• Available to Eligible ICPAS Members Spouse Domestic Partner Under Age 65: With the ICPAS Group 10-Year Level Term Life Insurance Plan, you can help protect your family from the financial burdens of your and/or your Spouse's/Domestic Partner's death.

• Renewable Until Age 75: You can renew your life insurance under this ICPAS Plan until age 75, subject to all Termination of Coverage provisions.

• Member and Spouse/Domestic Partner Coverage: Build a plan to help meet your needs, from $50,000 up to $250,000 (in $50,000 units).
  

• Affordable Group Rates That Remain Constant for 10 Years: Compare the premiums for the ICPAS Group 10-Year Level Term Life Insurance Plan to similar level term life plans on the market today. You'll probably be surprised at how much life insurance you can afford.

• Nonsmoker Rates which you may qualify for: If you have not smoked cigarettes, cigars or used a pipe or chewing tobacco, nicotine chewing gum or snuff in the last 12 months, you are eligible for a nonsmoker premium rate.

• Send No Money Until You're Approved

• Convenient Monthly Payment Option: A Preauthorized Check Payment Plan option offers a time-saving convenience.

• Exclusion: The two-year suicide exclusion, applies if a Covered Person commits suicide during the first two years coverage or the first two years immediately following an increase in coverage under this Policy.

• Portable Coverage: The Plan offers portable coverage that can follow you throughout your career. Make all the career changes you want and still be able to maintain this valuable protection.

ELIGIBILITY 

Available exclusively to ICPAS members under age 65, a citizen of the United States, it territories and protectorates who may apply for coverage for themselves and their Spouse/Domestic Partner. When Spouses are both Eligible Members, coverage may not be duplicated by applying as dependents of each other. Your Spouse/Domestic Partner must by under age 65, a citizen of the United States, its territories and protectorates, and not legally separated or divorced from you. In order to becomes insured, satisfactory evidence of insurability must be provided and the required premium must be paid. 

A dependent who is also an ICPAS member is eligible for either member or dependent coverage, but not both. If both member and spouse are covered as members, neither may insure the other as spouse. 

This program may vary and may not be available to residents of all states. 

APPLY FOR UP TO $250,000 OF COVERAGE 
Choose the amount of Group 10-Year Level Term Life Insurance you want to help protect you and your family for the next 10 Years without the worry of premiums that could go up or benefits that could go down due to your health or age. 
Amounts of Insurance: 
Members—$50,000 to $250,000 in $50,000 multiples 
Spouse/Domestic Partner—$50,000 to $250,000 in $50,000 multiples. Each Covered Person may not be covered: under more than two certificates of insurance; or for a total benefit amount under all certificates which exceeds $1,000,000.


PLAN FEATURES 

Pay Less If You’re a Qualified Nonsmoker 
Nonsmokers meeting the highest underwriting standards may qualify for the "Preferred Plus" rates that follow. Other nonsmokers may qualify for ’Preferred’ rates. You are considered a non-smoker if in the past 12 months you have not smoked cigarettes or cigars, or used a pipe, chewing tobacco, nicotine chewing gum or snuff.

Continuing Insurance After the 10-Year Term Ends 
Premiums will remain level for the first 10 years of coverage. At the end of the 10-year period, if you still meet requirements of eligibility, you may apply for re-entry. A written application and evidence of insurability satisfactory to Hartford Life and Accident Insurance Company is required.

Or you can be automatically transferred to a group annual renewable term life policy (ART)* with attained age rates, without evidence of insurability, and subject to all the terms and eligibility requirements of that policy.

*ART life policy premium rates are attained-age rates and may be changed at any time by the company. The initial premium rate will be based on the Covered Person’s then current age at the time of transfer. 

Keep Your Cost Manageable 
Rates have been provided on an annual basis per $1,000 of coverage to make it easier for you to compare this Plan to other insurance plans on the market today. Four modes of payment are available to suit your budget: quarterly billing, semiannual billing or annual billing; and our Monthly Preauthorized Check Payment Plan.

 

Your Cost

The cost of this life insurance is based upon the member's and spouse’s gender, amount of insurance requested, usage of tobacco/nicotine products, health status, and attained age on the date coverage is issued. Premium contributions will vary depending upon the options chosen. 

Only nonsmokers meeting the highest underwriting standards will qualify for ’Preferred Plus’ rates. Other nonsmokers may qualify for the higher ’Preferred’ or ’Standard’ rates. (Note: Smokers may only qualify for Standard Rates.) Upon approval of your application, you will be notified of the rate classification for each approved person. 

Current "Preferred Plus", "Preferred" & "Standard" Annual Premium Contribution† Per $1,000 Benefit Amount
	Amounts of $50,000 - $100,000
Member/Spouse Issue Age	Male (Nonsmoker)		Male (Smoker)	Female (Nonsmoker)		Female (Smoker)
	Preferred	Standard	Standard	Preferred	Standard	Standard
20-30	$1.00	$1.57	$2.25	$0.87	$1.26	$1.74
31	1.03	1.64	2.36	0.91	1.33	1.86
32	1.07	1.71	2.49	0.94	1.41	1.99
33	1.11	1.79	2.62	0.98	1.48	2.12
34	1.15	1.88	2.78	1.01	1.56	2.25
35	1.20	1.99	2.96	1.06	1.64	2.39
36	1.27	2.13	3.19	1.10	1.73	2.55
37	1.34	2.28	3.45	1.14	1.83	2.71
38	1.40	2.42	3.68	1.20	1.95	2.91
39	1.48	2.57	3.93	1.26	2.08	3.12
40	1.55	2.73	4.21	1.32	2.21	3.34
41	1.63	2.91	4.51	1.37	2.34	3.56
42	1.72	3.11	4.84	1.44	2.48	3.79
43	1.82	3.34	5.21	1.49	2.60	3.99
44	1.93	3.59	5.64	1.55	2.73	4.20
45	2.06	3.86	6.08	1.61	2.86	4.42
46	2.19	4.15	6.57	1.68	2.99	4.64
47	2.34	4.46	7.09	1.75	3.14	4.90
48	2.47	4.73	7.54	1.82	3.29	5.15
49	2.59	5.00	7.99	1.90	3.46	5.43
50	2.73	5.28	8.47	1.98	3.63	5.71
51	2.88	5.58	8.96	2.06	3.81	6.00
52	3.03	5.89	9.48	2.15	3.99	6.32
53	3.27	6.39	10.33	2.26	4.22	6.69
54	3.53	6.92	11.23	2.37	4.46	7.10
55	3.81	7.51	12.22	2.49	4.71	7.54
56	4.11	8.14	13.26	2.63	4.98	7.99
57	4.43	8.83	14.41	2.76	5.25	8.46
58	4.74	9.49	15.52	2.91	5.57	8.99
59	5.07	10.20	16.70	3.07	5.91	9.55
60	5.40	10.93	17.93	3.23	6.26	10.13
61	6.12	12.07	19.45	3.68	6.92	10.87
62	6.89	13.27	21.10	4.15	7.62	11.71
63	7.82	14.87	23.45	4.66	8.33	12.55
64	8.86	16.71	26.18	5.15	9.09	13.72

 

Current "Preferred Plus", "Preferred" & "Standard" Annual Premium Contribution† Per $1,000 Benefit Amount
	Amounts of $100,001 - $250,000
Member/Spouse Issue Age	Male (Nonsmoker)			Male (Smoker)	Female (Nonsmoker)			Female (Smoker)
	Preferred Plus	Preferred	Standard	Standard	Preferred Plus	Preferred	Standard	Standard
20-30	$0.68	$0.76	$1.34	$2.01	$0.58	$0.64	$1.02	$1.51
31	0.71	0.80	1.40	2.12	0.61	0.67	1.09	1.62
32	0.74	0.83	1.48	2.25	0.64	0.71	1.17	1.76
33	0.77	0.87	1.55	2.38	0.67	0.74	1.24	1.88
34	0.81	0.91	1.64	2.54	0.70	0.78	1.32	2.01
35	0.86	0.97	1.76	2.73	0.74	0.82	1.41	2.15
36	0.91	1.03	1.89	2.96	0.77	10.86	1.50	2.31
37	0.97	1.10	2.05	3.22	0.81	0.91	1.59	2.47
38	1.02	1.17	2.18	3.44	0.86	0.96	1.72	2.68
39	1.09	1.24	2.33	3.69	0.90	1.02	1.84	2.89
40	1.15	1.32	2.50	3.97	0.95	1.08	1.97	3.10
41	1.22	1.40	2.68	4.27	1.00	1.14	2.11	3.32
42	1.29	1.48	2.87	4.60	1.05	1.20	2.25	3.55
43	1.37	1.58	3.10	4.98	1.10	1.25	2.37	3.76
44	1.46	1.70	3.36	5.40	1.15	1.31	2.49	3.96
45	1.56	1.82	3.62	5.84	1.20	1.37	2.62	4.18
46	1.68	1.96	3.92	6.33	1.25	1.44	2.76	4.41
47	1.80	2.10	4.23	6.85	1.31	1.51	2.91	4.67
48	1.91	2.23	4.50	7.30	1.37	1.58	3.06	4.92
49	2.02	2.36	4.76	7.75	1.44	1.66	3.22	5.19
50	2.13	2.50	5.05	8.23	1.51	1.74	3.39	5.47
51	2.26	2.65	5.35	8.72	1.58	1.83	3.57	5.77
52	2.39	2.80	5.65	9.24	1.65	1.91	3.76	6.08
53	2.59	3.03	6.15	10.09	1.74	2.02	3.98	6.45
54	2.81	3.29	6.69	10.99	1.84	2.13	4.22	6.86
55	3.05	3.57	7.27	11.98	1.94	2.26	4.47	7.30
56	3.30	3.87	7.90	13.02	2.06	2.39	4.74	7.75
57	3.57	4.19	8.59	14.17	2.17	2.53	5.01	8.22
58	3.83	4.50	9.25	15.28	2.29	2.67	5.33	8.75
59	4.11	4.84	9.96	16.45	2.43	2.83	5.67	9.32
60	4.38	5.16	10.69	17.68	2.56	2.99	6.02	9.89
61	5.04	5.88	11.83	19.21	2.98	3.44	6.68	10.63
62	5.75	6.65	13.03	20.94	3.43	3.92	7.38	11.47
63	6.58	7.58	14.63	23.30	3.90	4.42	8.09	12.38
64	7.51	8.62	16.47	26.04	4.36	4.98	8.94	13.59

Rates and/or benefits may be changed on a class basis. Rates are based on the attained age of the Insured person.
Payable quarterly, semiannually, annually or via the Monthly Preauthorized Check Payment Plan as described previously. 
If paying by check, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.
As previously noted, member and Spouse/Domestic Partner benefits under this Plan are available in $50,000 multiples (units). 

Termination of Coverage: As long as you remain an active member of the Illinois CPA Society, pay your premium when due, and the master policy remains in force, you can keep your coverage until you turn age 75, or on the 10th anniversary of the Certificate Effective Date shown in the Schedule of Insurance.Your dependent’s coverage will remain in effect as long as your coverage is active, premiums are paid, and they meet the eligibility requirements. When Spouses or Domestic Partners are both Eligible Members, coverage may not be duplicated by applying as dependents of each other.

Send No Money Now! 
All you need to do is return the completed application. You will be billed for the appropriate premium upon approval of your application. 

OTHER IMPORTANT INFORMATION 

One Exclusion
If a Covered Person commits suicide: while sane or insane during his or her first two years of coverage under the Policy; we will only pay an amount equal to the premium paid for coverage to the date of death. The Life Insurance Benefit is payable if a Covered Person is insured under the Policy and commits suicide after the two year period. The two-year suicide exclusion applies if a Covered Person commits suicide during the two years immediately following an increase in coverage under this Policy. In either event, the Amount of Insurance payable will equal the Amount of Insurance in force prior to the increase plus an amount equal to the premium paid for the increase to the date of death. 

You Name Your Beneficiary
Your beneficiary is the person(s) last designated by you in writing, and recorded by or on behalf of Hartford Life and Accident 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/domestic partner insurance, contact the Administrator for the applicable forms. If no beneficiary has been made, benefits will be paid to the executors or administrators of your estate, all to your surviving spouse, if your spouse does not survive you, in equal shares to your surviving children, or if no child survives you, in equal shares to your surviving parents.

ADDITIONAL PLAN PROVISIONS

Effective Date 
Insurance will take effect on the date your application is approved and your first premium is paid.

Acceptance into this plan is subject to medical evidence of insurability as determined by The Hartford and underwriting guidelines. As part of the evidence of insurability process, a medical examination, medical test(s), or other evidence of good health may be required. Any exams/test requested by the company will be conducted at your convenience and at no expense to you. 

Certificate of Insurance 
This information explains the general purpose of the insurance described, but in no way changes or affects the Master Policy as actually issued. In the event of a discrepancy between this information and the Policy, the terms of the policy apply. All benefits are subject to the terms and conditions of the Policy. Policies underwritten by Hartford Life and Accident Insurance Company detail exclusions, limitations, reduction of benefits and terms under which the Policies may be continued in full or discontinued. Complete details are in the Certificate of Insurance issued to each insured individual and the Master Policy issued to the Policyholder.

30-Day Free Look
If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, within 30 days. Your coverage will be invalidated, and you will be sent a full refund minus any claims paid no questions asked! 

 

Notice of Insurance Information Practices

 

This notice applies to residents of: All states, excluding Massachusetts

The Hartford Life and Accident Company respects your right to privacy and values your trust. This Notice explains how we collect, use and protect your personal information and your rights regarding that information.

Information We Collect
While your application for insurance is our primary source of information about you, we may also need to collect or verify information from other sources such as physicians and other medical and health care providers and professionals, health facilities such as hospitals, clinics, pharmacies, employers, consumer reporting agencies, and insurance-support organizations, which may provide us with an investigative consumer report about you. Organizations that provide us with consumer reports about you may disclose the contents of the report to others for which such organization performs such services. We may collect personal information about you that is necessary to determine your eligibility for insurance, to service your insurance policy, and otherwise as permitted by law; the information may include information from which judgments can be made about your age, health and medical history, occupation, avocations, finances, credit, character, habits, general reputation, or any other personal characteristics. We also collect information about your transactions with us, such as the products you buy from us; the amount you paid for those products; your account balances; and your payment and claims history.

Personal History Interview
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.

Medical Information Bureau (MIB) Pre-Notice 
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite Model 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.

Disclosure of Personal Information
We will not disclose your personal information to third parties without your authorization except in connection with our business or as otherwise permitted or required by law. For example, in connection with our general business practices, we may disclose personal information we collect to: companies performing services or functions on our behalf, including other insurers, agents or insurance support organizations, including for the purpose of determining your eligibility for insurance benefits or payments; detect or prevent fraud or criminal activity in connection with insurance transactions; medical care institutions or medical professionals for the purposes of verifying coverage or benefits; insurance regulatory authorities or law enforcement of other governmental authorities to prevent or prosecute the perpetration of fraud; the policyholder of a group insurance policy (for example an employer who provides group insurance) for purposes of reporting claims experience, conducting an audit of our operations or services, risk mitigation or other permissible purposes; third parties who collect data regarding claims for purposes of underwriting and claims handling, or to a third party as otherwise permitted or required by law; or reinsurers.

How We Protect Your Information
We employ administrative, technical and physical safeguards to protect the security, confidentiality and integrity of personal information. We will continue to protect your information even when a business relationship no longer exists between us.

Right to Access and Right to Correct/Amend/Delete
You have the right to learn what personal, including medical, information we have in our files about you, to whom it has been recently disclosed, to have access to the information, to correct the information, and to receive a copy. We are not required to provide you access to information that is collected when we evaluate a claim or when the possibility of a lawsuit exists.

Please contact us if you would like access to your information from your files. There may be a reasonable charge for copies of records. If you think your file contains incorrect information, notify us indicating what you believe is incorrect and your reasons. We will investigate the matter and either correct our records or place a statement from you in our files explaining why you believe the information is incorrect. We will also notify persons or organizations to whom we previously disclosed the information of the change or your statement.

If you request access to medical record information that was supplied to us by a medical care institution or medical professional, we may choose to provide it to a medical professional designated by you.

Rights Relating to Adverse Underwriting Decision
You have the right to certain information relating to adverse underwriting decisions we may make about You, including the reason for such decision. In the event we make an adverse underwriting decision relating to You, we will provide You with information regarding such decision and Your rights.

How to make a request: If you wish to exercise your rights as provided in this notice, please provide us with your full name, complete address, your policy number or other identifying information and a reasonable description of the information you wish to access or correct. Please send your written request to: The Hartford, Attn: Medical Underwriting, PO Box 2999, Hartford, CT 06104-2999.
Form PA-10210 (2018)

 

 

This notice applies to residents of Massachusetts.

 

NOTICE OF INSURANCE INFORMATION PRACTICES
To properly underwrite and administer your application for insurance coverage, we must collect certain information concerning your insurability. You are our most important source of information, but we may also contact other sources such as medical professionals and institutions, employers and other insurance companies. While all information regarding your insurability will be treated as confidential, in some situations, and in compliance with applicable law, we may disclose necessary items of information to third parties without your specific authorization.

INVESTIGATIVE CONSUMER REPORTS – NOT APPLICABLE TO RESIDENTS OF NEW YORK
As part of our procedure for processing your application, an investigative consumer report may be prepared by an outside insurance reporting organization. Personal information may be collected from others regarding your general reputation and lifestyle. If an interview is conducted with someone other than you, we will inform you of your right to be interviewed in connection with the preparation of the investigative consumer report. You have the right to send a written request within a reasonable period of time to receive additional detailed information about the nature and scope of this investigation.

PERSONAL HISTORY INTERVIEW
To provide you, our client, with the best possible service, we may also conduct what we call a personal history interview. This is a phone call placed from our underwriting office. Its purpose is to make sure that the application information is complete. Our interviewers are trained to conduct their calls in a friendly, professional manner. The nature of the information discussed is always treated as personal and confidential and will only be used to assess your eligibility for insurance.

MEDICAL INFORMATION BUREAU (MIB) PRE-NOTICE
Information regarding your insurability will be treated as confidential. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may, however, make a brief report thereon to the MIB, Inc., formerly known as Medical Information Bureau, a not-for-profit membership organization of insurance companies, which operates an information exchange on behalf of its members. If you apply to another MIB member company for life or health insurance coverage, or a claim for benefits is submitted to such a company, MIB, upon request, will supply such company, with the information about you in its file. Upon receipt of a request from you, MIB will arrange disclosure of any information in your file. Please contact MIB at (866) 692-6901 (TTY (866) 346-3642). If you question the accuracy of the information in MIB's file, you may contact MIB and seek a correction in accordance with the procedures set forth in the Federal Fair Credit Reporting Act. The address of MIB's information office is 50 Braintree Hill Park, Suite Model 400, Braintree, Massachusetts 02184-8734. Hartford Life Insurance Company, Hartford Life and Accident Insurance Company, or their reinsurers, may also release information from their files to other insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Information for consumers about MIB may be obtained on its website at www.mib.com.

ACCESS, CORRECTION AND DISCLOSURE
You can obtain access to personal information about you contained in our policy files by sending us a written request. You may also request any necessary corrections, amendments or deletion of any information in our files which you believe to be inaccurate or irrelevant. Hartford Life Insurance Company or Hartford Life and Accident Insurance Company or its reinsurer(s) may release information in their files to other life insurance companies to whom you may apply for life or health insurance, or to whom a claim for benefits may be submitted. Also, please be advised that personal and confidential information collected by us may, in certain circumstances, be disclosed to third parties without authorization. A notice providing further description of the circumstances under which information about you may be disclosed and the types of persons and organizations to whom it may be disclosed will be sent to you upon your written request. If you desire further information or access to your personal information, please send your written request to: Hartford Life Insurance Company or Hartford Life and Accident Insurance Company, 200 Hopmeadow St., Simsbury, CT 06089.
PA-9369

You can request up to $150,000* of coverage on member and spouse. 

Issuance of this policy is handled over the Internet and the mail. You can review the materials in the privacy of your home and purchase your policy directly through the mail without meeting with an agent. You can, of course, talk to a licensed representative if you'd like. Please click the Contacts section for the toll-free number.

You will have 30 days from the date of receipt to review the insurance certificate. If you are not satisfied with the terms of the certificate, simply return it to the Insurance Administrator and any premiums paid will be refunded in full, minus any claims paid.

This plan is underwritten by Hartford Life and Accident Insurance Company, under Group Policy No. AGT-1760, on Life Form Series includes GBD-1000, GBD-1100 or state equivalent.

Available exclusively to ICPAS members under age 65 who may apply for coverage for themselves and their Spouse/Domestic Partner. When Spouses are both Eligible Members, coverage may not be duplicated by applying as dependents of each other. Your Spouse/Domestic Partner must by under age 65, a citizen of the United States, its territories and protectorates, and not legally separated or divorced from you. In order to becomes insured, satisfactory evidence of insurability must be provided and the required premium must be paid.

A dependent who is also an ICPAS member is eligible for either member or dependent coverage, but not both. If both member and spouse are covered as members, neither may insure the other as spouse. 

This program may vary and may not be available to residents of all states.

Members—$50,000 to $250,000 in $50,000 multiples 
Spouse/Domestic Partner—$50,000 to $250,000 in $50,000 multiples, not to exceed 100% of member’s coverage

Pay Less If You’re a Qualified Nonsmoker 

Nonsmokers meeting the highest underwriting standards may qualify for the ’Preferred Plus’ rates. Other nonsmokers may qualify for ’Preferred’ or ’Standard’ rates.

Issuance of this policy is handled over the Internet and the mail. You can review the materials in the privacy of your home and purchase your insurance directly through the mail without meeting with a salesperson. You can, of course, talk to a licensed representative if you'd like. Please view the Contact Us section for the Program Administrator's toll-free number.

You will become covered under The Policy on the Certificate Effective Date shown in the Schedule of Insurance, subject to payment of the required premium.

If a Covered Person commits suicide: while sane or insane during his or her first two years of coverage under the Policy; we will only pay an amount equal to the premium paid for coverage to the date of death. The Life Insurance Benefit is payable if a Covered Person is insured under the Policy and commits suicide after the two year period. The two-year suicide exclusion applies if a Covered Person commits suicide during the two years immediately following an increase in coverage under this Policy. In that event, the Amount of Insurance payable will equal the Amount of Insurance in force prior to the increase plus an amount equal to the premium paid for the increase to the date of death.

When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the Plan. If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, within 30 days. Your coverage will be invalidated, and you will be sent a full refund, minus any claims paid no questions asked!