Premiums are Expected to Remain Level for 10 or 20 Years
Term coverage is the purest kind of life insurance, with no costly savings features. Here is term life insurance you can depend on for premiums that are not expected to go up for the length of your term and coverage amounts that will never go down. You can renew coverage up to age 75, subject to all termination of coverage provisions.
The Group 10-Year Level Term Life Insurance is available to NSBA members and spouses under age 65 and the 20-Year Policy is available to members/spouses under age 55. This Group Level Term Life Insurance helps you protect your family from the financial burdens of you or your spouse’s premature death.
You can select a coverage amount to help meet your needs, from $100,000 up to $1,000,000, in $1,000 units (up to $500,000 for spouse, not to exceed member's coverage). The Coverage features "Preferred" and "Standard" non-smoker rates and you can benefit from volume discounts when you apply for higher amounts of insurance. Plus, send no money until you are approved.
Consider Your Eligibility
Before you request coverage, you must be a member in good standing of the Nebraska State Bar Association (NSBA) and residing in the U.S. (Certain states are excluded, as noted in "Tell Me More"). Please wait until your application for membership is accepted before initiating your insurance requests. If you have any questions regarding membership, please call NSBA directly.
Get Quicker, Easier Service When You Apply
The information provided can make the medical underwriting process quicker and easier. By providing complete and accurate information, you avoid delays that may occur while we wait for missing information to be received and shorten the time needed for underwriting decisions and approvals.
New York Life Insurance Company relies on your answers and statements. Misstatements or failures to report information on your Application may be used as the basis for rescinding your insurance.
Your Application is subject to New York Life Insurance Company’s approval and more medical information may be requested. A physical exam, EKG, blood test or other information may be required. If so, we will arrange for an independent professional paramedic to contact you to perform these simple tests at your convenience. The exam and blood test will be paid for by the Plan.
Residents of Puerto Rico:
Please send your completed application to:
Global Insurance Agency, Inc.
P.O. Box 9023918
San Juan, PR 00902-3918
Certificate Of Insurance
This information is only a brief description of the principal provisions and features of the coverage. The complete terms and conditions are set forth in the group policy issued by New York Life Insurance Company to the Trustee of the Qualified Associations and Organizations Trust.
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the coverage.
30-Day FREE Look
If you’re not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated, and you will be sent a full refund, no questions asked!
We're here to help! Please contact us in whatever manner is most convenient for you.
Administered by:
| Address AMBA Administrators, Inc. 4050 114th Street Urbandale, Iowa 50322 |
|---|
| Phone 1-866-236-6582 |
| Hours M-F 7a-5p, Sat 8a-1p CT |
| Email [email protected] |
Underwritten by:
| Address New York Life Insurance Company 51 Madison Avenue New York, NY 10010 Under Group Policy Nos. G-30851-0 for the 10-year plan and G-30852-0 for the 20-year plan on Policy Forms GMR-FACE/G-30851-0 and GMR- FACE/G-30852-0. |
|---|
Eligibility
All NSBA members and their spouses under age 65 may apply for the 10-year policy; members and spouses under age 55 may apply for either the 10- or 20-year policy. In order to become insured, individuals must provide satisfactory evidence of insurability and pay the required premium.
This coverage is available only for residents of AL, AZ, CA, GA, HI, IN, IA, KS, MA, MI, NE, NV, NJ, OK, PA, RI, TN and Puerto Rico.
Apply for Up to $1,000,000 of Coverage
Choose the amount of Group 10 or 20-Year Level Term Life Insurance you need to help protect you and your family for the length of your term without the worry of benefits that could go down.
Amounts of Insurance:
The total amount of coverage an individual may have under all group life insurance policies underwritten by New York Life Insurance Company may not exceed $2,000,000. In addition, the total amount of coverage an individual may have under all policies issued by New York Life Insurance Company to the Trustees of the Qualified Associations and Organizations Trust may not exceed the maximum benefit option for any insured person.
Pay Less If You’re a Qualified Non–Smoker
Non–smokers meeting the highest underwriting standards may qualify for "Preferred" (the policy’s best) rates. Other nonsmokers may qualify for "Standard" Non Smoker (higher, but still specially-negotiated). Smokers may only qualify for "Smoker" rates.
Continuing Insurance After the Level Term Ends
Premiums are expected but not guaranteed to remain level for the length of your term–either 10 or 20 years, depending on which coverage you select. At the end of the term, you may reapply for level term rates then in effect for a subsequent period, provided the insured person is under age 65 for the 10-year policy or under age 55 for the 20-year policy, and otherwise eligible. If your application for a subsequent term is approved, your premium contribution will be based on the insured person’s age, health and tobacco/nicotine use at the time the subsequent term becomes effective for a new 10- or 20-year term.
If you and your spouse are not approved for a subsequent term, or you do not apply for a subsequent term, coverage will continue in force on a non–guaranteed rate basis, under which premium contributions increase as the insured ages.
Help Keep Your Cost Manageable
Two modes of payment are available to suit your budget: semiannual billing; and our semiannual or monthly Electronic Funds Transfer (EFT) option.
Valuable Living Benefit Provision "Accelerated Death Benefit"
The "Accelerated Death Benefit" option is available to help terminally ill insureds during a difficult and often financially challenging time. Under this provision, you may request one advance payment equal to 60% (maximum of $250,000) of your (or an insured dependent’s) in force life insurance to be paid while the terminally ill person is still alive. The request must be made at least 24 months prior to the insured person’s scheduled coverage termination age and the amount of insurance payable after the insured’s death will be reduced by this payment. (Premium contributions will not be reduced.)
This money can be used to help cover high prescription drug costs, medical bills, outstanding debts, to help pay for experimental treatments, the cost of modifications to your home, or for a family vacation – the choice is yours.
To qualify, a terminally ill insured must provide New York Life Insurance Company with proof of terminal illness and anticipated life expectancy (12 months or less), as well as any other necessary medical information requested. For additional details and limitations, please see the Certificate of Insurance.
Please note that receipt of Accelerated Death Benefits may affect your eligibility for public assistance programs and may be taxable. Prior to applying to receive such benefits, you should consult with the appropriate social services agency and seek the advice of a qualified tax advisor.
Exclusions
Coverage is payable for death by any cause except death from suicide during the first two years of coverage, whether sane or insane, for which the only benefit payable is the return of application premium contributions.
The validity of any amount of your life insurance which has been in force for two years during an insured’s lifetime will not be contested except for insurance eligibility provisions and nonpayment of premium contributions.
You Name Your Beneficiary
Your beneficiary is the person(s) last designated by you in writing and recorded by or on behalf of New York Life Insurance Company. You may change this beneficiary designation at any time by written request. You are the automatic beneficiary for dependent insurance as described in the Certificate of Insurance. If you wish to name another beneficiary for spouse insurance, contact the Administrator for the applicable forms. You may select any person, persons, trust or other legal entity as your beneficiary. If, at the time of your death, there are no surviving beneficiaries, benefits will be paid to the executor or administrator of your estate, or at the option of New York Life Insurance Company, to the surviving relatives in the following order of survival: spouse; children equally; parents equally; or brothers and sisters equally.
Ownership of Insurance
"Owner" means the person or entity with rights of ownership of this insurance as described in the Certificate of Insurance. If a transfer of ownership has been recorded by or on behalf of New York Life, or if initial ownership is by other than the member according to the information provided on the application, references throughout this coverage Information to "you" or "member" will mean "owner" as applicable.
Effective Date
Insurance will take effect on the date your application is approved by New York Life Insurance Company provided the initial contribution is paid within 31 days after the date you are billed (send no money now) and any person to be insured is actively performing the normal activities of a person in good health of like age [NC residents: a person of like age] on the date of approval.
Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities provided such date is within three months of the date insurance would have been effective, and the person is still eligible.
When Coverage Ends
Coverage will end when the insured person reaches age 75. Coverage will end earlier if: (a) premium contributions are not paid when due; (b) membership in the NSBA ceases; (c) the group coverage is terminated or modified by the Policyholder to end insurance for the group of insureds to which the member belongs; (d) if the insured requests to terminate insurance; (e) for the insured spouse the last day of the insurance period during which the insured spouse ceases to be the lawful, married spouse of the insured member.
Renewal Payments And Claims
Once you are accepted into the Program, you will have a 31–day grace period for your payment of renewal premium contributions. When you want to submit a claim, call or write the Administrator for claim forms.
Your Cost
To see the rate charts for this product, select the Insurance Application and Brochure PDF at the right.
The Program features "Preferred" and "Standard" Non-Smoker Rates. Plus, send no money until you are approved.
Important Notice
How New York Life Insurance Company Obtains Information and Underwrites Your Request for Group Level Term Life Insurance.
In this notice, references to "you" and "your" include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualifies for insurance, we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, LLC ("MIB"). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage or a claim for benefits is submitted to an MIB member company, medical or non medical information may be given to MIB and such information may then be furnished by MIB, upon request, to a member company.
Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.
MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other application for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.
New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing. However, this will not be done in connection with test results containing Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but will not disclose our underwriting decision.
New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a "need to know" basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.
If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life Insurance or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is MIB, LLC, 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 1-866-692-6901 (TTY 1-866-346-3642).
For NM residents: PROTECTED PERSONS1 have a right of access to certain CONFIDENTIAL ABUSE INFORMATION2 we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.
1PROTECTED PERSON means a victim of domestic abuse: who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured person.
2CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured family member, employer or associate of a victim of domestic abuse or a person with whom the applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.
| New York Life Insurance Company | 8/12ed. |
Answers about the program, including eligibility, options, customer service and more.
How do I apply?
Do I have to meet with an insurance agent?
What if I have second thoughts after I apply?
How much insurance should I consider?
Are there any exclusions?
When is the coverage effective?
Insurance will take effect on the date your application is approved by New York Life Insurance Company provided the initial contribution has been paid within 31 days after the date you are billed and any person to be insured is actively performing the normal activities of a person in good health of like age on the date of approval.
Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities, provided such date is within three months of the date insurance would have been effective and the person is still eligible
When does coverage end?
Insurance for you can remain in force until: (a) premium contributions are not paid when due, (b) CSEA membership ends, (c) the group plan is terminated or modified by the Policyholder or New York Life Insurance Company to end insurance for the group of insureds to which you belong, and (d) you request to terminate insurance. In addition, dependent coverage will terminate when your coverage terminates, or when the eligibility requirements are no longer being met. Upon your death, coverage for your insured dependents may continue as described in the Certificate of Insurance. Please note your AD&D coverage will end if you begin full-time active duty in the armed forces.
If you’re an Active Member, your coverage will end when you are no longer ACTIVELY-AT-WORK, as defined. However, if your insurance ends due to your retirement, you may elect to continue your life insurance under one of the available options. (AD&D insurance may not be continued after you retire.)
By whom is this coverage underwritten?
Underwritten by New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010 under Group Policy Nos. G-30851-0 for the 10-year policy and G-30852-0 for the 20 year policy on Policy Forms GMR-FACE/G-30851-0 and GMR-FACE/G-30852-0.
New York Life is licensed/authorized to transact business in all of the 50 United States, the District of Columbia and Puerto Rico. However, not all group coverage it underwrites are available in all jurisdictions. Please check the applicable insurance brochures for current availability.
New York Life’s state of domicile is New York, and NAIC ID # is 66915.
How much insurance should I consider?
Some insurance experts suggest that you purchase life insurance equal to five to nine times your current income. In addition, you should consider how much your dependents will need to maintain their lifestyle.
Who is eligible for this insurance?
This coverage is available exclusively to NSBA members and their spouses under age 65 for the 10-year policy and under age 55 for either the 10- or 20-year policy. In order to become insured, satisfactory evidence of insurability must be provided and the required premium must be paid.
A dependent who is also a member is eligible for either member or dependent coverage, but not both. If both the member and spouse are covered as members, neither may insure the other as spouse.
This coverage is available only for residents of AL, AZ, CA, GA, HI, IN, IA, KS, MA, MI, NE, NV, NJ, OK, PA, RI, TN and Puerto Rico.
How much insurance should I consider?
Members —$100,000 to $1,000,000 in $1,000 multiples.
Spouse — $100,000 to $500,000 in $1,000 multiples, not to exceed 100% of member’s coverage.
Note: The total amount of coverage an individual may request under all group life insurance plans underwritten by New York Life Insurance Company may not exceed $2,000,000. In addition, the total amount of coverage an individual may have under all group policies issued by New York Life Insurance Company to the Trustees of the Qualified Associations and Organizations Trust may not exceed the maximum benefit option for any insured person.
When is the coverage effective?
Insurance will take effect on the date your application is approved by New York Life Insurance Company, provided the initial premium contribution is paid within 31 days after the date you are billed (send no money now) and any person to be insured is performing the normal activities of a person in good health of like age on the date of approval.
Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities and the person is still eligible.
When does coverage end?
Coverage will end when the insured person reaches age 75. Coverage will end earlier if: (a) premium contributions are not paid when due; (b) membership in the NSBA ceases; (c) the group policy is terminated or modified by the Policyholder to end insurance for the group of insureds to which the member belongs; (d) if the insured requests to terminate insurance; (e) for the insured spouse the last day of the insurance period during which the insured spouse ceases to be the lawful married spouse of the insured member.
Are there any exclusions?
Coverage is payable for death by any cause except death from suicide during the first two years of coverage, whether sane or insane, for which the only benefit payable is the return of applicable premium contributions.
The validity of any amount of your life insurance which has been in force for two years during an insured’s lifetime will not be contested except for insurance eligibility provisions and nonpayment of premium contributions.
How does the Accelerated Death Benefit work?
The "Accelerated Death Benefit" option is available to help terminally ill insureds during a difficult and often financially challenging time. Under this provision you may request one advance payment equal to 60% (maximum of $250,000) of your (or an insured dependent’s) in force life insurance to be paid while the terminally ill person is still alive. The request must be made at least 24 months prior to the insured person’s scheduled coverage termination age and the amount of insurance payable after the insured’s death will be reduced by this payment. (Premium contributions will not be reduced.)
This money can be used to help cover high prescription drug costs...medical bills...outstanding debts...to help pay for experimental treatments...the cost of modifications to your home...or for a family vacation–the choice is yours.
To qualify, a terminally ill insured must provide New York Life Insurance Company with proof of terminal illness and anticipated life expectancy (12 months or less), as well as any other necessary medical information requested. For additional details and limitations, please see the Certificate of Insurance.
Please note that receipt of Accelerated Death Benefits may affect your eligibility for public assistance programs and may be taxable. Prior to applying to receive such benefits, you should consult with the appropriate social services agency and seek the advice of a qualified tax advisor.
What if I have second thoughts after I apply?
When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the policy. If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will be sent a full refund—no questions asked!