LIFE INSURANCE and ACCIDENTAL DEATH & DISMEMBERMENT BENEFITS
The Wappingers Congress of Teachers Welfare Trust Fund provides you with life insurance and accidental death and dismemberment ("AD&D") benefits at no cost to you. These benefits are provided through the insurance carrier. These benefits are for you, the active member, your spouse and for your eligible dependent children (the "insureds"). Your eligibility for these benefits is described on page 4.

What Is Your Life Insurance Benefit?
If an insured dies for any reason while covered under this Plan, the life insurance benefit will be paid to the designated beneficiary, as follows:
-death of the member, in the amount of $30,000.00
-death of the member's spouse, in the amount of $5,000.00
-death of the member's eligible dependent child, in the amount of $1,000.00.

Retirement (With respect to Life Insurance only)
The life insurance benefit is also extended to eligible retirees.

When you retire, you will have the option to continue the life insurance coverage by paying an annual premium directly to the Fund.

With respect to Retired Members over 70:

When you turn 70, the coverage will be reduced to $5,000 and the premium will be adjusted accordingly.

How Benefits Are Obtained?
1. A member of the family of the deceased or the beneficiary of the life insurance benefit notifies the Fund Office of the death of the member.
2. The beneficiary sends a certified copy of the death certificate to the Fund Office.
3. The beneficiary, or his/her authorized representative, completes the forms required by the life insurance company and sends them to the Fund Office.
4. A check in the appropriate amount will then be sent to the beneficiary.

Designation of the Beneficiary
The beneficiary is designated on the appropriate form provided by the life insurance company, available at the Fund Office.

It is important that the designation of beneficiary be kept up to date. If there is a change in your marital status or if your designated beneficiary should die, designate a new beneficiary promptly by completing a new card. These forms may be obtained upon request from the Fund' Office.

Should the last named beneficiary predecease the member, or should no beneficiary be named, instead of making payment to the appropriate estate, the insurance company has the right to make payment to the first surviving family members in the order listed below:
- spouse;
- child or children
- mother or father or
- sisters or brothers.


What Happens To Your Life Insurance If You Become Disabled?
Your life insurance benefit will continue after the date your insurance would otherwise have ended if you become disabled before you reach age 60. Coverage will continue with no premium requirement as long as you remain disabled and provide the required proof of disability to the insurance carrier within three months after your life insurance would otherwise end and as frequently as may be reasonably requested by the insurance company thereafter. You must also notify the Fund Office of your disability. Failure to do so may jeopardize your future benefits.

You are considered disabled if during the elimination period (9 months) you are not working in any occupation due to your injury or sickness and after the elimination period, due to the same injury or sickness, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by training, education or experience.

You will be eligible for continuing coverage with no premium requirement during your total and permanent disability if
- You are less than 60 and insured under
the plan. - You become disabled and remain disabled
during the elimination period.
- You meet the notice and proof of claim requirements for disability while your life insurance is in effect or within three months after it ends. The claim form is available from the Fund Office or you can request a claim form from the life insurance company. If you do not receive the form from the insurance company within 15 days of the request, send the insurance company written proof of claim without waiting for the form.
- A proof of claim based on your disability must include:
- That you are under the regular care of a physician;
- The date your disability began;
- The cause of your disability;
- The extent of your disability, including restrictions and limitations preventing you from performing your regular occupation or any gainfia occupation; and
- The name and address of any hospital or institution where you received treatment, including all attending physicians.
- the proof shows that you were disabled for at least nine months and that it is presumed the disability will continue, and
- you submit proof of your continuing disability within 45 days of request by the insurance company, which may be as frequently as is reasonable, in the opinion of the insurance company.

The insurance carrier may require that you be examined by a physician of their choice, or be interviewed by an insurance company representative, periodically throughout your disability, at the insurance company's expense.

The Amount of Your Benefit During Disability
The amount of life insurance continued during your disability is the amount for which you were eligible when active, prior to your disability. If you are not in active employment due to injury or sickness, any increased or additional coverage will begin on the date you return to active employment. Any decrease in coverage will take effect immediately but will not affect a payable claim that occurs prior to the decrease.

How Long Will Your Disability Life Insurance Benefit Continue?
Benefits will continue throughout your disability until the earliest of:
- you recover and are no longer disabled but do not return to active employment,
- the date you fail to furnish proper proof of your continued disability, or
- the date you fail to comply with the insurer's request that you be examined by its designated physician, or
- you reach age 65.

In any of these cases, you are eligible to convert to an individual policy at your own expense directly with the insurer as described in the following section.

Conversion Privilege Feature
If your life insurance benefits under the Plan end because you are no longer a covered member, you terminate your employment, a disability ends or you do not provide the required proof of disability, you may convert to an individual life insurance policy at your own expense directly with the insurer. To do so, you must submit a completed application and your first premium payment to the insurer within 31 days after the date your employment terminates or you or your dependents are no longer eligible to participate in the coverage of the plan.

You will not need a medical examination to be eligible to convert to an individual policy.

Converted insurance may be of any type of the level premium whole life plans then in use by the insurance company. The person may elect one year of Preliminary Term Insurance under the level premium whole life policy. However, the individual policy will not contain disability or other extra benefits.

If you die within the 31-day period between the date your group insurance ends and the converted individual policy begins, the benefits that would be available under your converted individual policy will be paid to your last named beneficiary.

The benefits paid under the Accelerated Benefit option may be taxable, and may affect eligibility for government benefits. You should consult your personal tax advisor regarding possible tax consequences.

Accidental Death and Dismemberment Benefit
The life insurance company will pay a benefit based on the life insurance benefit if, while you are insured under the policy, you sustain bodily injuries:
1. That result directly from an accident and independently of all other causes;
2. That, within 90 days of the date of the accident, result in one of the losses listed below; and
3. That are not excluded in the "Restrictions" section below.

Loss and Benefit Schedule
For loss of life: The Principal Sum
For permanent loss of one hand by severance at or above the wrist: 1/2 the Principal Sum
For permanent loss of one foot by severance at or above the ankle joint: 1/2 the Principal Sum
For the loss of the sight of one eye entirely, irrecoverably, and uncorrectable: 1/2 the Principal Sum
For two or more of the above losses in any one accident: The Principal Sum

The insurance company will not pay more than the Principal Sum, regardless of the number of losses in any one accident.

Restrictions
A benefit will not be paid for any loss that is caused, either directly or indirectly, or contributed to, by:
1. Physical or mental infirmity or disease.
2. Bacterial infection, unless the infection occurs simultaneously with and through an accidental cut or wound.
3. Suicide or an intentionally self-inflicted injury.
4. Participation in the commission of a felony.
5. War, declared or undeclared, or any act of war, or any resistance to armed invasion or aggression, or international police action with force of arms by any country or by the United Nations or any other assembly of nations.
6. Active participation in a riot.

The words "participation" and "riot" in the phrase "participation in a riot" will be defined as follows:

Participation - includes promoting, inciting, conspiring to promote or incite, aiding, abetting, and all forms of taking part in, but will not include actions taken in defense of public or private property, or actions taken in defense of the person of the insured, if such actions of defense are not taken against persons seeking to maintain or restore law and order including but not limited to police officers and firemen.

Riot - includes all forms of public violence, disorder, or disturbance of the public peace, by three or more persons assembled together, whether or not acting with a common intent, and whether or not damage to person or property or unlawful act or acts is the intent or the consequence of such disorder.

7. Medical or surgical treatment.
8. The voluntary ingestion, injection, inhalation, or absorption of any drug, poison, gas or fumes, unless administered on and in accordance with the advice of a physician.

Claim Payments
Upon receipt of due written Proof of Loss, for loss of life, benefits will be paid to your beneficiary. For any other loss, benefits will be paid to you.