Group Term Life Coverage

To apply, download an application by clicking on the Forms tab.

Issuance of this policy is handled through 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 ASME representative if you’d like. Please click the Contacts section for the toll-free number.

When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the policy. If you are not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated and you will be sent a full refund—no questions asked!

Some insurance experts suggest that you purchase life insurance equal to five to nine times your current income. In addition, you should consider how much your dependents will need to maintain their lifestyle.

Benefits are paid for death from any cause, at anytime, anywhere in the world* except suicide within the first two years of coverage, whether sane or insane — in which case, the benefits will be reduced to a refund of premiums paid. The validity of any amount of your life insurance which has been in force for two years during an insured’s lifetime will not be contested except for insurance eligibility provisions and non-payment of premium contributions. (There are exclusions for the optional AD&D benefit, as described in the brochure attachment. )

*Subject to U.S. government regulations on restricted countries

Insurance will take effect on the date your application is approved by New York Life Insurance Company provided the initial contribution has been paid within 31 days after the date you are billed, satisfactory evidence of insurability has been submitted, and any person to be insured is actively performing the normal activities of a person in good health of like age (NC residents: a person of like age) on the date of approval.

Any person who is not performing his/her normal daily activities as required will not become insured until the day he/she is performing such activities, provided such date is within three months of the date insurance would have been effective and the person is still eligible

Insurance for you can remain in force until age 100: (a) premium contributions are not paid when due, (b) ASME membership ends, (c) the group coverage is terminated or modified by the Policyholder or New York Life Insurance Company to end insurance for the group of insureds to which you belong, and (d) you request to terminate insurance. In addition, dependent coverage will terminate when your coverage terminates, or when the eligibility requirements are no longer being met. Upon your death, coverage for your insured dependents may continue as described in the Certificate of Insurance.

The ASME Insurance Trust incurs costs in connection with this policy. To provide and maintain this valuable membership benefit, it is reimbursed for these costs. ASME also receives a fee for the license of its name and logo for use in connection with this policy.

How New York Life Obtains Information and Underwrites Your Request for Group Term Life Insurance

In this notice, references to “you” and “your” include any person proposed for insurance. Information regarding insurability will be treated as confidential. In considering whether the person(s) in your request for insurance qualify for insurance, we will rely on the medical information you provide, and on the information you AUTHORIZE us to obtain from your physician, other medical practitioners and facilities, other insurance companies to which you have applied for insurance and MIB, LLC. (“MIB”). MIB is a not-for-profit organization of insurance companies, which operates an information exchange on behalf of its members. If you apply for life or health insurance coverage or a claim for benefits is submitted to an MIB member company, medical or non-medical information may be given to MIB and such information may then be furnished by MIB, upon request, to a member company.

Your AUTHORIZATION may be used for a period of 24 months from the date you signed the application for insurance, unless sooner revoked. The AUTHORIZATION may be revoked at any time by notifying New York Life in writing at the address provided. Your revocation will not be effective to the extent New York Life or any other person already has disclosed or collected information or taken other action in reliance on it, or to the extent that New York Life has a legal right to contest a claim under an insurance certificate or the certificate itself. The information New York Life obtains through your AUTHORIZATION may become subject to further disclosure. For example, New York Life may be required to provide it to insurance, regulatory or other government agencies. In this case, the information may no longer be protected by the rules governing your AUTHORIZATION.

MIB and other insurance companies may also furnish New York Life, its subsidiaries or the Plan Administrator with non-medical information (such as driving records, past convictions, hazardous sport or aviation activity, use of alcohol or drugs, and other applications for insurance). The information provided may include information that may predate the time frame stated on the medical questions section, if any, on this application. This information may be used during the underwriting and claims processes, where permitted by law.

New York Life may release this information to the Plan Administrator, other insurance companies to which you may apply for life and health insurance, or to which a claim for benefits may be submitted and to others whom you authorize in writing. However, this will not be done in connection with test results concerning Acquired Immune Deficiency Syndrome (AIDS) or Human Immunodeficiency Virus (HIV). We may also make a brief report of your protected health information to MIB, but we will not disclose our underwriting decision.

New York Life will not disclose such information to anyone except those you authorize or where required or permitted by law. Information in our files may be seen by New York Life and Plan Administrator employees, but only on a “need to know” basis in considering your request. Upon receipt of all requested information, we will make a determination as to whether your request for insurance can be approved.

If we cannot provide the coverage you requested, we will tell you why. If you feel our information is inaccurate, you will be given a chance to correct or complete the information in our files. Upon written request to New York Life or MIB, you will be provided with non-medical information. Generally, medical information will be given either directly to the proposed insured or to a medical professional designated by the proposed insured. Your request is handled in accordance with the Federal Fair Credit Reporting Act procedures. If you question the accuracy of the information provided by MIB, you may contact MIB and seek a correction. MIB’s information office is: MIB, LLC. 50 Braintree Hill Park, Suite 400, Braintree, MA 02184-8734, telephone 866-692-6901. Information for consumers about MIB may be obtained on its Web site at www.mib.com.

For NM Residents: PROTECTED PERSONS¹ have a right of access to certain CONFIDENTIAL ABUSE INFORMATION² we maintain in our files and they may choose to receive such information directly. You have the right to register as a PROTECTED PERSON by sending a signed request to the Administrator at the address listed on the application. Please include your full name, date of birth and address.

¹PROTECTED PERSON means a victim of domestic abuse; who has notified us that he/she is or has been a victim of domestic abuse; and who is an insured or prospective insured person.

²CONFIDENTIAL ABUSE INFORMATION means information about: acts of domestic abuse or abuse status; the work or home address or telephone number of a victim of domestic abuse; or the status of an applicant or insured family member, employer or associate of a victim of domestic abuse or a person with whom the applicant or insured is known to have a direct, close, personal, family or abuse-related relationship.

New York Life Insurance Company

7/15 ed.

If we can provide the coverage you requested, we will inform you as to when such coverage will be effective. Under no circumstances will coverage be effective prior to this date. Payment of a premium contribution with your application does not mean that there is any insurance in force before the effective date as determined by New York Life Insurance Company.

Certificate Of Insurance

This information is only a brief description of the principal provisions and features of the Policy. The complete terms and conditions are set forth in the group policy issued by New York Life Insurance Company to the Trustee of the Life Insurance for Members of the American Society of Mechanical Engineers.

When you become insured, you will be sent a Certificate of Insurance summarizing your benefits under the policy.

30-DAY FREE LOOK

If you’re not completely satisfied with the terms of your Certificate of Insurance, you may return it, without claim, within 30 days. Your coverage will be invalidated, and you will receive a full refund, no questions asked!

ASME Insurance Trust is compensated in connection with this group policy to provide and maintain this valuable membership benefit, it is reimbursed for these costs. ASME also receives a fee for the license of its name and logo for use in connection with this policy.