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55A - HARTFORD INSURNACE
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12/17/2019
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55A - HARTFORD INSURNACE
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Last modified
12/12/2019 5:45:00 PM
Creation date
12/12/2019 5:04:33 PM
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Template:
City Clerk
Doc Type
Agenda Packet
Agency
Human Resources
Item #
55A
Date
12/17/2019
Destruction Year
2024
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SCHEDULE OF INSURANCE <br />The Schedule(s) of Insurance for The Policy benefits listed below are shown in the Certificate(s) of Insurance, as <br />incorporated into The Policy. <br />1) Basic Life Insurance <br />2) Supplemental Life Insurance <br />3) Dependent Life Insurance <br />4) Long Term Disability Insurance <br />5) Accidental Death and Dismemberment Benefit <br />6) Supplemental Dependent Accidental Death and Dismemberment Benefit <br />The Schedule(s) of Insurance will address the: <br />1) benefit amounts and maximum limits; <br />2) eligibility and effective date requirements; and <br />3) other schedule amounts and limits; <br />which apply to the employees of the Policyholder. <br />Form GBD-1000 A (10/08) (CA) <br />y � • <br />
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