RETIREE AD&D

Accidental Death & Dismemberment

• The plan is open for enrollment year round
• Call Chartis (1-800-772-7863) to enroll
• Rates are increasing, see below for new plan costs.

2012 Plan Rates

Coverage Amount	Individual Plan Annual Cost	Individual and Spouse/Same-Sex Domestic Partner Annual Cost
$10,000	$15.00	$20.00
$25,000	$37.50	$50.00
$50,000	$75.00	$100.00
$100,000	$150.00	$200.00

Retirees who continued their employee coverage for a different amount will pay an annual cost of $1.50 per $1,000 of coverage for individuals and $2.00 per $1,000 of coverage for individual and spouse/same-sex domestic partner.