Shawnee State University

Administration Guide

GROUP LIFE INSURANCEProvided by Securian Financial

Policy No. 34697

Administered by Ochs, an affiliate of Securian Financial

This Guide provides a summary of plan provisions and procedures related to the insurance policies issued by Minnesota Life Insurance Company or Securian Life Insurance Company, affiliates of Securian Financial, to the policyholder and to any certificates related to those policies. In the event of a conflict between the terms of this Guide and the policies and/or certificates, the policies and/or certificates shall dictate the coverage and procedures. For purposes of this paragraph, the terms “policy”, “policies”, “certificate”, and “certificates” include any riders, supplements or amendments related thereto.

Securian Financial is the marketing name for Securian Financial Group, Inc., and its affiliates.

Table of Contents

KEY CONTACTS..................................................................................................................................3

BILLING….............................................................................................................................................4

CENSUS REQUEST.............................................................................................................................5

COMPLETING THE EVIDENCE OF INSURABILITY FORM...............................................................6

BENEFICIARY DESIGNATIONS AND CHANGES..............................................................................6

CONVERSION AND PORTABILITY.....................................................................................................6

LIFE BENEFITS EXTRA (LBE)..............................................................................................................7

MEDICAL UNDERWRITING PROCESS..............................................................................................7

LIFE INSURANCE CLAIMS PROCESS...............................................................................................8

LIFE INSURANCE FORMS..................................................................................................................9

NOTE: Coverages listed in this document may not be included in your group life insurance policy. Please refer to your group plan certificate for your specific coverage information. A PDF version of the certificate will be provided to you and should be made available to each insured employee.

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DEPARTMENTS CONTACTS DETAILS

Account Management and Client Services and Administration

Enrollment and Evidence of Insurability Submission

– Administered by Ochs

651-665-3789 1-800-378-7500

Amy Pals, Account Manager apals@ochsinc.com

Plan information Renewals Contract issues

Gao Vang, Client Services Specialist gvang@ochsinc.com

Conversion and portability Customer service Enrollment materials Technical assistance Day to day administration

questions

Mail forms to: Ochs400 Robert Street North, Suite 1880St Paul, MN 55101-7734

Send forms electronically to: OchsFax: 651-665-3791 orEmail: ochs@ochsinc.com

LifeBenefits Technical Assistance

Support Services:800-660-2479

Password reset First time login

Billing Remittance– Securian Financial

1-866-293-6047

Remit payment to: Minnesota LifeAttn: PO Box 64546400 Robert Street NorthSt. Paul, MN 55164-0546

Group-premium@securian.com

Billing and premium payment

Group Claims– Securian Financial

651-665-4086

Annie Melin ClaimsClientService@securian.com

Claims process Forms Claims status Status also available on

www.LifeBenefits.com

Claims submissions to:Securian FinancialPO Box 64114St. Paul, MN 55164

Submit e-Claims electronically to:Securian Financial

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www.LifeBenefits.com

BillingSelf-Administered clients will receive a premium remittance statement during implementation that is to be used to notify Securian Financial of the total number of lives and life insurance volume for all eligible employees/retirees for a given month.

The client will be responsible for the following: Storing coverage amounts on file for each eligible employee/retiree and their dependents Making updates to coverage amounts and/or premium amounts due to age reductions, salary

changes, new hires, terminations, underwriting approvals, age band changes, and any other change the would cause coverage/premium to change per the client’s policy.

Providing the number of eligible lives and volume for each line of coverage on the premium remittance statement.

Sending the premium remittance statement and payment on a timely basis. Securian Financial will not provide monthly reminders.

Providing a full census on an annual basis.

Sample Self Administration Statement

Bill Procedures

Payment is due on the 1st of the premium month. Clients have 31 days from that date to submit a timely payment.

Premium is to be calculated on the first-of-the-month basis (no proration of premium).o New Hires/Newly Eligible/Underwriting Approval

Premiums are due, beginning with the first day of the month following or coinciding with the eligibility date or underwriting approval date.

Example: If an employee becomes eligible/approved on April 5th, premiums are due beginning May 1st.

o Terminations/Cancelations Premiums are to be calculated through to the end of the month following

termination. Example: If an employee terminates on April 5th, premiums are due through the

month of April. If an employee enrolls for more than the guaranteed issue level of coverage, premiums for

coverage over the guaranteed issue level should not be deducted until Securian Financial has approved the coverage through the medical underwriting process.

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Submitting Premium Payment Premium payment can be made by either of the following methods:

Check Payment Wire Transfer Remit payment and remittance statement

via mail:Minnesota Life Insurance CompanyPO Box 64546400 Robert Street NorthSt. Paul, MN 55164-0546

Remit payment via ACH:US Bank NA800 Nicollet AveMinneapolis, MN 55402Attn: Policy #[insert policy #]Routing Number: 091-000022Account Number: 180110006004

Email premium remittance statement to:Group-Premium@Securian.com

Census Requests Ochs, on behalf of Securian Financial, may request census information for those individuals participating in the group life insurance plan.  This information is used for monitoring the plan’s performance, calculating state premium taxes, renewal pricing, and for reinsurance purposes.  Please be assured that Securian Financial will treat all data carefully.  It is protected and referenced in a de-identified way whenever possible.  Census includes fields such as, but not limited to: employee SSN/ID, employee address, employee date of birth, employee date of hire, employee salary, current coverage amounts for all lines of coverage, etc.

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Completing the Evidence of Insurability FormFor employees electing coverage over the guaranteed issue amount, an Evidence of Insurability (EOI) form must be completed and submitted for medical underwriting. The client is responsible for making sure all information needed is on the EOI form before sending to Ochs for processing. Please see the below attached instructions:

Self-Administered Groups:

Beneficiary Designation and ChangesDesignating a beneficiary for life insurance is important. It lets an employee determine to whom the proceeds should go. In addition, the entire proceeds are received income tax free by the beneficiary.

An employee may designate a beneficiary at any time, by completing the Beneficiary Designation form. If an employee does not designate a beneficiary, the beneficiary will default as indicated in the policy.

The insured employee is automatically the beneficiary for Dependent Life (spouse and child) Insurance.

If the employee wants to designate multiple beneficiaries, he or she must then decide what percentage of the total proceeds each individual should receive.

A self-administered client must store their own beneficiary designations. Securian Financial will request a copy of the beneficiary designation at the time of a claim.

Conversion/Portability ProcedureWhen an employee terminates or retirees, they have the option to elect to continue all or a portion of their in force insurance, as well as insurance for their dependents. Coverages may be continued without having to provide evidence of insurability. Former employees have 31 days from their termination date to elect to continue their coverage. Please check your policy to verify if portability is included. Premiums may be higher than those paid by active employees.

NOTE: It is the employer’s responsibility to provide their employees with the conversion and/or portability information. Securian Financial will NOT automatically send out a notice to the former employee regarding their options to continue their life insurance.

See Forms page for Conversion and Portability documents.

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LifeBenefitsExtra (LBE)Securian Financial provides a customized Human Resources website called LifeBenefitsExtra (LBE). During your initial implementation, an Access Agreement will be provided. Once the Access Agreement is signed and returned, an email will be sent to each user with their log-in information.

LBE is a secure online tool that gives benefit and payroll personnel instant access to information about their company’s group life insurance program, including:

Evidence of Insurability (EOI) and claims status, updated continuously throughout each day Report Builder™, a dynamic tool which allows online creation of customized underwriting and

claims reports Weekly claims and underwriting activity reports with e-mail notification when reports are available

to view (see sample below).

NOTE: This weekly email is your notice to update payroll for any underwriting approvals. This notification is the only notification you will get from Securian Financial regarding underwriting decisions.

Medical Underwriting ProcessPlease refer to your LifeBenefitsExtra website for additional information on the underwriting process. Follow the steps below to access the information:

Once logged into LifeBenefitsExtra, click on the Plan Support tab and choose Help and FAQ’s On the Help and FAQ’s page, click on Underwriting Process and/or Underwriting Information for

additional information.

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Life Claims ProcessBelow are the basic steps Securian Financial follows when presented with a life insurance claim. See Forms page for all forms needed to administer the Life insurance plan

Submission methods: eClaim (if applicable), completion of paper Notice of Death form by employer (form can then be emailed, faxed, or mailed), or beneficiary can contact Securian Financial directly

Benefit Payment Upon receipt of all necessary claim documents, the claims examiner makes determination within 7 to 10 calendar days. Benefit payment is made by sending check or direct deposit to beneficiary(ies). Benefits are typically paid in a lump sum. Interest is paid from the date of death to the date of benefit payment, at the higher of the state mandated rate (if any) or the company rate. Payment is made by the underwriting company, Minnesota Life Insurance Company.

Please refer to your LifeBenefitsExtra website for additional information on all claims processes. Follow the steps below to access this information:

Once logged into LifeBenefitsExtra, click on the Plan Support tab and choose Help and FAQ’s On the Help and FAQ’s page, click on Claims Process for additional information.

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Life Claim Process

Secu

rian

Empl

oyer

Bene

ficiar

y

Notifies employer of Death

Submits eclaim/notice of death

notification with coverage verification

and beneficiary designation

Examiner sends condolence letter and

requests completion of beneficiary statement and copy of certified

death certificate

Completes beneficiary statement and returns with copy of certified

death certificate

Status of claim is available to view

online at any time

Reviews information and

makes claim determination

Payment is made by sending check or direct deposit to

beneficiary(ies)

Beneficiary(ies) informed of reason for denial

Receives payment or denial

notification

Life Insurance FormsBelow you will find the plan summary and all forms to administer your life insurance plan:

Plan Summary and Enrollment FormsPlan

SummaryEnrollment

FormEvidence of

Insurability FormBeneficiary

FormVoluntary AD&D

Form

N/A N/A

Claim FormsNotice

of DeathAccelerated Death Claim

Waiver of Premium Attending Physician

Waiver of Premium Employer Statement

Waiver of Premium Notice of Disability

Conversion and PortabilityConversion Form Portability Form

LifeStyle Benefits Brochure LifeBenefitsExtra Guides

To let your employees know more about the LifeStyle Benefits, you can send this email to remind them of the resources automatically available

as part of being insured under your group life insurance benefit

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