org
1-800-368-3484
email: [email protected]
Page 2
ALIAS
RELATIONSHIP
( TO APPLICANT )
BIRTH DATE
( MM/DD/YY )
AGE
HEIGHT
( FT. IN. )
PHYSICIAN SECTION
WEIGHT
Name
( LBS. )
APPLICANT (Full Name)
Contact Information
Applicant Physician
Tel#
Fax#
Spouse/Domestic
Partner Physician
Tel#
Fax#
Child(ren) Physician
Tel#
Fax#
ELIGIBLE DEPENDENTS (Full Names)
Street Address (City, State, & Zip)
HEALTH QUESTIONS SECTION A
Member’s
Age
WAEPA
FEGLI Basic
Bi-weekly premiums
per $1,000 of coverage
Basic
Coverage
Savings
AGREEMENTS AND AUTHORIZATION
By applying for this coverage, do you intend to replace, discontinue, or exchange existing life insurance coverage ............................................................................................................ n Yes or n No
25
1.6¢
15.0¢
89%
•
diagnosed with any of the conditions shown in items A though J below,
To the best of my knowledge and belief, all written, telephonic, and electronic information I gave is true and complete. I also understand that coverage for
each of my dependents will not go into effect if a dependent is confined in a hospital or institution. The conditions for the requested insurance to be effective
are described in the policy and certificate. The approval of this request by the Insurance Company is one of those conditions. I understand and agree that:
30
1.6¢
15.0¢
89%
•
told by a medical professional he/she has, or may have, any of the conditions show in items A though J below,
(1) This request will be a part of the policy that provides the insurance.
85%
•
or been treated by a medical professional for any of the conditions shown in items A through J below?
(2) I may need to provide more medical information.
35
2.3¢
15.0¢
Within the last five years, have you or your eligible dependents been:
40
4.3¢
15.0¢
71%
A. High blood pressure, heart attack, chest pain or Angina, a heart murmur, poor circulation,
or any other condition affecting the heart or circulatory system?..................................................................................................................................................................................................................... n Yes or n No
45
6.2¢
15.0¢
59%
B. Diabetes, glandular condition, Hepatitis, or any condition affecting the esophagus, stomach, intestines, liver, or pancreas?............................................................................ n Yes or n No
50
9.4¢
15.0¢
37%
C. Asthma, Chronic Bronchitis, Emphysema, or any other condition affecting the lungs or respiratory tract?...................................................................................................................... n Yes or n No
55
14.3¢
15.0¢
5%
60
24.2¢
15.0¢
–
Member’s
Age
WAEPA
FEGLI
FEGLI
Option A Option B
Bi-weekly premiums
Optional
Coverage
Savings
25
1.6¢
3.0¢
3.0¢
20%
30
1.6¢
3.0¢
3.0¢
20%
35
2.3¢
4.0¢
4.0¢
23%
40
4.3¢
6.0¢
6.0¢
28%
45
6.2¢
9.0¢
9.0¢
31%
50
9.4¢
14.0¢
14.0¢
33%
55
14.3¢
27.0¢
28.0¢
49%
60
24.2¢
60.0¢
60.0¢
59%
Premium Refunds
Since 1996, WAEPA has returned over $58 million
to its members in premium refunds.
Tear here
FEGLI
Caution: Any person who knowingly and with intent to defraud any insurance company or other person: (1) files an application for
insurance or statement of claim containing any materially false information; or (2) conceals for the purpose of misleading, information
concerning any fact material thereto, commits a fraudulent insurance act.
Better Benefits
WAEPA
D. Any condition affecting the kidneys, urinary tract, prostate gland, or reproductive system?....................................................................................................................................................... n Yes or n No
(4) My dependent(s) may need to take medical tests. The results of those tests must be reported to the Insurance Company.
(5) I must report any change in my health, or of a dependent for whom coverage is requested, that happens before the insurance is effective.
(6) Requested insurance will not be effective for a person if the person does not meet the underwriting requirements on the date insurance is to be effective.
AUTHORIZATION
E. HIV infection, AIDS, or any other condition affecting the immune system or lymph nodes?........................................................................................................................................................ n Yes or n No
F. Stroke, Transient Ischemic Attack (TIA), Alzheimer’s disease, paralysis, epilepsy, fainting, seizures, headaches,
or other condition affecting the nervous system?.......................................................................................................................................................................................................................................................... n Yes or n No
G. Anemia or any other condition affecting the blood, Lupus, Arthritis, deformity, or loss of limb?. ............................................................................................................................................... n Yes or n No
H. Anxiety, Depression, Bipolar Disorder, or any other mental disorder or condition?............................................................................................................................................................................... n Yes or n No
I. Cancer, Tumor, Leukemia, Hodgkin’s Disease, Polyps, or Moles?...................................................................................................................................................................................................................... n Yes or n No
J. Alcohol or drug abuse or dependency?. ................................................................................................................................................................................................................................................................................ n Yes or n No
A. Used any controlled or illegal drug or other substance?........................................................................................................................................................................................................................................... n Yes or n No
B. Been seen for, or been advised to have sought treatment for, observation and/or consultation for surgery, medical
examination, and/or tests, such as blood, urine, X-rays, electrocardiograms, scans, biopsies, or any medical tests/exams not
listed here or above, other than normal routine physical exams?..................................................................................................................................................................................................................... n Yes or n No
C.
Used any medication prescribed by a physician or other medical practitioner, or used any form of alternative and
complementary medical treatment or remedy, including herbs or acupuncture?................................................................................................................................................................................ n Yes or n No
D.
Been seen, sought treatment for, consulted, advised they had and/or received any medical advice from a health care
practitioner for any disease, disorder and/or medical impairment not listed above?......................................................................................................................................................................... n Yes or n No
USE THE SPACE BELOW TO EXPLAIN “YES” ANSWERS. IF MORE SPACE IS NEEDED, USE A NEW PAGE, SIGN AND DATE IT AND ATTACH TO THIS FORM.
Condition
Date Occurred
Duration/Treatment Received
I understand that I and/or my authorized agent have the right to receive a copy of this authorization upon request.
I may revoke this authorization at any time in writing. Any such revocation will not: (1) change any action taken in reliance on the Authorization; and (2)
change the Insurance Company’s right to use the Authorization for contest of a claim or policy in accordance with the applicable law.
Within the last five years, have you or your eligible dependents:
Name of Person
I permit any hospital, clinic, health care practitioner, pharmacy, benefit manager, employer, insurance company, or any other person or organization having
information about the health, medical history, physical or mental condition, diagnosis or treatment, employment or income, or motor vehicle driving record,
of me or my children to disclose to the Insurance Company or its authorized agent, any such information, for the purpose of underwriting this application for
insurance or administering any claim under any insurance which is approved. This authorization is valid for 30 months from the date below. I accept that a
copy of this Authorization is as valid as the original.
I understand that the information will be used to assess my request for insurance.
HEALTH QUESTIONS SECTION B
Current Status
I understand that the information provided pursuant to this authorization may be disclosed by the recipient and is no longer subject to the protections of the
Health Insurance Portability and Accountability Act (HIPAA). (The Insurance Companies are subject to the Gramm-Leach-Bliley act and state privacy laws.
They do not disclose protected information except as permitted by those laws.)
X____________________________________________________
X____________________________________________________
Applicant’s Signature
Signature of Spouse/Domestic Partner (if applying)
Date
Date
Notice: Personal information may be collected from persons other than those proposed for coverage. Information may be disclosed to third parties without
your authorization as permitted by law. You have the right to access and correct all personal information collected. Additional information about the
insurance company’s privacy practices is available upon request.
TL-009320 (4/12)
As a WAEPA member, you’ll be eligible for a premium
refund too!
(3) I may need to take medical tests and report the results to the Insurance Company.
5.5
4/12
433 Park Avenue, Falls Church, VA 22046
Toll Free: 1-800-368-3484 www.waepa.org Email: [email protected]
Page 7
Page 8
Life Insurance
Insure Yourself: Our Most Popular Plans
Member Life Insurance Schedule of Benefits
Levels
Life
Insurance
AD & D
Common
Carrier
1
2
4
8
10
12
20
28
30
$25,000
$50,000
$100,000
$200,000
$250,000
$300,000
$500,000
$700,000
$750,000
$5,000
$10,000
$20,000
$40,000
$50,000
$60,000
$100,000
$140,000
$150,000
$10,000
$20,000
$40,000
$80,000
$100,000
$120,000
$200,000
$280,000
$300,000
Quarterly Premiums Based on Member/Associate Member’s Age
Under 25
$2.63
$5.25
$10.50
$21.00
$26.25
$31.50
$52.50
$73.50
$78.75
25-29
$2.63
$5.25
$10.50
$21.00
$26.25
$31.50
$52.50
$73.50
$78.75
30-34
$2.63
$5.25
$10.50
$21.00
$26.25
$31.50
$52.50
$73.50
$78.75
35-39
$3.75
$7.50
$15.00
$30.00
$37.50
$45.00
$75.00
$105.00
$112.50
40-44
$7.00
$14.00
$28.00
$56.00
$70.00
$84.00
$140.00
$196.00
$210.00
45-49
$10.00
$20.00
$40.00
$80.00
$100.00
$120.00
$200.00
$280.00
$300.00
50-54
$15.25
$30.50
$61.00
$122.00
$152.50
$183.00
$305.00
$427.00
$457.50
55-59
$23.25
$46.50
$93.00
$186.00
$232.50
$279.00
$465.00
$651.00
$697.50
Please visit www.waepa.org for a complete listing of benefits and rates.
Life insurance premiums automatically increase as
members enter new age groups. Coverage levels are
limited above age 60. If a member’s coverage exceeds
the limit as he or she enters a new age group, it will
automatically be reduced to the allowable amount.
Accidental death and dismemberment (AD&D) and
free common carrier coverage terminate at age 65.
All WAEPA coverage terminates at age 85.
Eligibility Requirements
More Flexibility
In addition to life insurance, your WAEPA policy also
includes these benefits:
• Accidental death and dismemberment coverage
• Free common carrier coverage
We also allow you to:
• Pay through convenient payroll deductions
• Change your coverage at any time
• Keep your coverage if you leave government
You’re eligible if you’re currently a non-military
government or Postal Service employee, you are less
than 65 years old, and you are a U.S. citizen.
You’re also eligible if you are a former non-military
federal employee, under age 65, currently receiving a
government retirement annuity.
The Bottom Line:
See www.waepa.org for full details on eligibility.
Better Insurance at a Better Price.
Page 3
Life Insurance
Insure Your Family: Our Most Popular Plans...
Dependent Life Insurance (Spouse Life Insurance)
Levels
1
2
5
10
15
20
25
$10,000
$20,000
$50,000
$100,000
$150,000
$200,000
$250,000
Dependent Life Insurance (Children)
2wks - 2yrs
$1,000
$2,000
$5,000
$10,000
$10,000
$10,000
$10,000
2yrs - 5yrs
$2,000
$4,000
$10,000
$20,000
$20,000
$20,000
$20,000
5yrs - 19yrs
$2,500
$5,000
$12,500
$25,000
$25,000
$25,000
$25,000
Quarterly Premiums Based on Member/Associate Member’s Age
Under 25
$1.50
$3.00
$7.50
$15.00
$22.50
$30.00
$37.50
25-29
$2.00
$4.00
$10.00
$20.00
$30.00
$40.00
$50.00
30-34
$2.25
$4.50
$11.25
$22.50
$33.75
$45.00
$56.25
35-39
$3.00
$6.00
$15.00
$30.00
$45.00
$60.00
$75.00
40-44
$4.00
$8.00
$20.00
$40.00
$60.00
$80.00
$100.00
45-49
$5.50
$11.00
$27.50
$55.00
$82.50
$110.00
$137.50
50-54
$8.00
$16.00
$40.00
$80.00
$120.00
$160.00
$200.00
55-59
$12.00
$24.00
$60.00
$120.00
$180.00
$240.00
$300.00
Please visit www.waepa.org for a complete listing of benefits and rates.
Eligibility Requirements
As a WAEPA member, you can add coverage for
the following to your WAEPA life insurance policy:
• Your spouse or domestic partner
• Your dependent children under the age of 19or up to age 23 if they are full-time students
Children born to you and your spouse/domestic partner will
automatically become insured under your established dependent
coverage when they are two weeks old. If you remarry, you will
have to complete a new application for your spouse and any
adopted children. Benefits for your former spouse terminate when
he or she is no longer married to you. Benefits for your children
terminate when they marry, attain age 19, or cease to be a fulltime student up to age 23. All dependent coverage terminates
when your spouse or domestic partner attains age 75.
Page 4
Purchasing WAEPA
Insurance for Your Family
One low premium covers all of your eligible dependents,
including your spouse or domestic partner. (Domestic
partners must complete the Domestic Partner Affidavit
which can be found at www.waepa.org.) While the chart
above shows only our most popular plans, you can
purchase exactly as much dependent coverage as you
need – in $10,000 increments, up to $250,000.
Dependent coverage may not exceed 50% of your own member
coverage. After you reach the age of 60, the amount of dependent
coverage you can purchase is limited. If your dependent coverage
exceeds this limit when you turn 60, it will automatically be
reduced to the amount permitted. If you and your spouse/domestic
partner are both WAEPA members, you cannot insure each other as
dependents, and only one of you may insure dependent children.
Both you and your spouse/domestic partner must be less than age
65 when you apply for dependent coverage. Spouses, domestic
partners, or children who are full-time members of the Armed
Forces are not eligible for dependent coverage.
Life Insurance
Why
WAEPA?
Better Insurance
Top 10 Reasons to Join WAEPA
Value: WAEPA exists as a non-profit association to help
federal employees get more insurance and pay less.
1. Lower premiums for you.
Save up to 85%.
Quality: Our coverage is underwritten by Life
Insurance Company of North America (LINA), a company
rated “excellent” by A.M. Best and Moody’s.
2. Lower premiums for your family. Cover
your spouse and dependent children for less.
Flexibility: Our insurance program is structured so
you can configure your coverage according to what you
need, not a fixed formula.
According to Our Members…
WAEPA recently engaged an independent research
firm to find out how our members feel about WAEPA
and FEGLI. Only those who had insurance through
WAEPA and FEGLI were included in our survey. Don’t
just take our word for it. Here’s what real government
employees had to say:
3. Eligibility for premium refunds. Since
1996, WAEPA has returned over
$58 million to its members.
4. More coverage options for you. WAEPA offers coverage from $25,000 up to $750,000.
5. More options for your spouse/domestic partner.
Dependent coverage from $10,000 to $250,000.
6. More protection for your dependent
children. WAEPA offers twice as
much coverage as FEGLI.
7. Associate Memberships. Your non-dependent adult children can join WAEPA and save on their own insurance.
WAEPA
FEGLI
Had a very favorable impression
of the organization
87%
31%
Believed the organization met
or exceeded expectations
97%
71%
Likely to recommend the
organization in the future
85%
35%
Likely to consider the organization
for future needs
9. Keep your WAEPA coverage. Even if you
retire or leave government service.
90%
37%
10. It’s more than just life insurance. Your WAEPA
coverage includes death and dismemberment,
additional accident benefits, and free common carrier insurance.
8. Complete flexibility. You can change your
coverage at any time (no need to wait
for an open season).
Over 60 Years of Service
WAEPA is a non-profit association (not an insurance company) formed during World War II by federal employees, for federal employees.
Now, we currently protect over 42,000 federal employees and their families with over $8.8 billion of life insurance coverage.
The critical benefit of all those policies is the ability to safeguard loved ones if the worst should happen. Ensuring that security at the lowest
possible cost has been our mission – and our honored commitment – since 1943.
Page 5
Life Insurance
How to Apply: Application Instructions...
Completing Your Application
Important Questions:
Select the level of coverage that best suits your needs.
You can set your coverage anywhere from $25,000 to
$750,000 – in $25,000 increments.
Q: Who is eligible to apply for WAEPA coverage?
There are two parts to your application. Use the form
on page seven to apply for a WAEPA Life Membership.
This entitles you to all the benefits of joining WAEPA and
makes you eligible for our low-cost coverage.
Use the form on page eight to detail your physical
condition. As part of our underwriting process, we may
request further information about your medical history
or require you to take a medical examination.
That’s it. You’ll be covered on the date our carrier has
certified your insurability and you have paid your first
premium.
Please sign the application on page nine and mail pages
seven, eight and nine of your completed application in
the enclosed envelope to:
WAEPA
433 Park Avenue
A:
Current or retired federal government employees,
and Postal Services employees. Spouses and adult
non-dependent children of WAEPA members may
join WAEPA as Associate Members and purchase
their own policies.
Q: How much insurance may I apply for?
A: Up to $750,000 for yourself, $250,000 for your
spouse or domestic partner, and $25,000 for
eligible dependent children.
Q: How do I apply?
A: Complete the attached application for WAEPA membership and life insurance and mail to WAEPA.
Q: Is a medical examination required?
A:
An exam may be required, dependent upon your age, the amount of coverage you’re applying for, and your health history. If you are requested to take an exam, it will be performed at no charge to you.
Q: How long will it take to get my insurance?
A: It may take as long as 12 weeks to complete the
application process.
Q: How are premiums calculated?
A: Premiums for coverage are based on your age
and will increase every five years as you enter a
new age group.
Q: How do I pay my premiums?
A:
Page 6
Premiums can be paid through payroll deduction or
monthly bank draft. You can also pay via check
or online electronic funds transfer on a quarterly,
semi-annual, or annual basis.
Life Insurance
Better Rates
Member Coverage
$25,000 up to $750,000
Dependent Coverage
$10,000 up to $250,000
Spouse*
Children
$1,000 up to $25,000
$2,500 up to $12,500
$25,000 up to $750,000
Not Available
Additional Benefits
www.waepa.org
1-800-368-3484
Page 2
ALIAS
RELATIONSHIP
( TO APPLICANT )
BIRTH DATE
( MM/DD/YY )
AGE
HEIGHT
( FT. IN. )
PHYSICIAN SECTION
WEIGHT
Name
( LBS. )
Contact Information
Applicant Physician
Tel#
Fax#
Spouse/Domestic
Partner Physician
Tel#
Fax#
Tel#
Fax#
Member’s
Age
WAEPA
FEGLI Basic
Bi-weekly premiums
Basic
Coverage
Savings
25
1.6¢
15.0¢
89%
•
30
1.6¢
15.0¢
89%
•
85%
•
35
2.3¢
15.0¢
40
4.3¢
15.0¢
71%
45
6.2¢
15.0¢
59%
50
9.4¢
15.0¢
37%
55
14.3¢
15.0¢
5%
60
24.2¢
15.0¢
–
Member’s
Age
WAEPA
FEGLI
FEGLI
Option A Option B
Bi-weekly premiums
Optional
Coverage
Savings
25
1.6¢
3.0¢
3.0¢
20%
30
1.6¢
3.0¢
3.0¢
20%
35
2.3¢
4.0¢
4.0¢
23%
40
4.3¢
6.0¢
6.0¢
28%
45
6.2¢
9.0¢
9.0¢
31%
50
9.4¢
14.0¢
14.0¢
33%
55
14.3¢
27.0¢
28.0¢
49%
60
24.2¢
60.0¢
60.0¢
59%
Premium Refunds
Tear here
FEGLI
Better Benefits
WAEPA
AUTHORIZATION
C.
D.
Condition
Date Occurred
Name of Person
Current Status
X____________________________________________________
X____________________________________________________
Date
Date
TL-009320 (4/12)
refund too!
5.5
4/12
Page 7
Page 8
Life Insurance
Better Rates
Member Coverage
$25,000 up to $750,000
Dependent Coverage
$10,000 up to $250,000
Spouse*
Children
$1,000 up to $25,000
$2,500 up to $12,500
$25,000 up to $750,000
Not Available
Additional Benefits
www.waepa.org
1-800-368-3484
Page 2
ALIAS
RELATIONSHIP
( TO APPLICANT )
BIRTH DATE
( MM/DD/YY )
AGE
HEIGHT
( FT. IN. )
PHYSICIAN SECTION
WEIGHT
Name
( LBS. )
Contact Information
Applicant Physician
Tel#
Fax#
Spouse/Domestic
Partner Physician
Tel#
Fax#
Tel#
Fax#
Member’s
Age
WAEPA
FEGLI Basic
Bi-weekly premiums
Basic
Coverage
Savings
25
1.6¢
15.0¢
89%
•
30
1.6¢
15.0¢
89%
•
85%
•
35
2.3¢
15.0¢
40
4.3¢
15.0¢
71%
45
6.2¢
15.0¢
59%
50
9.4¢
15.0¢
37%
55
14.3¢
15.0¢
5%
60
24.2¢
15.0¢
–
Member’s
Age
WAEPA
FEGLI
FEGLI
Option A Option B
Bi-weekly premiums
Optional
Coverage
Savings
25
1.6¢
3.0¢
3.0¢
20%
30
1.6¢
3.0¢
3.0¢
20%
35
2.3¢
4.0¢
4.0¢
23%
40
4.3¢
6.0¢
6.0¢
28%
45
6.2¢
9.0¢
9.0¢
31%
50
9.4¢
14.0¢
14.0¢
33%
55
14.3¢
27.0¢
28.0¢
49%
60
24.2¢
60.0¢
60.0¢
59%
Premium Refunds
Tear here
FEGLI
Better Benefits
WAEPA
AUTHORIZATION
C.
D.
Condition
Date Occurred
Name of Person
Current Status
X____________________________________________________
X____________________________________________________
Date
Date
TL-009320 (4/12)
refund too!
5.5
4/12
Page 7
Page 8
Life Insurance
WAEPA
( First )
( M.I. )
( Last )
WAEPA
And Here’s How...
w
by _______________________________________________________ since ____________________________________________
n Annually
n Semi-Annually
n Quarterly
n Monthly
An authorization
form permitting us
to transfer funds
from your checking
account will be
mailed to you.
• More coverage
• More benefits
Apply Now...
WAEPA Members:
Street _________________________________________________________________________________________________________
Cell Number ______________________________
What Makes
WAEPA Better...
n Payroll Deduction
Why You (Yes, You)
Need Insurance...
Life Insurance
Insurance Value
Serving Federal
employees
Since 1943
Page 9
Worldwide Assurance
for Employees of
433 Park Avenue
Toll Free: 1-800-368-3484
www.waepa.org
Page 10
Spend Far Less.
Scan the code above
The Bottom Line:
WAEPA
Better Insurance.
Better Prices.
Better Value.®
Life Insurance
WAEPA
( First )
( M.I. )
( Last )
WAEPA
And Here’s How...
w
by _______________________________________________________ since ____________________________________________
n Annually
n Semi-Annually
n Quarterly
n Monthly
An authorization
form permitting us
to transfer funds
from your checking
account will be
mailed to you.
• More coverage
• More benefits
Apply Now...
WAEPA Members:
Street _________________________________________________________________________________________________________
Cell Number ______________________________
What Makes
WAEPA Better...
n Payroll Deduction
Why You (Yes, You)
Need Insurance...
Life Insurance
Insurance Value
Serving Federal
employees
Since 1943
Page 9
Worldwide Assurance
for Employees of
433 Park Avenue
Toll Free: 1-800-368-3484
www.waepa.org
Page 10
Spend Far Less.
Scan the code above
The Bottom Line:
WAEPA
Better Insurance.
Better Prices.
Better Value.®

2013 Life Insurance Guide

Transcription

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