Accidental Death & Dismemberment Insurance
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Presented and Administered
by Selman & Company

Group Accidental Death & Dismemberment Insurance
Underwritten by New York Life Insurance Company
:: Plan Description

The following information describes an insurance benefit available to all participating Credit Union Members ages 18 and over. Please read carefully.

Plan Features

If you are an active Member of a participating Credit Union, you are at least 18 years old and reside in the U.S. (except FL, NY, SD, VT & WA) you may take advantage of $2,000* of Basic Accidental Death & Dismemberment (AD&D) coverage paid for by your Credit Union - at no cost to you! As such, you are also eligible to purchase up to $300,000* of Voluntary Coverage. Premiums will be conveniently deducted from your Credit Union account.

(*The Basic benefit amount and the Voluntary benefit amount reduce by 50% at Member age 70 and are further reduced by 50% at Member age 75. Premiums do not reduce.)

Family Coverage.
If Family Coverage is selected, you will automatically insure your lawful spouse for 50% of your Voluntary Principal Sum (60% if there are no dependent children). Each eligible dependent child (unmarried and under age 19 or 25 if full-time student) will be insured for 20% of your Voluntary Principal Sum.

Up to $300,000 of Voluntary Coverage at Competitive Rates!

Value Added Benefits to Choosing Voluntary Coverage. Complete descriptions can be found in the Certificate of Insurance.

1) Inflation Protection Benefit.
Your Voluntary Principal Sum will increase over time with no increase in premium.

2) Return of Premium.
If you or your covered spouse die as the result of a covered accident, your benefit can be increased by an amount equal to all premiums you paid to New York Life Insurance Company for coverage.

3) Accident In-Hospital Benefit.
When a covered accident requires an Insured Person be hospitalized, the plan can pay an additional benefit.

4) Seat Belt Provision.
If a covered loss of life occurs while the insured person is driving or riding in a private passenger car in which he/she was properly wearing a seat belt, the Voluntary benefits can increase.

5) Common Carrier Coverage.
Voluntary benefits can increase if the loss results from an injury that occurs while the insured Person is a passenger on a public conveyance.

6) Education Benefit.
If the death of the Insured Member results from a covered accident, the plan can pay an additional benefit on behalf of any eligible insured dependent child.

Note: Benefits 1-6 described above are not included in the No-Cost (Basic) coverage.

Your Cost

Currently Monthly Premiums as of 2016

Voluntary Principal Sum*

Member Only Cost Per Month

Family Plan Cost Per Month

























Benefit amounts are not guaranteed and are subject to change by agreement between the Executive Trust and New York Life. Premiums may be changed by agreement between the Executive Trust and New York Life on any premium due date and on any date which benefits are changed. However, your rates may be changed only if they are changed for all others in the same class of insureds. For example, a class of insureds is all others with the same issue age. Coverage reduces at later ages, as described in this brochure.

How the Plan Works

Your Benefit Payment Summary
If a specified loss is caused directly and independently by an accidental injury while coverage is in force, and said loss occurs within 365 days of the injury, the plan will pay as follows:

% of Principal Sum

Loss of Life


Loss of Two Limbs


Loss of Sight of Both Eyes


Loss of Speech and Hearing


Loss of One Limb


Loss of Sight of One Eye


Loss of Speech or Hearing


Loss of One Limb and the Loss of One Sight in One Eye


Loss of Thumb and Index Finger of Same Hand


Quadriplegia (total paralysis of both upper and lower limbs)


Paraplegia (total paralysis of both lower limbs)


Hemiplegia (total paralysis of upper and lower limbs on one side of the body)


Loss of limb means actual severance at or above the wrist or ankle joint. Loss of sight, speech, and hearing means complete and irrevocable loss thereof. Paralysis means complete and irreversible paralysis of such limbs. The total benefit payable for all losses due to a single accident will not be more than the Principal Sum. Only one amount, the largest to which the Insured Person is entitled, is paid for all losses resulting from one accident.

Additional Plan Provisions

Effective Date of Coverage.
Effective Date of Coverage. Your new or increased coverage will become effective on the date specified by New York Life Insurance Company, provided the initial premium contribution has been paid and a completed application has been submitted. A Certificate of Insurance will be mailed to you after your effective date. When you receive your Certificate of Insurance, read it carefully. If you are not completely satisfied with the terms of your new insurance, simply return your Certificate, without claim, within 30 days and your premium will be promptly refunded. Your insurance will then be invalidated.

Your coverage will end on the earliest of the following: on or after the next premium due date if you are no longer an eligible Member of a Credit Union that is participating in the Executive Trust; the required premium is not paid when due; the Insured Person enters full-time active duty in the Armed Forces; or the group policy is terminated or modified to end coverage for the class of eligible persons to which the Insured Person belongs. Termination will not affect a claim for a covered loss due to an accident that occurred while coverage was in effect. Coverage for your insured spouse or child will end when your coverage ends or when the dependent eligibility requirements are no longer being met.

Exclusions and Limitations

No benefits will be paid for a loss caused by or resulting from: intentionally self-inflicted injury, suicide or any attempt thereat, while sane or insane; voluntary self-administration of any drug or chemical substance not prescribed by, and taken according to the directions of a doctor (accidental ingestion of a poisonous substance is not excluded); use of alcohol; incarceration for or participation (except as a victim) in a crime, illegal occupation/activity, riot, insurrection or terrorist activity; declared or undeclared war or act of war; or an accident which occurs while on active duty service in any armed forces; the covered person?s participation in an organized race; hang-gliding, parasailing, or parachuting, except parachuting for self-preservation; operating, riding in or descending from any aircraft except when riding as a passenger on a commercial flight; sickness, disease, bodily or mental infirmity or medical or surgical treatment thereof; or bacterial or viral infection, regardless of how contracted.

This information is a brief description of important features of the plan. It is not a contract. The complete terms and conditions of coverage are set forth in group policy number G-29213-0 on Policy Form GMR issued in Delaware to the Executive Trust. The group policy is subject to the laws of the jurisdiction in which it is issued. Additional information is contained in the Certificate of Insurance which is issued to the persons who become insured under the plan. The availability of this offer may change. Please keep this material as a reference for filing with your Certificate of Insurance. You must also be a Member of a Credit Union participating in the Executive Trust.

Underwritten by: New York Life Insurance Company, 51 Madison Avenue, New York, NY 10010 under Group Policy No. G-29213-0 on Policy Form GMR-FACE/G-29213-0.

Administered by: Selman & Company, 6110 Parkland Boulevard, Cleveland, OH 44124. Phone: 877.665.7563

Arkansas License# 247064

California License# 0I01599

Your Credit Union incurs costs in connection with this sponsored plan. To provide and maintain this valuable Member benefit, it is reimbursed for these costs. Your Credit Union also receives a fee in connection with this plan.

Accidental Death & Dismemberment Insurance
Underwritten by New York Life Insurance Company
51 Madison Avenue, New York, NY 10010 on Policy Form GMR
Sponsored by Matson Employees' Federal Credit Union
Presented and Administered by Selman & Company
6110 Parkland Boulevard
Cleveland, OH 44124
877-665-7563 - Phone
440-646-9339 - Facsimile
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