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Benefits Information
FSA Plan Documents

The Company provides eligible Team Members with both a Basic Term Life Insurance benefit and an Accidental Death & Dismemberment (AD&D) insurance benefit. Both of these insurance benefits are provided by Sun Life. The Company pays 100% of the cost of this benefit.

Life insurance provides a lump sum of money to your beneficiary(ies) upon your death.  Your beneficiaries will receive payments whether you die of natural or accidental causes. AD&D insurance provides a lump sum payment if your death or dismemberment is the direct result of an accident. If you die as the result of an accident, your beneficiary(ies) will receive both benefits. If you become dismembered as a result of an accident, you (and not your beneficiary(ies) will be paid according to a schedule of indemnities listed in the plan document.
The following is a summary of the benefits provided under this plan.  The amounts listed apply to each benefit.  For example, if you are a director, earn $85,000 per year,  and die as the direct result of an accident, your beneficiary(ies) will receive $340,000.  If you die of natural causes, your beneficiary(ies) will receive $170,000.

Plan Summary
Job Classification Benefit Amount

Officers, Vice Presidents and Above

200% of annual salary, up to a maximum of $500,000
The minimum benefit is $10,000
Benefits are rounded up to the nearest $1,000.

Directors

200% of annual salary, up to a maximum of $300,000
The minimum benefit is $10,000
Benefits are rounded up to the nearest $1,000.

All other full time benefit eligible hourly and salary Team Members

150% annual salary, up to a maximum of $150,000
The minimum benefit is $10,000
Benefits are rounded up to the nearest $1,000.

This life insurance policy does not have a cash value, but it can be converted to an individual policy upon separation of employment.

If you are aged 65 or older, the amount, or “face value” of your insurance decreases below these stated levels.  If you have any questions regarding how this provision affects your insurance benefit, please contact Benny’s Café at 1-888-873-8326 for more information.
It’s important to designate a beneficiary to receive your insurance payment in the event of your death.  To change your beneficiary at any time please call Benny’s Café.

 

Base Life & AD&D Forms:
Beneficiary Change Form
Conversion Notice/Application
Conversion Kit
Accelerated Death Benefit Life Claim Packet (Accelerated Life Claim Form)

 

 

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