New Employee Benefits Enrollment - Dow Corning

DEPENDENT LIFE
Coverage is effective on your first day of work. See Benefit Enrollment Information page for details on
how to enroll for benefit coverage.
If you waive coverage or fail to enroll within two months from your start date, you will receive no
coverage for the current calendar year, and you must wait until the next annual enrollment period to
enroll for coverage.
Plan Highlights
The Dependent Life Insurance plan provides coverage in the event of the death of your spouse or
dependent child. A variety of coverage options are available, offering flexibility for families.
Dependent Life Insurance for Spouse or Domestic Partner
You can purchase life insurance coverage for your spouse or domestic partner in increments of $10,000
up to a maximum of $250,000. If you wish to enroll your spouse or domestic partner for Dependent
Life Insurance, the following applies:
� The employee MUST be enrolled for Optional Life Insurance.
� The spouse’s or domestic partner’s Dependent Life coverage amount CANNOT exceed the
employee’s Optional Life coverage amount.
� Evidence of Insurability (EOI) is required if you wish to enroll for more than $40,000 in
coverage.
Dependent Life Insurance for Children
You can purchase life insurance coverage for your eligible child(ren) in increments of $5,000 up to a
maximum of $20,000.
� You pay one premium no matter how many children you have.
� Evidence of Insurability is not required to enroll for any level of Child Dependent Life
Insurance.
You should know…
� Rates are reduced for tobacco-free spouses or domestic partners.
� A tobacco-free person is defined as someone who is tobacco-free (including smokeless tobacco)
for 12 months or more.
� If your spouse or domestic partner is an Employee or Retiree of Dow Corning you may enroll each
other, but only one of you may enroll for coverage for your children.
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