Life and AD&D Benefit Summaries - 2025
When providing a Summary of Benefits (SOB) to an applicant or Blue Shield member, you must also include a Notice of Language Assistance. (PDF, 1 MB)
The following benefit summaries are for groups of 101 or more employees, effective 2025.
| Life plans | Benefit Summaries |
|---|---|
| Group Life and AD&D Insurance $15,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $20,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $25,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $30,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $35,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $40,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $50,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $60,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $65,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $75,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $80,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $100,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $120,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $125,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $150,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $175,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance $200,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 1 x Annual Salary to $100,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 1 x Annual Salary to $150,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 1 x Annual Salary to $200,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 1 x Annual Salary to $300,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 1 x Annual Salary to $500,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 2 x Annual Salary to $100,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 2 x Annual Salary to $150,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 2 x Annual Salary to $200,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 2 x Annual Salary to $300,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |
| Group Life and AD&D Insurance, 2 x Annual Salary to $500,000 | English (PDF, 150 KB) Spanish (PDF, 139 KB) |