Flexible Ancillary Solutions Coverage You Can Count On
Since 1991, Nippon Life Benefits has offered quality, customized employee benefits and is committed to exceptional service and care for our valued customers. We offer comprehensive, flexible ancillary coverage, including Dental, Life, Disability, and Vision, with multi-lingual support in Japanese, Korean, and Spanish. We have an AM Best Credit Rating of A- Excellent1.
As a U.S. subsidiary of Japan-based Nippon Life Insurance, we're backed by one of the world's largest mutual life insurers2, with over $656 billion in assets3 and an A+ (Superior) rating from AM Best.4
With competitive rates, extensive provider networks, and outstanding customer service, our plans are customized to meet your unique needs and budget.
Dental Provider Networks
With NLB Dental Network Access, your clients gain access to all participating providers from the nation’s top four dental networks, combined into one powerful, seamless solution.
Access to Aetna Dental, Careington, Connection Dental, and DenteMax networks
Over 500,000 participating locations nationwide
One seamless network experience
Dental Insurance
Our customizable dental solutions maximize your benefit dollars with comprehensive coverage and exceptional service. We offer Usual, Customary, and Reasonable (UCR) and Maximum Allowable Charge (MAC) options for utmost flexibility to meet your unique needs.
Vision (powered by EyeMed)
Our comprehensive vision plan provides affordable coverage for employees. It includes allowances for eye exams, lenses, frames, and contacts. With the extensive EyeMed Insight network, we offer access to 154,000 providers.
Life Insurance
We offer affordable Basic, Dependent, and Supplemental Life insurance coverage to employees and their families. Let us protect what matters most to you.
Accidental Death and Dismemberment
(AD&D)
We offer low-cost AD&D coverage for employees. This coverage provides additional protection in case of accidental loss of life, limb(s), or eyesight.
Disability Insurance
We provide both Short Term and Long Term disability coverage, ensuring you have the support you need during times of illness or injury.
Online Benefits management
Streamline benefits management with our user-friendly website, nipponlifebenefits.com, and our mobile app for on-the-go dental and vision coverage.
Dental Underwriting Guidelines ®
Discounts are available
• Dental Discount Program: Eligibility is based on coverage duration with the current dental provider and requires a minimum 50% employer contribution
• Packaging Discount: Progressive discounts are applied when dental coverage is bundled with one, two, or three additional lines of coverage
Required Enrollment
General Guidelines
Minimum group size is 2 enrolled employees as a stand-alone offering
Non-Takeover Benefits Groups having dental for the first time are limited to a maximum benefit of $3000
Takeover Benefits
Eligible Groups
Ineligible Groups
After two years of coverage with NLB, such groups can choose any dental maximum
Groups with prior dental coverage for at least 12 months qualify for takeover benefits
Eligible Groups are corporations, partnerships, and sole proprietorships where there is a clear employee / employer relationship
Multiple Employer Trust, Multiple Employer and Welfare Associations, Associations, Taft Hartley Welfare Funds, Employee Leasing Firms, Professional Sports Teams, Franchise Groups, and Professional Employee Organizations (PEOs) are not eligible for coverage with Nippon Life Benefits
Ineligible Employees Contract or 1099 employees, seasonal employees and temporary employees
Carve Out Groups 2 or more enrolled employees
Must be traditional group distinction (management / non-management, salaried / hourly, union / non-union, etc.)
Annual Open
Enrollment without deferred enrollment requirement
Dual Option
Minimum waiting period for timely entrants for Class III services and ortho
Standard on all plans
The minimum group size is 10 enrolled employees
At least one employee must be enrolled in each benefit offering
a) For adult ortho, it must be included on both plans
b) No rate guarantee (over 1 year) on either plan
c) Plan differential can’t be greater than 50% between high and low plan
12-month waiting period on major services for non-takeover groups with less than 5 enrolled employees
Employer Contribution If an employer contributes at least 50% of the employee premium, our contributory guidelines apply There is no dependent participation requirement
Participation 100% for non-contributory plans. Waivers permitted where allowed by state Contributory – greater of 2 enrolled employees or 25%
Eligibility
Dental coverage is available to full-time employees actively working a minimum of 30 hours per week With Underwriting approval, the number of hours may be modified. FL is 25+ hours per week
Dependent Coverage Employees must be enrolled with dental coverage before it is offered to their dependents
Dependent Age Our standard plans cover dependents to age 26 excluding FL which is up to age 30
Dental Underwriting Guidelines (Continued)
General Guidelines
Required Enrollment If experience isn’t available, then accounts up to 149 enrolled employees may be quoted in the field using manual rates
Underwriting approval is needed to quote any case of 150 or more enrolled employees
On accounts of 100 enrolled employees or more, OR for any size dental case that is currently ASO, if experience has been made available, NLB requires experience to be submitted to the HO to be reviewed prior to issuing a quote
We require:
• Current benefits
• Current rates
• Renewal rates (if available)
Rate Guarantee
And for the past two years:
• Paid premium
• Paid claims
• Monthly enrollment
One year guarantee is standard, but a two-year option is available
When a two-year rate option is offered, Nippon Life Benefits reserves the right to modify rates after one year if there has been a change in enrollment of 25%
Not available over 99 enrolled employees
No rate guarantees permitted in FL COBRA
No more than 20% of the covered enrolled employees may be on COBRA
Guidelines
• Available to transferred groups with 5 or more enrolled employees
• Non-transferred business for 5-9 enrolled employees is limited to child only coverage Benefit Maximum
Requires 10 or more enrolled employees, maximum coinsurance is 60% or less for major services, has in network deductible of at least $25 and must be takeover business Never applies to orthodontia
Out-of-Network
Available options: 90th, 80th, or MAC (Maximum Allowable Charge)
Missing Tooth Provision We will cover missing teeth provided the group has current group dental coverage and a minimum of five (5) enrolled employees on the Nippon Life Benefits dental plan. Requirements do not apply in CA, where missing teeth are always covered.
Voluntary Plans
Required Enrollment The minimum case size is 2 covered employees excluding NY which requires a minimum of 5 enrolled
Carve Out Groups Same group types subject to size and participation requirement for voluntary
Employer Contribution If an employer contributes less than 50% of the employee premium, our voluntary guidelines apply
Participation The greater of 2 enrolled employees or 25% of all eligible employees without consideration of waivers
Vision Underwriting Guidelines (Powered by EyeMed)
Our comprehensive vision plan provides affordable coverage for employees. It includes allowances for eye exams, lenses, frames, and contacts. With the extensive EyeMed Insight network, we offer access to 154,000 providers.
General Guidelines
Required Enrollment The minimum case size is 2 enrolled employees for voluntary For non-contributory plans, the minimum case size is 5 enrolled employees for stand-alone and 2 enrolled employees with another coverage
Eligible Groups
Eligible Groups are corporations, partnerships, and sole proprietorships where there is a clear employee / employer relationship
Ineligible Groups Multiple Employer Trust, Multiple Employer and Welfare Associations, Associations, Taft Hartley Welfare Funds, Employee Leasing Firms, Professional Sports Teams, Franchise Groups, and Professional Employee Organizations (PEOs) are not eligible for coverage with Nippon Life Benefits
Ineligible Employees Contract or 1099 employees, seasonal employees and temporary employees and retirees
Carve Out Groups
Employer Contribution
Minimum Participation
2 enrolled employees are subject to the minimum case size above Must use standard classifications, i.e., hourly / salaried, union / non-union, management / non-management
Non-Contributory plans have 100% employer contribution, and contributory have at least 50% employer contribution toward employee coverage Contribution is not required for dependents
Voluntary plans have less than 50% employer contribution toward employee coverage Waivers are permitted in states where they are not prohibited
25% subject to the minimum number of enrolled employees requirements outlined above
Eligibility Coverage is available to full-time employees actively working a minimum of 30 hours per week
Dependent Coverage Employees must be enrolled with vision coverage before it is offered to their dependents
Open Enrollment Standard
Employees may only join the plan at the annual enrollment period Once enrolled, benefits begin immediately with no waiting period
Dual Option Not allowed
Dependent Age
Rating for groups under 300 covered enrolled employees
Rating for groups with 300 or more covered enrolled employees with prior coverage
Dependent coverage is to age 26
Manual quotes will be provided on prospects up to 300 covered employees without Underwriting involvement
Must be referred to HO In addition to the census, we require:
• Current Benefits
• Current rates
• Renewal rates (if available)
And for the past two years:
• Paid premium
• Paid claims
• Monthly enrollment
If experience isn’t available, accounts up to 299 enrolled employees may be quoted in the field using manual rates
Underwriting approval is needed for any case of 300 or more enrolled employees
COBRA
No more than 20% of the covered enrolled employees may be on COBRA
Basic Life and AD&D Underwriting Guidelines
• Flat Plans: Equal insurance for all employees
• By Class: Benefits are based on specific employee classes (e.g., owners, managers, salary, hourly)
• Multiple of Earnings Plans: Insurance based on a multiple of annual earnings. Options for varying levels by occupation, salary, or service length. Voluntary plans available
General Guidelines
Required Enrollment 2 enrolled employees sold in combination with Medical, Dental, Disability, or Vision 5 or more as a stand-alone offering
Minimum Number of Hours Minimum of 30 hours per week excluding FL which is 25+
Years in Business No requirement Will write start-up plans
Participation Requirements 75% participation required if contributory 100% participation is required if the benefit is totally employer-paid
Employer Contribution Requirements Minimum of 50% employer contribution for employee coverage
Carve Outs 2 enrolled employees or more Must be based on common classifications, i.e., hourly / salaried, management / non-management / non-union / union, etc.
Employer Contribution Requirements 50% or more employer contribution
Eligible Groups Eligible groups are corporations, partnerships, and sole proprietorships where there is a clear employee / employer relationship
Multiple Employer Trust, Multiple Employer Welfare Associations, Associations, Taft Hartley Welfare Funds, Employee Leasing Firms, and Professional Employee Organizations (PEO) are not eligible for Life coverage with Nippon Life Benefits
Eligible Employees Owners, sole proprietors, partners, officers, trustees, and directors are eligible only if they qualify as fulltime employees (30 hours) Part-time, temporary, 1099 employees, and seasonal employees are not eligible for coverage
Accidental Death and Dismemberment Benefit May be provided in an amount equal to the Basic Life benefit If purchased, it is packaged with Life Insurance (not free-standing)
2-9 enrolled employees 10-49 enrolled employees 50-99 enrolled employees 100+ enrolled employees
$50,000
$100,000
$150,000 Based on formula
Available Plan Designs Flat schedules cover all employees for the same benefit in any $5,000 increment from $10,000 up until the maximum amount permitted for the number of employees covered. Scheduled plans based on class (i.e., salaried / hourly, management / non-management). The occupational classes should be clearly defined, and the amounts of insurance should be smoothly graded. Benefits must be proportionate to income levels. No benefit in any one class should be any higher than 4 times the next lowest class, and no more than 16 times between the lowest class and the highest class when there are multiple classes. The benefit is generally based on base salary but can include overtime pay, commissions, bonuses, etc.
Basic Life and AD&D Underwriting Guidelines (Continued)
• Eligible dependents are a lawful spouse and unmarried children from 14 days to age 19 (or age 26 if a full-time student at an accredited school, college, or university)
• The employee must be enrolled for a dependent to have coverage
• Below requirements are based on enrolled employees
or
or
For dependents age 70 and over, the GI will be the lesser of $20,000 or 50% of the employee’s amount
• Lessor of $10,000 or 50% of spouse (min of $2,500)
• If the spouse is not covered, the child benefit is 25% of an employee with a minimum of $2,500 & a maximum of $10,000 based on group size
• 14 days to 6 months benefit is $100
Supplemental and Voluntary Life Underwriting Guidelines
• Flat Plans: Equal insurance for all employees
• By Class: Benefits are based on specific employee classes (e.g., owners, managers, salary, hourly)
• Multiple of Earnings Plans: Insurance based on a multiple of annual earnings. Options for varying levels by occupation, salary, or service length
Required Enrollment
Rating
Minimum Number of hours
Years in Business
Waiting Period Requirement
Participation Requirements
Employer Contribution Requirements
Carve Outs
Eligible Groups
Minimum of 5 enrolled employees
Rate using current enrollment if known
Use eligible enrollment if unknown or if this is a new offering
Final rates will be based on actual enrollment
Minimum of 30 hours per week
It can vary with Underwriting approval
FL is 25+ hours per week
No requirement
We will write start up plans
No waiting period requirement
Greater of 25% participation or 5 enrolled employees
No employer contribution requirement
5 enrolled employees minimum
Must be based on common classifications, i.e., hourly / salaried, management / non-management / non-union / union, etc.
Eligible Groups are corporations, partnerships, and sole proprietorships where there is a clear employee / employer relationship
Multiple Employer Trust, Multiple Employer and Welfare Associations, Associations, Taft Hartley Welfare Funds, Employee Leasing Firms, and Professional Employee Organizations (PEO) are not eligible for Life coverage with Nippon Life Benefits
Eligible Employees owners, sole proprietors, partners, officers, trustees, and directors are eligible only if they qualify as full-time employees (30 hours)
Part-time, temporary, 1099 employees and seasonal employees are not eligible for coverage
Retired Employees
Accidental Death and Dismemberment Benefit
Not Eligible
May be provided in an amount equal to the Basic Life benefit If purchased, it is packaged with Life Insurance (not free-standing)
Other Requirements Supplemental Life is sold with Basic Life Voluntary is sold without Basic Life
Rate Guarantee 2 years
Maximum Benefit
5 – 99 enrolled employees $300,000
• Overall maximum of $300,000 for Supplemental and Voluntary Life
• Overall maximum of $600,000 for Basic and Supplemental Life combined
• The Supplemental or Voluntary benefit may not exceed 4 times the salary
Supplemental and Voluntary Life Underwriting Guidelines (Continued)
General Guidelines
Guarantee Issue Amounts: Participation 5-99 Enrolled employees
• 5-9 covered
• 10 or more covered
100+
• 25-34%
• 35-49%
• 50% or more
Available Plan Designs
Dependent Life Benefit
Dependent Participation Requirement
Minimum Dependent Spouse Benefit
Maximum Dependent Spouse Benefit
Guarantee Issue Amount for Spouse
Dependent Child Benefit
Maximum Benefit Limitation
$50,000
$100,000
$100,000
$200,000
$300,000
• Employers can choose a flat schedule or a multiple of earnings plan (1-4 times salary)
• Benefits are generally based on base salary but may include overtime, bonuses, and commissions if based on multiple of earnings
• Eligible dependents are a lawful spouse and unmarried children from 14 days to age 26
There is no participation requirement for Supplemental and Voluntary Dependent Life; however, the employee must purchase Supplemental or Voluntary Life
$5,000
• 5-49 enrolled employees Lesser of $50,000 or 50% of employee benefit
• 50-99 enrolled employees Lesser of $75,000 or 50% of employee benefit
• 100+ enrolled employees Lesser of $100,000 or 50% of employee benefit
• 5-99 enrolled employees
$25,000
• 100+ enrolled employees $50,000 For dependents age 70 or over, the GI is $10,000
• Over 6 months lessor of $10,000 or 50% of spouse (Minimum of $2,000)
• Ages 14 days to 6 months benefit is $100
• If the spouse is not enrolled for coverage, the benefit is 25% of the employee benefit
• Dependent Child benefit is guarantee issue
• Spouse benefit may not exceed 50% of the employee benefit
• Child benefit may not exceed 50% of spouse benefit
• If the spouse is not covered, the child benefit is 25% of an employee with a minimum of $2,000 and a maximum of $10,000
Short Term Disability Underwriting Guidelines
• Multiple plan options with the flexibility to customize coverage to employer groups
• Programs focus on both partial income replacement and employee rehabilitation
• Disability claim experts go above and beyond to help employees return to work
General Guidelines
Required Enrollment 2+ enrolled employees (Stand-alone 5+ enrolled)
Years in Business 2 year requirement
Participation Requirements
• Noncontributory 100% of eligible employees
• Contributory 75% of eligible employees
• Voluntary greater of 5 enrolled or 25% of eligible employees
Participation in Workers’ Compensation and SSDI Required
Benefit Percent 50%, 60%, 66 2/3%, 20% with no offset
Maximum Weekly Benefit 2-9 enrolled employees:
• Coverage up to $2500 weekly
• Guarantee Issue: $1500 weekly 10-99 enrolled employees:
• Coverage up to $2500 weekly
• Guarantee Issue: $2500 weekly
Minimum Benefit Percent for SDI States 20% with no offsets
Integration Family Social Security plus all other eligible policy other income offsets
Elimination Period 2+enrolled employees: 0/7, 7/7, 7/14,14/14 or 29/29-day EP options
Definition of Disability Partial with an 80% earnings test
Benefit Duration
• 2-9 enrolled employees: 13 or 26 week options
• 10-99 enrolled employees: 13, 26, or 52 week options
Pre-Ex 3 / 12 (may vary depending on state requirements)
Carve Outs 2 enrolled employees or more
Rate Guarantee 2 years
Eligible Employees Owners, sole proprietors, partners, officers, trustees, and directors are eligible only if they qualify as full-time employees (30 hours)
Part-time, temporary, 1099 employees and seasonal employees are not eligible for coverage
Eligible Groups Eligible groups are corporations, partnerships, and sole proprietorships where there is a clear employee / employer relationship
Long Term Disability Underwriting Guidelines
• Multiple plan options with the flexibility to customize coverage to employer groups
• Programs focus on both partial income replacement and employee rehabilitation
• Disability claim experts go above and beyond to help employees return to work
Minimum Employer Contribution %
Participation in Workers’ Compensation and SSDI Required
Participation Requirements
• Less than 6 eligible employees requires 100%
• Noncontributory 100% of eligible employees
• Contributory 75% of eligible employees
• Voluntary greater of 10 enrolled or 25% of eligible employees
Maximum Monthly Benefit
Highest monthly maximums available with underwriting approval; highest available maximum based on top 3 salaries
Minimum Monthly Benefit
• Coverage up to $6,000 monthly for 2-9 enrolled
• Guarantee Issue: $6,000 monthly for 2-9 enrolled
• Coverage up to $7,500 monthly for 10+ enrolled
• Guarantee Issue: $7,500 monthly for 10+ enrolled
of 10% of gross monthly benefit and $100 (May vary based on state requirements)
Long Term Disability Underwriting Guidelines (Continued)
• Multiple plan options with the flexibility to customize coverage to employer groups
• Programs focus on both partial income replacement and employee rehabilitation
• Disability claim experts go above and beyond to help employees return to work
Eligible Groups Corporations, partnerships and sole proprietorships where there is a clear employee / employer relationship
Eligible Employees Owners, sole proprietors, partners, officers, trustees, and directors are eligible only if they qualify as full-time employees (30 hours) Part-time, temporary, 1099 employees, and seasonal employees are not eligible for coverage
Ineligible Industries: STD & LTD
Policy Series NP 5500, et al, and Booklet-Certificate Series NBM 5100, et al is underwritten by Nippon Life Insurance Company of A merica®marketing name Nippon Life Benefits®, NAIC number 81264, licensed & authorized in all states plus DC, except not ME, NH or WY, domiciled in Iowa, with a principal place of business at 666 Third Avenue, Suite 2201, NY, NY 10017. Nippon Life Benefits is a member company (subsidiary) of Japan -based Nippon Life Insurance Company. Nippon Life Benefits is responsible for its own financial condition and contractual obligations. Benefits may vary by state. For costs and an y further details of coverage, including exclusions, any reductions or limitations, and the terms under which the policy may be continued in force, see your Nippon Life Benefits representative.