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2024 Employee Benefit Guide
____________________________________________thrivesonbalance–balancingprofessionalandpersonalworlds–balancingworkandrest–whilealwaysbalancingcostandvalue.Wealsounderstandthatbalancemustbeindividualized.Whatisrightforonepersonmaynotbeappropriateforanother.Itisourgoaltoofferchoicesallowingyoutotailoryourbenefitsplanspecificallytowhatisbestforyouandyourfamilymembers.YourChoices___ Providesacompletepackageofbenefitsaimedatprovidingflexibleinsuranceprotectionandprogramstomeetyourever-changingneeds.___ sharesthecostofsomebenefitswithyou,whilemakingadditionalbenefitsavailablethatyoupayforifyouchoosetoenroll.Thepartofthebenefitcoststhatyouareresponsibleforwillbeautomaticallydeductedfromyourpaycheck,eitherbeforeorafteryourtaxesarecalculated.BenefitPre-TaxorPostTaxWhopaysthecost?WhydoIpayforsomebenefitswithbefore-taxmoney?Whilenotallbenefitsqualifyforpre-taxcontribution,thereisadefiniteadvantagetopayingforthosethatdo:Takingthemoneyoutbeforeyourtaxesarecalculatedlowerstheamountofyourtaxableincome.Therefore,youpaylessintaxes.HowYourBenefitsWorkFull-timeemployeesareeligibleformostbenefitson_____________________________________ofhire.MakingChangesGenerally,youcanonlychangeyourbenefitschoicesduringtheannualBenefitsEnrollmentPeriod.However,youcanchangeyourbenefitschoicesduringtheyearifyouhavealifeeventchange.Lifeeventchangesincludebutarenotlimitedto:· Marriage· Divorce· Birth,adoption,orplacementforadoptionofaneligiblechild· Deathofyourspouseorcoveredchild· Changeinyouoryourspouse’sworkstatusthatresultsincancellationofyourbenefits· BecomingeligibleforMedicareorMedicaidduringtheyearIfyouhavealifeeventchange,youmustnotifyHumanResourceswithin31daysofthechange(forexample,amarriageorbirthcertificate).Ifyoudo notnotifyHumanResourceswithin31days,youwillhavetowaituntilthenextannualOpenEnrollmentperiodtomakebenefitschangesunlessyouhaveanotherlifeeventchange.Anychangesyoumaketoyourbenefitchoicesmustbedirectlyrelatedtothelifeeventchange.Accurate Meter & SupplyAccurate Meter & SupplyAccurate Meter & Supplythe first day of the month following 60 daysAccurate Meter & SupplyPre-Tax Employer SharedPre-Tax Employee PaidPre-Tax Employee PaidHealth InsuranceDental InsuranceVision InsuranceEmployer PaidN/AEmployee PaidPost-TaxEmployee PaidPost-TaxEmployee PaidPost-TaxEmployee PaidEmployee PaidPost-TaxPost-TaxBasic Life - 25kVoluntary LifeAccidentCritical IllnessHospitalShort Term Dis.Long Term Dis.Employer PaidPost-Tax
PortabilityIfyouleavethecompany,someofyourbenefitsendandsomeofyourbenefitsareportable.Thismeansyoucantakethemwithyouifyouleave,aslongasyoucontinuetopaythepremiumsyourself.Onceterminated,youwillbenotifiedthroughthemailifanyofyourbenefitsareportable.WhenCoverageEndsBenefitsendonthelastdayofthemonthfollowingterminationorwhenyouceasetomeeteligibilityguidelines. Lookingahead……Nowlet’slookateachbenefitthatmakesupthebenefitsprogram.Inthefollowingpages,you’lllearnmoreaboutthevaluablebenefitsyouremployeroffers.You’llalsoseehowchoosingtherightcombinationofbenefitscanhelpprotectyouandyourfamily’shealth.NOTES:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Continuing Your CoverageUndercertaincircumstances,youmay continue yourhealthcarecoveragewhenitwouldotherwiseend.ThisiscalledCobraappliestotheseplans:· HealthInsurance· DentalInsurance· VisionInsuranceWhencan I continue coverage under____________________?Youand/oryourdependentsareeligibletocontinuehealthcarecoverageunder________________________If coverageislostbecause:· Your employment endsforanyreasonother than“grossmisconduct”.· Yourworkhours are significantlyreduced.· Youdie.· Youbecome entitled toandenrollinMedicarepriortolosingcoverage.· Youdivorceorbecomelegallyseparatedfromyourspouse.· Yourdependentlosesdependentstatus.________________CobraCobraCobraAccurate Meter & Supply
OutInOutInDeductible $10,000$3,000$10,000$6,000Family Deductible $20,000$9,000$20,000$15,800Coinsurance 60%80%50%80%Out-Of-Pocket Unlimited$8,150 ($16,300)Unlimited$8,150 ($16,300)Office Visit 60% After Ded.$35 Copay50% After Ded.$40 CopaySpecialty Doctor Office Visit 60% After Ded.$70 Copay50% After Ded.$80 CopayInpatient Hospital Services 60% After Ded.80% After Ded.50% After Ded.80% After Ded.Diagnostic Lab & X-Ray 60% After Ded.No Charge50% After Ded.80% After Ded.Advanced Imagining 60% After Ded.80% After Ded.50% After Ded.80% After Ded.Urgent Care 60% After Ded.$75 Copay50% After Ded.$75 CopayEmergency Room$500 Copay + 80% After Ded.As INN$500 Copay + 80% After Ded.As INN10/20/70/120/150/2500/10/50/100/150/25010/20/70/120/150/2500/10/50/100/150/250RXEmployee OnlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyBi-Weekly Rate$643.53$363.19$454.27$35.47$0.00Bi-Weekly RateBCBS PPOBCBS PPO$285.28$362.58$509.40MTBCB044MTBCP028
Accurate Utility SupplyAll Eligible EmployeesGroup Number: 00058303Everyone deserves a GuardianEvery day, Guardian gives 26 million Americans thesecurity they deserve through our insurance andwealth management products and services.We’ve partnered with your organization to offeryou a range of employee benefits. Inside this pack,you’ll find the plans your employer thinks you mightbenefit from.Know your benefitsYour benefits support your physical andfinancial wellbeing, to help keep you andyour loved ones protected.With Guardian, you’re in good hands.We’ve been delivering on our promises forover 150 years, and we’re looking forwardto doing the same for you too.Read through this information.Find out more about your benefits.Talk to your employer if you needhelp or have any questions.Customer Service (888) 600-1600Monday to Friday | 8am to 8:30pm ET 123This document is a summary of the major features of the insurancecoverage that's been agreed to with your employer – it isn't your contract.© Copyright 2020 The Guardian Life Insurance Company of AmericaWorkplace benefitsWelcome toYour coverage optionsDentalinsuranceTaking care of teeth andoverall healthVisioninsuranceLooking after youreyesightand relatedhealth issuesLifeinsuranceProtecting yourfamily'sfinancial futureDisabilityinsuranceCoverage ifyou're temporarilyunable to workCritical illnessinsuranceTakingcare of the expenses ifyou're critically illAccidentinsuranceHelpingyou cover expensesafter an accidentHospital indemnityinsuranceCovering someof yourhospitalstaycosts
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Watch our videoLearn how dental insurance canprotect your long-term health.DentalinsuranceTaking care of your teeth is about morethan just covering cavities and cleanings.It also means accounting for more expensivedental work, and your overall health.With dental insurance, routine preventive care can lead tobetter overall health. And you’ll be able to save money if anyextensive dental work is required.Who is it for?Everyone should have access to great dental coverage, which is why weoffer comprehensive plans that are available through employers as part ofyour benefit offerings.What does it cover?Dental insurance helps to protect your overall oral care. That includesservices like preventive cleanings, x-rays, restorative services like fillings,and other more serious forms of oral surgery if you ever need them.Why should I consider it?Poor oral health isn’t just aesthetic, it’s also been linked to conditionsincluding diabetes, heart disease, and strokes. So, while brushing andflossing every day can help keep your teeth clean, nothing should replaceregular visits to the dentist.You willreceive these benefits if you meet theconditions listedin the policy.Staying healthyJoe visits his dentist fora routinedental cleaning, totake care of histeeth as well as his overall health.Oral health is about more than justteeth and gums. It’s also essentialfor a range of other health andwellbeing reasons:Cardiovascular disease: Someresearch suggests that heartdisease, clogged arteries, andstrokes may be linked toinflammation and infectionsfrom oral bacteria.Osteoporosis: Weak and brittlebones may be linked to tooth loss.Diabetes: Research shows thatpeople with gum disease find itmore difficult to control theirblood sugar levels.Alzheimer’s disease: Worseningoral health is seen as Alzheimer'sdisease progresses.All information contained here isfrom the Mayo Clinic, Oral Health:A Window to Your Overall Health,www.mayoclinic.com. 2021.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-157076 (07/25)3
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITYSUPPLY Kit created 11/17/2023All Eligible Employees Group number:00058303Your dental coveragePPO plan, you'll have access to one of the largest networks of dentists with two reimbursement levels that give you more controlover savings. You will always save money with any dentist in Guardian's network and when they belong to a tier in the Tier 1reimbursement level you will maximize your savings. Reimbursement for covered services received from a non-contracted dentistwill be based on a percentile of the prevailing fee data for the dentist's zip code.Your Dental Plan PPOTier 1 Tier 2Your Network is DentalGuard Preferred NetworkIn-Network Out-of-NetworkCalendar year deductibleTier 1 Tier 2Individual $50 $50Family limit 3 per family (applies to all levels)Waived for Preventive PreventiveCharges covered for you (co-insurance)Tier 1 Tier 2Preventive Care 100% 100%Basic Care 80% 80%Major Care 50% 50%Orthodontia Not Covered (applies to all levels)Annual Maximum Benefit$1500 (applies to all levels)Maximum RolloverYes (applies to all levels)Rollover Threshold $700Rollover Amount $350Rollover Account Limit $1250Lifetime Orthodontia MaximumNot Applicable (applies to all levels)Dependent Age Limits26 (applies to all levels)4
A Sample of Services Covered by Your PlanYour dental coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/23All Eligible Employees Group number:00058303PPOPlan pays (on average)Tier 1 Tier 2Preventive Care Cleaning (prophylaxis) 100% 100%Frequency:2 in 12 Months (applies to all levels)Fluoride Treatments 100% 100%Limits: No Age Limits (applies to all levels)Oral Exams 100% 100%Sealants (per tooth) 100% 100%X-rays 100% 100%X-rays other than bitewings inBasic 80%Basic CareFillings‡ 80% 80%Simple Extractions 80% 80%Major Care Anesthesia* 50% 50%Bridges and Dentures 50% 50%Dental Implants 50% 50%Inlays, Onlays, Veneers** 50% 50%Perio Surgery 50% 50%Periodontal Maintenance 50% 50%Frequency: Once Every 6 Months (applies to alllevels)Repair & Maintenance ofCrowns, Bridges & Dentures50% 50%Root Canal 50% 50%Scaling & Root Planing (per quadrant) 50% 50%Single Crowns 50% 50%Surgical Extractions 50% 50%Deferred Services for Future Employees Major Services - 12 MonthsGuardian’s Preferred Provider Organization consists of Dentists in the DentalGuard Preferred (“DGP”) network. These tiersrepresent specific benefit levels as described in Your Schedule of Benefits. Network access varies by geographic location and zip code.Please visit www.Guardianlife.com to confirm your Dentist’s tiered participation.This is only a partial list of dental services. Your certificate of benefits will show exactly what is covered and excluded. **For PPO andor Indemnity members, Crowns, Inlays, Onlays and Labial Veneers are covered only when needed because of decay or injury or otherpathology when the tooth cannot be restored with amalgam or composite filing material. When Orthodontia coverage is for"Child(ren)" only, the orthodontic appliance must be placed prior to the age limit set by your plan; If full-time status is required byyour plan in order to remain insured after a certain age; then orthodontic maintenance may continue as long as full-time student statusis maintained. If Orthodontia coverage is for "Adults and Child(ren)" this limitation does not apply. *General Anesthesia – restrictionsapply. ‡For PPO and or Indemnity members, Fillings – restrictions may apply to composite fillings.5
Your dental coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/23All Eligible Employees Group number: 00058303Manage Your Benefits:Go to www.Guardianlife.com to access secure information aboutyour Guardian benefits including access to an image of your IDCard. Your on-line account will be set up within 30 days after yourplan effective date.Find A Dentist:Visit www.Guardianlife.comClick on “Find A Provider”; You will need to know your plan, whichcan be found on the first page of your dental benefit summary.Need Assistance?Call the Guardian Helpline (888) 600-1600, weekdays,8:00 AM to 8:30 PM, EST. Refer to your member ID (socialsecurity number) and your plan number: 00058303Please call the Guardian Helpline if you need to useyour benefits within 30 days of plan effective date.Please note, self-serve options over the phone oronline at Guardian Anytime are not available until thecase is fully implemented, please wait to speak to alive agent when calling the Guardian Helpline.EXCLUSIONS AND LIMITATIONSnImportant Information about Guardian’s DentalGuard Indemnity andDentalGuard Preferred Network PPO plans: This policy provides dentalinsurance only. Coverage is limited to those charges that are necessary toprevent, diagnose or treat dental disease, defect, or injury. Deductibles apply.The plan does not pay for: oral hygiene services (except as covered underpreventive services), orthodontia (unless expressly provided for), cosmetic orexperimental treatments (unless they are expressly provided for), anytreatments to the extent benefits are payable by any other payor or for whichno charge is made, prosthetic devices unless certain conditions are met, andservices ancillary to surgical treatment. The plan limits benefits for diagnosticconsultations and for preventive, restorative, endodontic, periodontic, andprosthodontic services. The services, exclusions and limitations listed above donot constitute a contract and are a summary only. The Guardian plandocuments are the final arbiter of coverage. Contract # DG7-P et al.DentalGuard Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in allstates. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter ofcoverage. This policy provides DENTAL insurance only.Policy Form # GP-1-DG2000, et al, GP-1-DEN-166
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of Americaguardianlife.com© Copyright 2023 The Guardian Life Insurance Company of AmericaDepending on a plan’s annual maximum, if claims made for acertain year don’t reach a specied threshold, then the setmaximum rollover amount can be rolled over.How maximum rollover works*Submit a claim (withoutexceeding the paid claimsthreshold of a benet year),and Guardian will roll overa portion of your unusedannual dental maximum.Automatic rolloverOral HealthRewardsProgramRegular visits to the dentist can help preventand detect the early signs of serious diseases.That’s why Guardian’s Maximum Rollover Oral Health RewardsProgram encourages and rewards members who visit thedentist, by rolling over part of your unused annual maximuminto a Maximum Rollover Account (MRA). This can be used infuture years if your plan’s annual maximum is reached.* This example has been created for illustrative purposes only.** If a plan has a dierent annual maximum for PPO benets vs. non-PPO benets, ($1500 PPO/$1000 non-PPO for example) the non-PPO maximumdetermines the Maximum Rollover plan. May not be available in all states.Guardian’s Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in allstates. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the nal arbiter of coverage.Information provided in this communication is for informational purposes only. Dental Policy Form No. GP-1-DEN-16. GUARDIAN® is a registered service markof The Guardian Life Insurance Company of America ® ©Copyright 2023 The Guardian Life Insurance Company of America.2023-158786 (07/25)Plan annualmaximum**Threshold Maximumrollover amountMaximum rolloveraccount limit$1,500Maximum claimsreimburesment$700Claims amount thatdetermines rollover eligibility$350Additional dollars added toa plan’s annual maximumfor future years$1,250The limit that cannotbe exceeded within themaximum rollover account7
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Watch our videoHow vision insurance can helpyou see clearly as you get older.VisioninsuranceVision insurance helps protect thehealth of your eyes by providing coveragefor benefits that often aren’t coveredby regular medical insurance.Protecting your eyesight means allowing for routine visitsto the optometrist for eye exams, as well as coverage forglasses and contacts. Make sure your eyes remain in greatshape at any age – no matter how much time you spendstaring at digital screens.Who is it for?Even if you have perfect eyesight, it’s important to have regular eye examsto make sure you’re still seeing clearly. Most of us may eventually needvision correction, which is why we offer vision insurance to cover some ofthe costs.What does it cover?Vision insurance covers benefits not typically included in medical insuranceplans. It covers things like routine eye exams, allowances towards thepurchase of eyeglasses and contact lenses, as well as discounts oncorrective Lasik surgery.Why should I consider it?Regular eye exams can detect more than failing eyesight, they can also pickup diseases like glaucoma and diabetes. Vision problems are one of themost prevalent disabilities in the United States, making vision insuranceespecially useful for anyone who regularly needs to purchase eyeglasses orcontacts, or anyone who simply wants to help protect their eyesight andgeneral health.You willreceive these benefits if you meet theconditions listedin the policy.20/20 coverageDavidnotices thathisvision isdeteriorating. He goes in for an eyeexam, and is diagnosedwith myopia,which means he needsglasses.Average cost of vision exam: $171Average cost of frames andlenses: $350Total cost: $521With a Vision policyfrom Guardian,Davidpaysjust $10 forhis eye exam.After$25 incopay, his lenses are fullycovered, and he pays $96 for hisframes.David’s total out-of-pocket expenseis $131, saving him $390.This example is for illustrativepurposes only. Your plan’s coveragemay vary. See your plan’sinformationon the following pages for specificamounts and details.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158788 (07/25)9
Your vision coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Group number:00058303Option 1: Significant out-of-pocket savings available with your Full Feature plan by visiting one of Davis Vision's networklocations including retail centers such as Costco®, Wal-Mart®, JCPenney®, Target®, Sam’s Club®, Pearle®, Visionworks®. You canalso use your network benefits online at Visionworks®.com, glasses®.com, WarbyParker®.com, or 1800contacts®.com.Your Vision PlanFull Feature - DesignerYour Network is Davis VisionYour Bi-weekly premium $ 3.02You and Spouse $ 5.73You and Child(ren) $ 5.83You, Spouse and Child(ren) $ 9.24CopayExams Copay $ 10Materials Copay (waived for elective contact lenses) $ 10Sample of Covered Services You pay (after copay if applicable):In-network Out-of-networkEye Exams $0 Amount over $50Single Vision Lenses $0 Amount over $48Lined Bifocal Lenses $0 Amount over $67Lined Trifocal Lenses $0 Amount over $86Lenticular Lenses $0 Amount over $126Frames 80% of amount over $130*² Amount over $48Contact Lenses (Elective and conventional) 85% of amount over $130* Amount over $105Contact Lenses (Planned replacement and disposable) 85% of amount over $130* Amount over $105Contact Lenses (Medically Necessary) $0 Amount over $210Cosmetic Extras Avg. 40-60% off retail price No discountsGlasses (Additional pair of frames and lenses) 50% at Visionworks and 30% at otherin network providersNo discountsLaser Correction Surgery Discount Savings of 40-50% off national averageprice thru Davis laser vision networkNo discountsService FrequenciesExams Every calendar yearLenses (for glasses or contact lenses)‡‡ Every calendar yearFrames Every calendar yearNetwork discounts (glasses and contact lens professional service) Applies to first purchase & courtesy discount from most providers onsubsequent purchases.Dependent Age Limits 26Visit www.Guardianlife.com and click on “Find a Provider”This is only a partial list of vision services. Your certificate of benefits will show exactly what is covered and excluded.10
Your vision coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Group number: 00058303Davis•‡‡Benefit includes coverage for glasses or contact lenses, not both.•Contact lenses from Davis Vision's Collection are available at most private practice locations with Full Feature and Materials Only plans. Contacts from the collectionare covered in full including fitting and evaluation, in excess of the plan's materials copay. Elective contacts that are not part of the Collection are covered up to theplan's elective contact lens allowance and the materials copay is waived.•*Additional discounts are not available at all private practice locations. Costco, Walmart, Sam’s Club, glasses.com, and 1800contacts.com do not allow additionaldiscounts.•For Davis Vision, complete eyeglasses must be purchased at one time from one provider. For example, if a member purchases only lenses, he or she cannotpurchase frames later in the same benefit period. The member is not eligible for new vision materials until the next benefit period. Only charges for an initialpurchase can be used toward the material allowance. Any unused balance remaining after the initial purchase cannot be banked for future use.•2Extra $50 at Visionworks stores and at Visionworks.com.•In Network Routine Retinal Screening Covered after no more than a $39 copay.•Members can use their in network benefits at visionworks.com, warbyparker.com, glasses.com, and 1800contacts.com. Additional discounts are not available atglasses.com or 1800contacts.com. Discounts may vary at Warby Parker.EXCLUSIONS AND LIMITATIONSImportant Information: This policy provides vision care limited benefits healthinsurance only. It does not provide basic hospital, basic medical or majormedical insurance as defined by the New York State Insurance Department.Coverage is limited to those charges that are necessary for a routine visionexamination. Co-pays apply. The plan does not pay for: orthoptics or visiontraining and any associated supplemental testing; medical or surgical treatmentof the eye; and eye examination or corrective eyewear required by anemployer as a condition of employment; replacement of lenses and framesthat are furnished under this plan, which are lost or broken (except at normalintervals when services are otherwise available or a warranty exists). The planlimits benefits for blended lenses, oversized lenses, photochromic lenses,tinted lenses, progressive multifocal lenses, coated or laminated lenses, aframe that exceeds plan allowance, cosmetic lenses; U-V protected lenses andoptional cosmetic processes.The services, exclusions and limitations listed above do not constitute a contractand are a summary only. The Guardian plan documents are the final arbiter ofcoverage. Contract #GP-1-DAVIS-05-VIS et al.Laser Correction Surgery:In Network savings of 40-50% off national average price of traditional Lasik areavailable at over 1000 locations across the Davis nationwide network of laservision correction providersLaser surgery is not an insured benefit. The surgery is available at a discountedfee. The covered person must pay the entire discounted fee. In addition, thelaser surgery discount may not be available in all states.Guardian’s Vision Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in allstates. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. This policy provides vision care limited benefits healthinsurance only. It does NOT provide basic hospital, basic medical or major medical insurance as defined by the New York State Department of FinancialServices. Plan documents are the final arbiter of coverage.Policy Form # GP-1-GVSN-1711
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Watch our videoHow life insurance protectsfamilies and covers critical costs.LifeinsuranceIf something happens to you, lifeinsurance can help your familyreduce financial stress.Lifeinsurance helpsprotect your family’sfinances byprovidinga cash benefitifyou passaway. Thisensuresthatthey’ll befinancially supported, andcancoverimportant things frombillsto funeral costs. With life policies, youcanget affordablelifeinsurance protectionfor a setperiodof time.Who is it for?Everyone’s life insurance needs are different, depending on their familysituation. That’s why group life insurance through an employer is an easierand more affordable option than individual life insurance.What does it cover?Life insurance protects your loved ones by providing a benefit(which is usually tax-exempt) if you pass away.Why should I consider it?Life insurance is about more than just covering expenses. Dependingon your circumstances, it could take your family years to recover from theloss of your income.With a life insurance benefit, your family will have extra money to covermortgage and rent payments, legal or medical fees, childcare, tuition,and any outstanding debts.Guardian,itssubsidiaries, agents,and employeesdonot providetax,legal,or accountingadvice. Consult your tax, legal,or accountingprofessionalregardingyourindividual situation.Preparing and planningJorge’sneverconsidered purchasinglife insurance, butafter being offered itthrough work,he decides it’s a smartway toprotecthis family.Jorge has a mortgage, and becausehis wife is helping to take care of hermother, she only works part-time. Inaddition,his daughter is about tostart college.Jorge looks at how his family wouldbe affected by losing him.Average funeral cost: $9,000Average mortgage debt: $202,000Average cost of college: $17,000 -$44,000Average household credit card debt:$8,500With life insurance, Jorge canmake sure that part of thesecosts are covered if somethinghappens to him.This example is forillustrativepurposesonly.Your plan’scoveragemay vary. See your plan’sinformationonthe following pagesfor specificamounts and details.You willreceive thesebenefitsif you meetthe conditionslistedin the policy.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158796 (07/25)13
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Your life coverageBASIC LIFE VOLUNTARY TERM LIFEEmployee Benefit Your employer provides $25,000Basic Term Life coverage for allfull time employees.$10,000 increments to amaximum of $500,000. See CostIllustration page for details.Accidental Death and Dismemberment Your Basic Life coverage includesAccidental Death andDismemberment coverage.Employee, Spouse & Child(ren)coverage. Maximum 1 times lifeamount.Spouse Benefit N/A $1,000 increments to a maximumof $250,000. See Cost Illustrationpage for details.‡Child Benefit N/A Your dependent children agebirth† to 26 years.$1,000 increments to a maximumof $10,000. Subject to state limits.See Cost Illustration page fordetails.Guarantee Issue: The ‘guarantee’ means you are not required toanswer health questions to qualify for coverage up to and includingthe specified amount, when you sign up for coverage during the initialenrollment period.Guarantee Issue coverage up to$25,000 per employeeWe Guarantee Issue coverage upto:Employee Less than age 65$100,000, 65-69 $50,000, 70+$10,000.Spouse Less than age 65 $25,000,65-69 $10,000, 70+ $0.Dependent children $10,000.Premiums Covered by your company if youmeet eligibility requirementsIncrease on plan anniversary afteryou enter next five-year agegroupPortability: Allows you to take coverage with you if you terminateemployment.Yes, with age and otherrestrictions, including evidence ofinsurabilityYes, with age and otherrestrictions14
Your life coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Group number: 00058303BASIC LIFE VOLUNTARY TERM LIFEConversion: Allows you to continue your coverage after your groupplan has terminated.Yes, with restrictions; seecertificate of benefitsYes, with restrictions; seecertificate of benefitsAccelerated Life Benefit: A lump sum benefit is paid to you if youare diagnosed with a terminal condition, as defined by the plan.Yes YesWaiver of Premiums: Premium will not need to be paid if you aretotally disabled.For employees disabled prior toage 60, with premiums waiveduntil age 65, if conditions are metFor employees disabled prior toage 60, with premiums waiveduntil age 65, if conditions metBenefit Reductions: Benefits are reduced by a certain percentage asan employee ages.35% at age 65, 50% at age 70 35% at age 65, 50% at age 70Subject to coverage limitsVoluntary Life: Infant coverage is limited based on age.Spouse coverage terminates at age 70.The Guarantee Issue amount may be subject to reductions by percentage at the ages shown in this summary.Annual Election Option allows employees to increase the amount of their life coverage without a medical exam when they re-enroll in their company’s Voluntary Lifeplan. This option allows employees to step up to an amount of up to $50,000, up to the Guarantee Issue amount.15
Voluntary Life Cost Illustration:To determine the most appropriate level of coverage, as a rule of thumb, you should consider about 6 - 10 times your annual income,factoring in projected costs to help maintain your family’s current life style.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Bi-weekly premiums displayed. Cost of AD&D is included.Policy Election Amount Policy Election Cost Per Age BracketEmployee< 30 30–34 35–39 40–44 45–49 50–54 55–59 60–6465–69†$10,000 $.55 $.66 $.90 $1.24 $1.96 $2.91 $4.19 $5.47 $7.00$20,000 $1.09 $1.32 $1.80 $2.48 $3.91 $5.83 $8.37 $10.93 $13.99$30,000 $1.63 $1.98 $2.70 $3.73 $5.87 $8.74 $12.56 $16.39 $20.99$40,000 $2.18 $2.64 $3.60 $4.97 $7.83 $11.65 $16.75 $21.86 $27.99$50,000 $2.72 $3.30 $4.50 $6.21 $9.79 $14.56 $20.93 $27.32 $34.99$60,000 $3.27 $3.96 $5.40 $7.45 $11.74 $17.47 $25.12 $32.79 $41.98$70,000 $3.81 $4.62 $6.30 $8.69 $13.70 $20.39 $29.30 $38.25 $48.98$80,000 $4.36 $5.28 $7.20 $9.93 $15.66 $23.30 $33.49 $43.72 $55.98$90,000 $4.90 $5.94 $8.10 $11.17 $17.61 $26.21 $37.68 $49.18 $62.97$100,000 $5.45 $6.60 $9.00 $12.42 $19.57 $29.12 $41.86 $54.65 $69.97$110,000 $5.99 $7.26 $9.90 $13.66 $21.53 $32.04 $46.05 $60.11 $76.97$120,000 $6.54 $7.92 $10.80 $14.90 $23.48 $34.95 $50.23 $65.58 $83.96$130,000 $7.08 $8.58 $11.70 $16.14 $25.44 $37.86 $54.42 $71.04 $90.96$140,000 $7.63 $9.24 $12.60 $17.38 $27.40 $40.77 $58.61 $76.51 $97.96$150,000 $8.17 $9.90 $13.50 $18.62 $29.35 $43.69 $62.79 $81.97 $104.95$160,000 $8.71 $10.56 $14.40 $19.87 $31.31 $46.60 $66.98 $87.43 $111.95$170,000 $9.26 $11.22 $15.30 $21.11 $33.27 $49.51 $71.17 $92.90 $118.95$180,000 $9.80 $11.88 $16.20 $22.35 $35.23 $52.42 $75.35 $98.36 $125.95$190,000 $10.35 $12.54 $17.10 $23.59 $37.18 $55.33 $79.54 $103.83 $132.94$200,000 $10.89 $13.20 $18.00 $24.83 $39.14 $58.25 $83.72 $109.29 $139.94$210,000 $11.44 $13.86 $18.90 $26.07 $41.10 $61.16 $87.91 $114.76 $146.94$220,000 $11.98 $14.52 $19.80 $27.31 $43.05 $64.07 $92.10 $120.22 $153.93$230,000 $12.53 $15.18 $20.70 $28.56 $45.01 $66.98 $96.28 $125.69 $160.93$240,000 $13.07 $15.84 $21.60 $29.80 $46.97 $69.90 $100.47 $131.15 $167.93$250,000 $13.62 $16.50 $22.50 $31.04 $48.92 $72.81 $104.65 $136.62 $174.92$260,000 $14.16 $17.16 $23.40 $32.28 $50.88 $75.72 $108.84 $142.08 $181.92$270,000 $14.71 $17.82 $24.30 $33.52 $52.84 $78.63 $113.03 $147.55 $188.92$280,000 $15.25 $18.48 $25.20 $34.76 $54.79 $81.55 $117.21 $153.01 $195.91$290,000 $15.79 $19.14 $26.10 $36.01 $56.75 $84.46 $121.40 $158.47 $202.9116
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number: 00058303Voluntary Life Cost Illustrationcontinued< 30 30–34 35–39 40–44 45–49 50–54 55–59 60–6465–69†$300,000 $16.34 $19.80 $27.00 $37.25 $58.71 $87.37 $125.59 $163.94 $209.91$310,000 $16.88 $20.46 $27.90 $38.49 $60.67 $90.28 $129.77 $169.40 $216.91$320,000 $17.43 $21.12 $28.80 $39.73 $62.62 $93.19 $133.96 $174.87 $223.90$330,000 $17.97 $21.78 $29.70 $40.97 $64.58 $96.11 $138.14 $180.33 $230.90$340,000 $18.52 $22.44 $30.60 $42.21 $66.54 $99.02 $142.33 $185.80 $237.90$350,000 $19.06 $23.10 $31.50 $43.45 $68.49 $101.93 $146.52 $191.26 $244.89$360,000 $19.61 $23.76 $32.40 $44.70 $70.45 $104.84 $150.70 $196.73 $251.89$370,000 $20.15 $24.42 $33.30 $45.94 $72.41 $107.76 $154.89 $202.19 $258.89$380,000 $20.70 $25.08 $34.20 $47.18 $74.36 $110.67 $159.07 $207.66 $265.88$390,000 $21.24 $25.74 $35.10 $48.42 $76.32 $113.58 $163.26 $213.12 $272.88$400,000 $21.79 $26.40 $36.00 $49.66 $78.28 $116.49 $167.45 $218.59 $279.88$410,000 $22.33 $27.06 $36.90 $50.90 $80.23 $119.41 $171.63 $224.05 $286.87$420,000 $22.87 $27.72 $37.80 $52.15 $82.19 $122.32 $175.82 $229.51 $293.87$430,000 $23.42 $28.38 $38.70 $53.39 $84.15 $125.23 $180.01 $234.98 $300.87$440,000 $23.96 $29.04 $39.60 $54.63 $86.11 $128.14 $184.19 $240.44 $307.87$450,000 $24.51 $29.70 $40.50 $55.87 $88.06 $131.05 $188.38 $245.91 $314.86$460,000 $25.05 $30.36 $41.40 $57.11 $90.02 $133.97 $192.56 $251.37 $321.86$470,000 $25.60 $31.02 $42.30 $58.35 $91.98 $136.88 $196.75 $256.84 $328.86$480,000 $26.14 $31.68 $43.20 $59.59 $93.93 $139.79 $200.94 $262.30 $335.85$490,000 $26.69 $32.34 $44.10 $60.84 $95.89 $142.70 $205.12 $267.77 $342.85$500,000 $27.23 $33.00 $45.00 $62.08 $97.85 $145.62 $209.31 $273.23 $349.85Policy Election AmountSpouse$1,000 $.05 $.07 $.09 $.12 $.20 $.29 $.42 $.55 $.70$2,000 $.11 $.13 $.18 $.25 $.39 $.58 $.84 $1.09 $1.40$3,000 $.16 $.20 $.27 $.37 $.59 $.87 $1.26 $1.64 $2.10$4,000 $.22 $.26 $.36 $.50 $.78 $1.17 $1.67 $2.19 $2.80$5,000 $.27 $.33 $.45 $.62 $.98 $1.46 $2.09 $2.73 $3.50$6,000 $.33 $.40 $.54 $.75 $1.17 $1.75 $2.51 $3.28 $4.20$7,000 $.38 $.46 $.63 $.87 $1.37 $2.04 $2.93 $3.83 $4.90$8,000 $.44 $.53 $.72 $.99 $1.57 $2.33 $3.35 $4.37 $5.60$9,000 $.49 $.59 $.81 $1.12 $1.76 $2.62 $3.77 $4.92 $6.30$10,000 $.55 $.66 $.90 $1.24 $1.96 $2.91 $4.19 $5.47 $7.0017
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number: 00058303Voluntary Life Cost Illustrationcontinued< 30 30–34 35–39 40–44 45–49 50–54 55–59 60–6465–69†$11,000 $.60 $.73 $.99 $1.37 $2.15 $3.20 $4.61 $6.01 $7.70$12,000 $.65 $.79 $1.08 $1.49 $2.35 $3.50 $5.02 $6.56 $8.40$13,000 $.71 $.86 $1.17 $1.61 $2.54 $3.79 $5.44 $7.10 $9.10$14,000 $.76 $.92 $1.26 $1.74 $2.74 $4.08 $5.86 $7.65 $9.80$15,000 $.82 $.99 $1.35 $1.86 $2.94 $4.37 $6.28 $8.20 $10.50$16,000 $.87 $1.06 $1.44 $1.99 $3.13 $4.66 $6.70 $8.74 $11.20$17,000 $.93 $1.12 $1.53 $2.11 $3.33 $4.95 $7.12 $9.29 $11.90$18,000 $.98 $1.19 $1.62 $2.24 $3.52 $5.24 $7.54 $9.84 $12.59$19,000 $1.04 $1.25 $1.71 $2.36 $3.72 $5.53 $7.95 $10.38 $13.29$20,000 $1.09 $1.32 $1.80 $2.48 $3.91 $5.83 $8.37 $10.93 $13.99$21,000 $1.14 $1.39 $1.89 $2.61 $4.11 $6.12 $8.79 $11.48 $14.69$22,000 $1.20 $1.45 $1.98 $2.73 $4.31 $6.41 $9.21 $12.02 $15.39$23,000 $1.25 $1.52 $2.07 $2.86 $4.50 $6.70 $9.63 $12.57 $16.09$24,000 $1.31 $1.58 $2.16 $2.98 $4.70 $6.99 $10.05 $13.12 $16.79$25,000 $1.36 $1.65 $2.25 $3.10 $4.89 $7.28 $10.47 $13.66 $17.49$26,000 $1.42 $1.72 $2.34 $3.23 $5.09 $7.57 $10.88 $14.21 $18.19$27,000 $1.47 $1.78 $2.43 $3.35 $5.28 $7.86 $11.30 $14.75 $18.89$28,000 $1.53 $1.85 $2.52 $3.48 $5.48 $8.15 $11.72 $15.30 $19.59$29,000 $1.58 $1.91 $2.61 $3.60 $5.68 $8.45 $12.14 $15.85 $20.29$30,000 $1.63 $1.98 $2.70 $3.73 $5.87 $8.74 $12.56 $16.39 $20.99$31,000 $1.69 $2.05 $2.79 $3.85 $6.07 $9.03 $12.98 $16.94 $21.69$32,000 $1.74 $2.11 $2.88 $3.97 $6.26 $9.32 $13.40 $17.49 $22.39$33,000 $1.80 $2.18 $2.97 $4.10 $6.46 $9.61 $13.81 $18.03 $23.09$34,000 $1.85 $2.24 $3.06 $4.22 $6.65 $9.90 $14.23 $18.58 $23.79$35,000 $1.91 $2.31 $3.15 $4.35 $6.85 $10.19 $14.65 $19.13 $24.49$36,000 $1.96 $2.38 $3.24 $4.47 $7.05 $10.48 $15.07 $19.67 $25.19$37,000 $2.02 $2.44 $3.33 $4.59 $7.24 $10.78 $15.49 $20.22 $25.89$38,000 $2.07 $2.51 $3.42 $4.72 $7.44 $11.07 $15.91 $20.77 $26.59$39,000 $2.12 $2.57 $3.51 $4.84 $7.63 $11.36 $16.33 $21.31 $27.29$40,000 $2.18 $2.64 $3.60 $4.97 $7.83 $11.65 $16.75 $21.86 $27.99$41,000 $2.23 $2.71 $3.69 $5.09 $8.02 $11.94 $17.16 $22.41 $28.69$42,000 $2.29 $2.77 $3.78 $5.21 $8.22 $12.23 $17.58 $22.95 $29.3918
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number: 00058303Voluntary Life Cost Illustrationcontinued< 30 30–34 35–39 40–44 45–49 50–54 55–59 60–6465–69†$43,000 $2.34 $2.84 $3.87 $5.34 $8.42 $12.52 $18.00 $23.50 $30.09$44,000 $2.40 $2.90 $3.96 $5.46 $8.61 $12.81 $18.42 $24.04 $30.79$45,000 $2.45 $2.97 $4.05 $5.59 $8.81 $13.11 $18.84 $24.59 $31.49$46,000 $2.51 $3.04 $4.14 $5.71 $9.00 $13.40 $19.26 $25.14 $32.19$47,000 $2.56 $3.10 $4.23 $5.84 $9.20 $13.69 $19.68 $25.68 $32.89$48,000 $2.61 $3.17 $4.32 $5.96 $9.39 $13.98 $20.09 $26.23 $33.59$49,000 $2.67 $3.23 $4.41 $6.08 $9.59 $14.27 $20.51 $26.78 $34.29$250,000 $13.62 $16.50 $22.50 $31.04 $48.92 $72.81 $104.65 $136.62 $174.92Policy Election AmountChild(ren)$1,000 $0.22 $0.22 $0.22 $0.22 $0.22 $0.22 $0.22 $0.22 $0.22$2,000 $0.43 $0.43 $0.43 $0.43 $0.43 $0.43 $0.43 $0.43 $0.43$3,000 $0.65 $0.65 $0.65 $0.65 $0.65 $0.65 $0.65 $0.65 $0.65$4,000 $0.86 $0.86 $0.86 $0.86 $0.86 $0.86 $0.86 $0.86 $0.86$5,000 $1.08 $1.08 $1.08 $1.08 $1.08 $1.08 $1.08 $1.08 $1.08$6,000 $1.30 $1.30 $1.30 $1.30 $1.30 $1.30 $1.30 $1.30 $1.30$7,000 $1.51 $1.51 $1.51 $1.51 $1.51 $1.51 $1.51 $1.51 $1.51$8,000 $1.73 $1.73 $1.73 $1.73 $1.73 $1.73 $1.73 $1.73 $1.73$9,000 $1.94 $1.94 $1.94 $1.94 $1.94 $1.94 $1.94 $1.94 $1.94$10,000 $2.16 $2.16 $2.16 $2.16 $2.16 $2.16 $2.16 $2.16 $2.16Refer to Guarantee Issue row on page above for Voluntary Life GI amounts.Premiums for Voluntary Life Increase in five-year incrementsInfant coverage is limited for the first two weeks of infant’s life.Spouse coverage premium is based on Employee age.†Benefit reductions apply.The Guarantee Issue amount may be subject to reductions by percentage at the ages shown in this summary.19
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number: 00058303LIMITATIONS AND EXCLUSIONS:A SUMMARY OF PLAN LIMITATIONS AND EXCLUSIONS FOR LIFE ANDAD&D COVERAGE:You must be working full-time on the effective date of your coverage; otherwise, yourcoverage becomes effective after you have completed a specific waiting period. Employeesmust be legally working in the United States in order to be eligible for coverage.Underwriting must approve coverage for employees on temporary assignment: (a)exceeding one year; or (b) in an area under travel warning by the US Department of State.Subject to state specific variations. Evidence of Insurability is required on all late enrollees.This coverage will not be effective until approved by a Guardian underwriter. This proposalis hedged subject to satisfactory financial evaluation. Please refer to certificate of coverage forfull plan description.Dependent life insurance will not take effect if a dependent, other than a newborn, isconfined to the hospital or other health care facility or is unable to perform the normalactivities of someone of like age and sex.Accelerated Life Benefit is not paid to an employee under the following circumstances: onewho is required by law to use the benefit to pay creditors; is required by court order to paythe benefit to another person; is required by a government agency to use the payment toreceive a government benefit; or loses his or her group coverage before an acceleratedbenefit is paid.Voluntary Life Only:We pay no benefits if the insured’s death is due to suicide within two years from theinsured’s original effective date. This two year limitation also applies to any increase inbenefit. This exclusion may vary according to state law. Late entrants and benefit increasesrequire underwriting approval.GP-1-R-LB-90, GP-1-R-EOPT-96Guarantee Issue/Conditional Issue amounts may vary based on age and case size. See yourPlan Administrator for details. Late entrants and benefit increases require underwritingapproval.For AD&D: We pay no benefits for any loss caused: by willful self-injury; sickness, diseaseor medical treatment; by participating in a civil disorder or committing a felony; Travelingon any type of aircraft while having duties on that aircraft; by declared or undeclared act ofwar or armed aggression; while a member of any armed force (May vary by state); whiledriving a motor vehicle without a current, valid driver’s license; by legal intoxication; or byvoluntarily using a non-prescription controlled substance. Contract #GP-1-R-ADCL1-00 etal. We won't pay more than 100% of the Insurance amount for all losses due to the sameaccident, except as stated. The loss must occur within a specified period of time of theaccident. Please see contract for specific definition; definition of loss may vary depending onthe benefit payable.Guardian Group Life Insurance underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are notavailable in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents arethe final arbiter of coverage.Policy Form # GP-1-LIFE-1520
Watch our videoHow short term disability insurancecan supplement your income.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Group number: 000583032023-158798 (07/25)You willreceive thesebenefitsif you meetthe conditionslistedin the policy.DisabilityinsurancePartial incomereplacementMike injures hisback ina bicycleaccident andcan’t work for 13 weeks.Unpaid time off work: 13 weeksElimination period: 1 weekAfter a 1-week elimination periodfollowing his accident, Mike’sGuardian Short Term Disabilitypolicy kicks in and replaces $400 ofhis weekly income for the remaining12 weeks of his rehabilitation.This gives him a total of $4,800 tocover his expenses while he’s unableto work.This example is for illustrativepurposes only. Your plan’s coveragemay vary. See your plan’sinformationon the following pages for specificamounts and details.Short term disabilityDisability insurance covers a part of yourincome, so you can pay your bills if you’reinjured or sick and can’t work.Disability may be more common than you might realize, andpeople can be unable to work for all sorts of different reasons.There are times when many disabilities can be caused bylllness, including common conditions like heart disease andarthritis. However, many disabilities aren't covered byworkers' compensation.Who is it for?If you rely on your income to pay for everyday expenses, thenyou should probably consider disability insurance. It helps ensure thatyou’ll receive a partial income if you’re injured or too sick to work.What does it cover?Many disability insurance plans pay out a portion or percentageof your income if you’re diagnosed with a serious illness orexperience an injury that prevents you from doing your job.Why should I consider it?Accidents happen, and you can’t always anticipate if or when you’llbecome sick or injured. That’s why it’s important to have a disabilitypolicy that helps you pay your bills in the event of being unable tocollect your normal paycheck.21
Watch our videoHow long term disability insurancecan supplement your income.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158797 (07/25)You willreceive thesebenefitsif you meetthe conditionslistedin the policy.DisabilityinsurancePartial incomereplacementJim suffers a heartattack thatleaveshim unable towork for two years.Unpaid time off work: 24 monthsElimination period: 6 monthsAfter a 6 month elimination period,Jim’s Guardian Long Term Disabilitypolicy kicks in and replaces $2,000 ofhis monthly income forthe remaining18 months of his disability or illness.This gives him a total of $36,000 tocover his expenses while he’s unableto work.This example is for illustrativepurposes only. Your plan’s coveragemay vary. See your plan’sinformationon the following pages for specificamounts and details.Long term disabilityDisability insurance covers a part of yourincome, so you can pay your bills if you’reinjured or sick and can’t work.Disability may be more common than you might realize, andpeople can be unable to work for all sorts of different reasons.There are times when many disabilities can be caused bylllness, including common conditions like heart disease andarthritis. However, many disabilities aren't covered byworkers' compensation.Who is it for?If you rely on your income to pay for everyday expenses, thenyou should probably consider disability insurance. It helps ensure thatyou’ll receive a partial income if you’re injured or too sick to work.What does it cover?Many disability insurance plans pay out a portion or percentageof your income if you’re diagnosed with a serious illness orexperience an injury that prevents you from doing your job.Why should I consider it?Accidents happen, and you can’t always anticipate if or when you’llbecome sick or injured. That’s why it’s important to have a disabilitypolicy that helps you pay your bills in the event of being unable tocollect your normal paycheck.22
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Your disability coverageShort-Term Disability Long-Term Disability.Coverage amount60% of salary to maximum$1500/week60% of salary to maximum$8000/monthMaximum payment period: Maximum length of time you canreceive disability benefits.11 weeksSocial Security Normal RetirementAgeAccident benefits begin: The length of time you must bedisabled before benefits begin.Day 15 Day 91Illness benefits begin: The length of time you must be disabledbefore benefits begin.Day 15 Day 91Evidence of Insurability: A health statement requiring you toanswer a few medical history questions.Health Statement may be required Health Statement may be requiredGuarantee Issue: The ‘guarantee’ means you are not required toanswer health questions to qualify for coverage up to and includingthe specified amount, when applicant signs up for coverage duringthe initial enrollment period.We Guarantee Issue $1500 incoverageWe Guarantee Issue $8000 incoverageMinimum work hours/week: Minimum number of hours youmust regularly work each week to be eligible for coverage.Planholder Determines Planholder DeterminesPre-existing conditions: A pre-existing condition includes anycondition/symptom for which you, in the specified time periodprior to coverage in this plan, consulted with a physician, receivedtreatment, or took prescribed drugs.3 months look back; 12 monthsafter 2 week limitation3 months look back; 12 monthsafter exclusionPremium waived if disabled: Premium will not need to be paidwhen you are receiving benefits.Yes YesSurvivor benefit: Additional benefit payable to your family if youdie while disabled.No 3 monthsUNDERSTANDING YOUR BENEFITS—DISABILITY (Some information may vary by state)lDisability (long-term): For first two years of disability, you will receive benefit payments while you are unable to work inyour own occupation. After two years, you will continue to receive benefits if you cannot work in any occupation based ontraining, experience and education.lEarnings definition: Your covered salary excludes bonuses and commissions.lSpecial limitations: Provides a 24-month benefit limit for specific conditions including mental health and substance abuse.Other conditions such as chronic fatigue are also included in this limitation. Refer to contract for details.lWork incentive: Plan benefit will not be reduced for a specified amount of months so that you have part-time earnings whileyou remain disabled, unless the combined benefit and earnings exceed 100% of your previous earnings.23
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITYSUPPLY Kit created 11/17/2023All Eligible Employees Group number:00058303Short-Term Disability Plan Cost Illustration:To determine the most appropriate level of coverage, you should consider your current basic monthly expenses.Policy amounts shown based on sample salary amounts only.< 25 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60+Your premium rate$0.125 $0.143 $0.180 $0.180 $0.197 $0.233 $0.322 $0.393 $0.518Election Cost Per Age Bracket< 25 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60+$20,000 Annual Salary$231 Weekly Benefit $1.33 $1.53 $1.92 $1.92 $2.10 $2.48 $3.43 $4.19 $5.52$30,000 Annual Salary$346 Weekly Benefit $2.00 $2.28 $2.87 $2.87 $3.15 $3.72 $5.14 $6.28 $8.27$40,000 Annual Salary$462 Weekly Benefit $2.67 $3.05 $3.84 $3.84 $4.20 $4.97 $6.87 $8.38 $11.05$50,000 Annual Salary$577 Weekly Benefit $3.33 $3.81 $4.79 $4.79 $5.25 $6.21 $8.58 $10.47 $13.80$60,000 Annual Salary$692 Weekly Benefit $3.99 $4.57 $5.75 $5.75 $6.29 $7.44 $10.28 $12.55 $16.54$70,000 Annual Salary$808 Weekly Benefit $4.66 $5.33 $6.71 $6.71 $7.35 $8.69 $12.01 $14.66 $19.32$80,000 Annual Salary$923 Weekly Benefit $5.33 $6.09 $7.67 $7.67 $8.39 $9.93 $13.72 $16.74 $22.07$90,000 Annual Salary$1,038 Weekly Benefit $5.99 $6.85 $8.62 $8.62 $9.44 $11.16 $15.43 $18.83 $24.82$100,000 Annual Salary$1,154 Weekly Benefit $6.66 $7.62 $9.59 $9.59 $10.49 $12.41 $17.15 $20.93 $27.59$110,000 Annual Salary$1,269 Weekly Benefit $7.32 $8.38 $10.54 $10.54 $11.54 $13.65 $18.86 $23.02 $30.34$120,000 Annual Salary$1,385 Weekly Benefit $7.99 $9.14 $11.51 $11.51 $12.59 $14.89 $20.58 $25.12 $33.1124
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITYSUPPLY Kit created 11/17/2023All Eligible Employees Group number:00058303A SUMMARY OF DISABILITY PLAN LIMITATIONSAND EXCLUSIONSnEvidence of Insurability may be required on all late enrollees. This coveragewill not be effective until approved by a Guardian underwriter. Thisproposal is hedged subject to satisfactory financial evaluation. Please refer tocertificate of coverage for full plan description.nYou must be working full-time on the effective date of your coverage;otherwise, your coverage becomes effective after you have completed aspecific waiting period.nEmployees must be legally working in the United States in order to beeligible for coverage. Underwriting must approve coverage for employees ontemporary assignment: (a) exceeding one year; or (b) in an area under travelwarning by the US Department of State. Subject to state specific variations.nFor Long-Term Disability coverage, we pay no benefits for a disability causedor contributed to by a pre-existing condition unless the disability starts afteryou have been insured under this plan for a specified period of time. Welimit the duration of payments for long term disabilities caused by mental oremotional conditions, or alcohol or drug abuse.nFor Short-Term Disability coverage, benefits for a disability caused orcontributed to by a pre-existing condition are limited, unless the disabilitystarts after you have been insured under this plan for a specified period oftime. We do not pay short term disability benefits for any job-related oron-the-job injury, or conditions for which Workers' Compensation benefitsare payable.nWe do not pay benefits for charges relating to a covered person: taking partin any war or act of war (including service in the armed forces) committing afelony or taking part in any riot or other civil disorder or intentionallyinjuring themselves or attempting suicide while sane or insane. We do notpay benefits for charges relating to legal intoxication, including but notlimited to the operation of a motor vehicle, and for the voluntary use of anypoison, chemical, prescription or non-prescription drug or controlledsubstance unless it has been prescribed by a doctor and is used asprescribed. We limit the duration of payments for long term disabilitiescaused by mental or emotional conditions, or alcohol or drug abuse. We donot pay benefits during any period in which a covered person is confined toa correctional facility, an employee is not under the care of a doctor, anemployee is receiving treatment outside of the US or Canada, and theemployee’s loss of earnings is not solely due to disability.nThis policy provides disability income insurance only. It does not provide"basic hospital", "basic medical", or "medical" insurance as defined by theNew York State Insurance Department.nIf this plan is transferred from another insurance carrier, the time an insuredis covered under that plan will count toward satisfying Guardian'spre-existing condition limitation period. State variations may apply.nWhen applicable, this coverage will integrate with NJ TDB, NY DBL, CASDI, RI TDI, Hawaii TDI and Puerto Rico DBA, DC PFML and WA PFML.Guardian’s Group Short Term Disability and Long Term Disability Insurance are underwritten and issued by The Guardian Life Insurance Company ofAmerica, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incuradditional costs. This policy provides disability income insurance only. It does NOT provide basic hospital, basic medical or major medical insurance asdefined by the New York State Department of Financial Services. Plan documents are the final arbiter of coverage.Policy Form #GP-1-STD07-1.0, et al, GP-1-STD-15, #GP-1-LTD07-1.0, et al, GP-1-LTD-1525
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CriticalillnessinsuranceCritical illness insurance may help youcover expenses not covered by yourhealth insurance.It’s a cash payment you receive if you ever experiencea serious illness like cancer, a heart attack, or a stroke,giving you the financial support to focus on recovery.Who is it for?Critical illness insuranceisasupplementalpolicy forpeoplewhoalreadyhave healthinsurance.It provides you withanadditional payment tocover expenseslikedeductibles, treatments,andlivingcosts.What does it cover?Critical illnesses include strokes, heart attacks, Parkinson’s diseaseand cancer. Our policies can cover over 30 major illnesses, helpingyou stay financially stable by paying you a lump sum if you’rediagnosed with one of them.Why should I consider it?Health coverage is becoming more expensive, with higher co-pays,premiums, and deductibles. Critical illness insurance is an affordableway to supplement and pay for additional expenses that your healthinsurance doesn’t cover. Our policies typically provide payments forthe first and second time you’re diagnosed with a covered illness.Plus, critical illness insurance is portable and payments are madedirectly to you.Watch our videoHow critical illness insurancehelps cover the costs of treatment.You willreceive thesebenefitsif you meetthe conditionslistedin the policy.Critical costsJohn is hospitalized aftera heartattack, and hastocover the costoffive days as an inpatient.Average heart attackhospitalization expense: $53,000Average Major Medical deductible:$1,500MajorMedicalcovers 80%ofthecostafter the deductible is met, but John’sstill responsible for 20%: $10,300.Totalout-of-pocketamount forJohn(deductible + coinsurance): $11,800.John has a $10,000 Guardian CriticalIllness policy, which covers themajority of these out-of-pocketexpenses.This example is for illustrativepurposes only. Your plan’s coveragemay vary. See your plan’sinformationon the following pages for specificamounts and details.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158782 (07/25)27
Your critical illness coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Group number: 00058303CRITICAL ILLNESSBenefit Amount(s)Employee may choose a lump sum benefit up to $30,000. Please seeyour cost illustration for a full list of available benefit amounts.CONDITIONSCancer1stOCCURRENCE2ndOCCURRENCEInvasive Cancer 100% 50%Carcinoma In Situ 30% 0%Benign Brain or Spinal Tumor 100% 0%Skin Cancer $250 $0BRCA 1 & BRCA 2 30% Not CoveredBone Marrow Failure (including Stem Cells) 100% 50%Lung and Vascular DisorderAneurysm 10% 0%Pulmonary Embolism 30% 0%Stroke – Moderate 50% 25%Stroke – Severe 100% 50%Transient Ischemic Attack (TIA) 10% 0%Heart ConditionsCoronary Artery Disease 10% 0%Coronary Artery Disease – bypass needed 50% 0%Heart Attack 100% 50%Heart Failure 100% 50%Pacemaker 10% 0%Additional ConditionsKidney Failure 100% 50%Major Organ Failure 100% 50%1stOCCURRENCE ONLYAddison's Disease 30%Coma100%Loss of Hearing 100%Loss of Sight 100%Loss of Speech 100%Permanent Paralysis 100% for 1 or more limbsSevere Burns 100%Neurological DisordersAlzheimer's Disease – Early 50%Alzheimer’s Disease – Advanced 100%ALS (Lou Gehrig's Disease) 100%Dementia – other causes 100%Huntington's Disease 30%28
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Your critical illness coverageCRITICAL ILLNESSMultiple Sclerosis – Early 50%Multiple Sclerosis – Advanced 100%Myasthenia Gravis 30%Parkinson's Disease – Early50%Parkinson's Disease – Advanced100%Spouse Benefit 50% of employee's lump sum benefitChild Benefit- children age Birth to 26 years 50% of employee's lump sum benefitBenefit Reductions: Benefits are reduced by a certain percentage asan employee ages50% at age 70Guarantee Issue: The ‘guarantee’ means you are not required toanswer health questions to qualify for coverage up to and including thespecified amount, when you sign up for coverage during the initialenrollment period or the annual open enrollment period.We Guarantee Issue up to:Less than age 70 $20,000For a spouse:Less than age 70 $10,000For a child: All AmountsHealth questions are required if the elected amount exceedsthe Guarantee Issue, as well as for all applicants age 70+regardless of elected amount.Portability: Allows you to take your Critical Illness coverage withyou if you terminate employment.IncludedPre-Existing Condition Limitation: A pre-existing conditionincludes any condition for which you, in the specified time period priorto coverage in this plan, consulted with a physician, receivedtreatment, or took prescribed drugs.3 months prior/6 months treatment free/12 months afterWaiver of Premium: If you become disabled due to a coveredcritical illness that is diagnosed after the employee’s effective date, andyou remain disabled for 90 days, we will waive the premium due aftersuch 90 days for as long as you remain disabled.IncludedHealth Screening Benefit $50 Employee, $50 Spouse, $50 Child per year limit.Condition Definitions• BRCA1 or BRCA2 Mutation: occurs the date you’re scheduled to undergo a mastectomy, or ovary or fallopian tube removal prior to abreast or ovarian cancer diagnosis as a preventive measure.• Stroke - Moderate: requires clinical evidence of infarction of brain tissue, or intracranial or subarachnoid hemorrhage.• Stroke - Severe: a permanent neurological deficit which persists at least 30 days after the event.• Coronary Artery Disease: requires a diagnosis and severity level that requires one or more of the following procedures: atherectomy(rotation or laser), balloon angioplasty, laser angioplasty, stent implantation, thrombectomy (angiojet).• Coronary Artery Disease - requiring a bypass: requires a diagnosis to be of such a severity that it requires one or more coronary arterybypass grafts.• Heart Failure: requires a heart valve replacement or acceptance into the heart transplant waiting list.• Kidney Failure: occurs on the earlier date of when renal or peritoneal dialysis begins, or the date you’re accepted onto the kidney transplantwaiting list of a recognized kidney transplant program in the United States.29
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Your critical illness coverage• Major Organ Failure: occurs on the date you’re accepted onto the liver, pancreas or lung transplant waiting list of a recognized transplantprogram in the United States.• Early-Stage Alzheimer’s Disease: occurs on the date a physician diagnoses the progression which causes a loss of cognitive ability andfunctioning.• Advanced Alzheimer’s Disease: occurs on the date a physician diagnoses the cognitive decline to have progressed to the point that there’spermanent inability to perform 2 or more Activities of Daily Living.• Early-Stage Multiple Sclerosis (MS): must be diagnosed by a physician and confirmed by neurological exams, imaging studies, and analysis ofcerebrospinal fluid.• Advanced Stage Multiple Sclerosis (MS): requires neurological deficits for at least six months and confirmed by neurological exams, imagingstudies, and analysis of cerebrospinal fluid.• Early-Stage Parkinson’s Disease: occurs on the date diagnosed by a physician with at least 1 symptom(s) affecting movement and the centralnervous system.• Advanced Parkinson’s Disease: occurs on the date diagnosed by a physician and requires at least 3 or more symptom(s) affecting movementand the central nervous system.30
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Group number:00058303Critical Illness Cost IllustrationTo determine the most appropriate level of coverage, you should consider your current basic monthly expenses andexpected financial needs during a Critical Illness.Spouse coverage premium is based on Employee ageChild cost is included with employee election.Bi-weekly Premiums DisplayedElection Cost Per Age Bracket< 25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60--64 65-69 70+†$15,000 Benefit AmountEmployee $15,000Spouse $7,500$3.60$1.80$3.67$1.84$5.54$2.77$6.85$3.43$10.04$5.02$15.51$7.75$21.95$10.98$31.02$15.51$41.89$20.95$57.12$28.56$78.37$39.19$30,000 Benefit AmountEmployee $30,000Spouse $15,000$7.20$3.60$7.34$3.67$11.08$5.54$13.71$6.85$20.08$10.04$31.02$15.51$43.89$21.95$62.03$31.02$83.77$41.89$114.23$57.12$156.74$78.37†Benefit reductions may apply. See plan details.EXCLUSIONS AND LIMITATIONSA SUMMARY OF PLAN LIMITATIONS AND EXCLUSIONS FOR CRITICALILLNESS:We will not pay benefits for a Second occurrence (recurrence) of a CriticalIllness unless the Covered Person has not exhibited symptoms or received careor treatment for that Critical Illness for at least 6 months in a row prior to therecurrence. For purposes of this exclusion, care or treatment does not include:(1) preventive medications in the absence of disease: and (2) routine scheduledfollow-up visits to a doctor. If one illness causes or contributes to anotherillness, we’ll pay benefits for only one of these illnesses. We’ll pay for the illnessthat has the larger benefit. If the benefit amounts for the illness are the same,we’ll let you choose which one we pay.We do not pay benefits for claims relating to a covered person: taking part inany war or act of war (including service in the armed forces) committing a felonyor taking part in any riot or other civil disorder or intentionally injuringthemselves or attempting suicide while sane or insane.Employees must be legally working in the United States in order to be eligiblefor coverage. Underwriting must approve coverage for employees on temporaryassignment: (a) exceeding 1 year; or (b) in an area under travel warning by theUS Department of State, subject to state specific variations.If the plan is new (not transferred): During the exclusion period, this CriticalIllness plan does not pay charges relating to a pre-existing condition. If this planis transferred from another insurance carrier, the time an insured is coveredunder that plan will count toward satisfying Guardian’s pre-existing conditionlimitation period. A pre-existing condition includes any condition for which anemployee, in a specified time period prior to coverage in this plan, consults witha physician, receives treatment, or takes prescribed drugs. No benefit will bepaid until the earlier of the treatment free period or a specified time periodafter the effective date. Please refer to the plan documents for specific timeperiods. State variations may apply.Guardian’s Critical Illness plan does not provide comprehensive medicalcoverage. It is a basic or limited benefit and is not intended to cover all medicalexpenses. It does not provide “basic hospital,” “basic medical,” or “ medical”insurance as defined by the New York State Insurance Department.Health questions are required on 1) late enrollees and 2) enrollees over age 69(not applicable in FL). This coverage will not be effective until approved by aGuardian underwriter.This policy will not pay for a diagnosis of a listed critical illness that is madebefore the insured’s Critical Illness effective date with Guardian.The policy has exclusions and limitations that may impact the eligibility for or entitlementto benefits under each covered condition. See your certificate booklet for a full listing ofexclusions & limitations..If Critical Illness insurance premium is paid for on a pre tax basis, the benefit may betaxable. Please contact your tax or legal advisor regarding the tax treatment of yourpolicy benefits..Contract # CI – 23 - PGuardian’s Critical Illness Insurance is underwritten and issued by The Guardian Life Insurance Company of America,New York, NY. Products are notavailable in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the finalarbiter of coverage. This policy provides limited benefits health insurance only. It does not provide basic hospital, basic medical or major medicalinsurance as defined by the New York State Department of Financial Services.Policy Form # GP-1-LAH-12R; CI – 23 - P31
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Watch our videoHow accident insurancecan get you back on your feet.AccidentinsuranceAccidents happen. With accident insurance,you can help them hurt a bit less.Accident insurance is an extra layer of protection thatgives you a cash payment to help cover out-of-pocketexpenses when you suffer an unexpected, qualifying accident.Who is it for?Nobody can predict when an accident might happen. That’s whyaccident insurance is an important add-on policy for people who wantto supplement the health and disability insurance coveragethey already have individually or through an employer.What does it cover?Accident Insurance pays you lump sum of benefits after you suffer anaccident. This could be more than 40 different circumstances, including:emergency treatment, ambulance, burns, dislocations, fractures, hospitalconfinement, and surgery.Why should I consider it?Health coverage may become more expensive, with higher co-pays,premiums, and deductibles. Accident insurance can be a simple, affordableway to help supplement and cover additional expenses your health anddisability insurance may not cover, including x-rays, ambulance services,deductibles, and even things like rent or groceries.Plus, accident insurance is portable and payments are made directlyto you.Added supportduring recoveryAmanda breaks her leg falling off herbike and needs emergencytreatment.Average non-surgical broken legtreatment expense: $2,500Average Major Medical deductible:$1,500Major Medical covers 80% of thesurgical cost after the deductible ismet, but Amanda’s still responsiblefor 20%: $200Total out-of-pocket amount forAmanda (deductible + coinsurance):$1,700Amanda’s Guardian Accident policypays her a benefit of $1,700, whichcovers all of her out-of-pocketexpenses.This example is forillustrativepurposesonly.Your plan’scoveragemay vary. See your plan’sinformationonthe following pagesfor specificamounts and details.You willreceive thesebenefitsif you meetthe conditionslistedin the policy.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158779 (07/25)33
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITYSUPPLY Kit created 11/17/2023All Eligible Employees Group number:00058303Your accident coverageACCIDENTCOVERAGE - DETAILSYour Bi-weekly premium $5.43You and Spouse $9.01You and Child(ren) $9.36You, Spouse and Child(ren) $12.94Accident Coverage Type Off JobPortability - Allows you to take your Accident coverage with you if you terminateemployment.IncludedACCIDENTAL DEATH AND DISMEMBERMENTBenefit Amount(s)Employee $50,000Spouse $25,000Child $12,500Catastrophic LossQuadriplegia, Loss of speech & hearing (both ears),Loss of Cognitive function: 100% of AD&DHemiplegia & Paraplegia: 50% of AD&DCommon Carrier 200% of AD&D benefitCommon Disaster 200% of Spouse AD&D benefitDismemberment - Hand, Foot, SightSingle: 50% of AD&D benefitMultiple: 100% of AD&D benefitDismemberment - Thumb/Index Finger Same Hand, Four Fingers Same Hand, AllToes Same Foot25% of AD&D benefitSeatbelts and Airbags Seatbelts: $10,000 & Airbags: $15,000Reasonable Accommodation to Home or Vehicle$2,500WELLNESS BENEFIT - Per Year Limit$50Child(ren) Age Limits Children age birth to 26 yearsRAINY DAY FUNDBenefit Amount: $400Rollover Maximum: $200Fund Maximum: $800FEATURESAir Ambulance $1,000Ambulance $300Blood/Plasma/Platelets $300Burns (2nd Degree/3rd Degree)9 sq inches To 18 sq inches: $0/$1,70018 sq inches To 35 sq inches: $850/$3,350Over 35 sq inches: $2,500/$10,000Burns - Skin Graft 50% of burn benefit34
Your accident coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITY SUPPLY Kit created 11/17/2023All Eligible Employees Group number: 00058303FEATURES (Cont.)Child Organized Sport - Benefit is paid if the covered accident occurred while yourcovered child, age 18 years or younger, is participating in an organized sport that isgoverned by an organization and requires formal registration to participate.25% increase to child benefitsChiropractic Visits $50/visit, up to 6 visitsComa $10,000Concussion Baseline Study $25Concussions $200Diagnostic Exam (Major) $200Dislocations Schedule up to $2,000Doctor Follow-Up Visits $75, up to 6 treatmentsEmergency Dental Work $400/Crown, $100/ExtractionEmergency Room Treatment $100Epidural Anesthesia Pain Management $100, 2 times per accidentEye Injury $200Family Care—Benefit is payable for each child attending a Child Care center while theinsured is confined to a hospital, ICU or Alternate Care or Rehabilitative facility dueto injuries sustained in a covered accident.$20/day, up to 30 daysFractures Schedule up to $5,000Gun Shot Wound $750Hospital Admission $1,000Hospital Confinement $250/day - up to 1 yearHospital ICU Admission $2,000Hospital ICU Confinement $500/day - up to 15 daysInitial Dr. Office/Urgent Care Facility Treatment$100Joint Replacement (Hip/Knee/Shoulder) $2,500/$1,250/$1,250Knee Cartilage $500Laceration Schedule up to $400Lodging - The hospital stay must be more than 50 miles from the insured'sresidence.$150/day, up to 30 days for companion hotel stayMedical Appliance—Wheelchair, motorized scooter, leg or back brace, cane,crutches, walker, walking boot that extends above the ankle or brace for the neck.Schedule up to $500Outpatient Therapies $35/day, up to 10 daysPost-Traumatic Stress Disorder $400Prosthetic Device/Artificial Limb1: $7502 or more: $1,500Rehabilitation Unit Confinement $100/day, up to 15 daysRuptured Disc With Surgical Repair $500Surgery (Cranial, Open Abdominal, Thoracic, Hernia) MaxSchedule up to $1,500Hernia: $300Surgery (Exploratory or Arthroscopic) $150Tendon/Ligament/Rotator Cuff1: $5002 or more: $1,00035
Your accident coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITY SUPPLY Kit created 11/17/2023All Eligible Employees Group number: 00058303FEATURES (Cont.)Transportation - Benefit is paid if you have to travel more than 50 miles one way toreceive special treatment at a hospital or facility due to a covered accident.$0.50 per mile, limited to $300/round trip, up to 3times per accidentTraumatic Brain Injury — A nondegenerative, noncongenital Injury to the brain froman external nonbiological force, requiring Hospital Confinement for 48 hours ormore and resulting in a permanent neurological deficit with significant loss of musclefunction and persistent clinical symptoms.$4,000X - Ray $40UNDERSTANDING YOUR BENEFITS:• Common Carrier – Benefit is paid if an insured's death occurs due to an accident while riding as a fare-paying passanger ina public conveyance. If this is paid, we do not pay the Accidental Death benefit.• Common Disaster – Benefit is paid if both you & your spouse die in a covered accident or separate covered accidentswithin the same 24 hour period.• Reasonable Accomodation – Benefit is payable if a modification is required to an insured's place of residence or vehicledue to an Accidental Dismemberment or Catastrophic loss.• Emergency Room Treatment – Benefit is paid only when an insured is examined or treated within 72 hours of a coveredaccident.• Rainy Day Fund – Can pay benefits when a claimant has exhausted a frequency limitation that applies to a particular benefit.Rainy Day Fund will apply to the following benefits Air Ambulance, Ambulance, Blood/Plasma/Platelets, Chiropractic visits,Diagnostic Exam (Major), Doctor Follow-Up visits, Emergency Dental Work, Epidural Anesthesia Pain Management, EyeInjury, Family Care, Fractures, Gun Shot Wound, Hospital Confinement, Hospital ICU Confinement, Joint Replacement, KneeCartilage, Lodging, Outpatient Therapies, Rehabilitation Unit Confinement, Ruptured Disc with Surgical Repair, Surgery(Cranial, Open Abdominal, Thoracic, Hernia), Surgery (Exploratory and Arthroscopic), Transportation and X-Ray, if they areincluded on your plan.36
Your accident coverageGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATE UTILITY SUPPLY Kit created 11/17/2023All Eligible Employees Group number: 00058303LIMITATIONS AND EXCLUSIONS:A SUMMARY OF ACCIDENT LIMITATIONS AND EXCLUSIONS:Employees must be working in the United States in order to be eligible forcoverage. Underwriting must approve coverage for employees on temporaryassignment: (a) exceeding 1 year; or (b) in an area under travel warning by theUS Department of State, subject to state specific variations.This proposal summarizes the major features of the Guardian Accident benefitplan. It is not intended to be a complete representation of the proposed plan.For full plan features, including exclusions and limitations, please refer to yourPolicy.This proposal is hedged subject to satisfactory financial evaluation.We don’t pay benefits for any Injury caused by or related to directly orindirectly: Sickness, disease, mental infirmity or medical or surgical treatment;the covered person being legally intoxicated; declared or undeclared war, act ofwar, or armed aggression; service in the armed forces, National Guard, ormilitary reserves of any state or country; taking part in a riot or civil disorder;commission of, or attempt to commit a felony; intentionally self-inflicted Injury,while sane or insane; suicide or attempted suicide, while sane or insane; travelor flight in any kind of aircraft, including any aircraft owned by or for thepolicyholder, except as a fare-paying passenger on a common carrier;participation in any kind of sporting activity for compensation or profit, includingcoaching or officiating; riding in or driving any motor-driven vehicle in a race,stunt show or speed test; participation in hang gliding, bungee jumping, sailgliding, parasailing, parakiting, ballooning, parachuting, zorbing or skydiving; anaccident that occurred before the covered person is covered by this plan;injuries to a dependent child received during birth; voluntary use of any poison,chemical, prescription or non-prescription drug or controlled substance unless:(1) it was prescribed for a covered person by a doctor, and (2) it was used asprescribed. In the case of a non-prescription drug, this Plan does not pay forany Accident resulting from or contributed to by use in a manner inconsistentwith package instructions. "Controlled substance" means anything called acontrolled substance in Title II of the Comprehensive Drug Abuse Preventionand Control Act of 1970, as amended from time to time. Job related or on thejob injuries for the employee are excluded if Accident coverage is off job only.Contract # GP-1-ACC-18If Accident insurance premium is paid for on a pre tax basis, the benefit may be taxable.Please contact your tax or legal advisor regarding the tax treatment of your policybenefits.Guardian’s Accident Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not availablein all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter ofcoverage. This policy provides Accident insurance only. It does not provide basic hospital, basic medical or major medical insurance as defined by theNew York State Department of Financial Services.IMPORTANT NOTICE –THISPOLICY DOES NOT PROVIDE COVERAGE FOR SICKNESS.Policy Form # GP-1-AC-BEN-12, et al., GP-1-LAH-12R; GP-1-ACC-1837
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HospitalindemnityinsuranceHospital indemnity insurance can coversome of the cost associated with a hospitalstay, letting you focus on recovery.Being hospitalized for illness or injury can happen to anyone,at any time. While medical insurance may cover hospital bills,it may not cover all the costs associated with a hospital stay.That’s where hospital indemnity coverage can help.Who is it for?Hospitalindemnityinsuranceisfor peoplewhoneedhelpcoveringthe costsassociated witha hospitalstay iftheysuddenly becomesickorinjured.What does it cover?If you are admitted to a hospital for a covered sickness or injury, you’llreceive payments that can be used to cover all sorts of costs, including:• Deductibles and co-pays.• Travel to and from the hospital for treatment.• Childcare service assistance while recovering.Why should I consider it?Health coverage is becoming more expensive, with higher co-pays,premiums, and deductibles. Hospital indemnity insurance can help payfor out-of-pocket costs associated with being hospitalized, giving youmore of a financial safety net for unplanned expenses brought on by ahospital stay.Plus, hospital indemnity insurance is portable and payments are madedirectly to you – even if you didn’t incur any out-of-pocket expenses.Watch our videoHow hospital indemnity insurancecan give you a comfortable stay.You willreceive thesebenefitsif you meetthe conditionslistedin the policy.Be preparedJohn is hospitalized aftera heartattack, and hastocover the cost offive days asan inpatient.Average heart attackhospitalization expense: $53,000Average Major Medical deductible:$1,500MajorMedicalcovers 80%ofthe costafter the deductible is met, but John’sstill responsible for 20%: $10,300.Totalout-of-pocketamount forJohn(deductible + coinsurance): $11,800.John’s Guardian Hospital Indemnitypolicy pays him $1,000 for hospitaladmission.The policy gives him a total paymentof $1,000 to help cover the out-of-pocket amount.This example is for illustrativepurposes only. Your plan’s coveragemay vary. See your plan’sinformationon the following pages for specificamounts and details.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate UtilitySupply Kit created 11/17/2023All Eligible Employees Groupnumber:000583032023-158795 (07/25)39
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATEUTILITYSUPPLY Kit created 11/17/2023All Eligible Employees Groupnumber:00058303Your hospital indemnity coveragetheHospital IndemnityOption 1Coverage DetailsYour Bi-weekly premium $4.87You and Spouse $13.49You and Child(ren) $9.58You, Spouse and Child(ren) $18.20BenefitsHospital/ICU Admission $1,000 per admission, limited to 1 admission(s) perinsured and 3 admission(s) per covered family perbenefit year.Hospital/ICU Confinement $100/$100 per day, limited to 15 day(s) per insuredper benefit year.Pre-Existing Conditions Limitation - A pre-existing condition includes any conditionfor which you, in the specified time period prior to coverage in this plan, consulted with aphysician, received treatment, or took prescribed drugs.3 months prior/6 months treatment free/12 monthsafterPortability - Allows you to take your Hospital Indemnity coverage with you if youterminate employment.IncludedChild(ren) Age Limits Children age birth to 26 yearsUNDERSTANDING YOUR BENEFITS – HOSPITAL INDEMNITYHospital Admission & Hospital ICU Admission benefits are not payable on the same day.Premium will be waived if you are hospitalized for more than 30 days.Hospital admission or confinement benefits are not payable for a newborn unless the child is admitted to the Neonatal ICU.Hospital/ICU confinement benefits are not payable on the same day as Hospital/ICU admission benefit.After initial enrollment, Hospital Indemnity coverage will continue as long as an insured is actively at work.40
Your hospital indemnity coveragetheGUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaACCURATEUTILITY SUPPLY Kit created 11/17/2023All Eligible Employees Groupnumber:00058303LIMITATIONS AND EXCLUSIONS:In order to be eligible for coverage: Employees must be legally working: (a) in the United States or (b) outside the United States, for a US based employer, in acountry or region approved by Guardian.An applicant must enroll within 31 days of the coverage effective date. An open enrollment will occur each year during a 30 day time period specified by thepolicyholder. If an applicant does not enroll during their initial enrollment period, he/she may not enroll until the next open enrollment period.This Plan will not pay benefits for:• Treatment relating to a covered person: taking part in any war or act of war (including service in the armed forces), commission of or attempt to commit afelony, an act of terrorism, or participating in an illegal occupation, riot or insurrection..• Suicide or any intentionally self-inflicted injuryElective surgery;Surgery to correct vision or hearing, unless medically necessary surgery for glaucoma, cataracts or other sickness or injury;Dental care, dental xrays, or dental treatment;Gastric or intestinal bypass services including lap banding, gastric stapling, and other similar procedures to facilitate weight loss; the reversal, or revision of suchprocedures; or services required for the treatment of complications from such procedures. This exclusion does not apply to completion of a weight reductionprogram that may be payable under the Health Screening benefit ;Rest cures or custodial care, or treatment of sleep disorders;Cosmetic surgery. This Exclusion does not apply to reconstructive surgery:(a) on an injured part of the body following infection or disease of the involved part;(b) of a congenital disease or anomaly of a covered dependent newborn or adopted infant; or(c ) on a nondiseased breast to restore and achieve symmetry between two breasts following a covered Mastectomy;Treatment or removal of warts, moles, boils, skin blemishes or birthmarks, bunions, acne, corns, calluses, the cutting and trimming of toenails, care for flat feet,fallen arches or chronic foot strain;Service, treatment or loss related to alcoholism or drug addiction, except for drugs prescribed by the Covered Person’s Doctor and taken as prescribed;Care or treatment for mental or nervous disorders;Services, treatment or loss rendered in any Veterans Administration or Federal Hospital, except if there is a legal obligation to pay;Services or treatment Provided by a Doctor, Nurse or any other person who is employed or retained by a Covered Person or who is a Covered Person’sSpouse, parent, brother, sister, child, Domestic Partner or partner in a civil union.Surgery and treatment, procedures, products or services that are experimental or investigative.Hospital Confinement and/or Hospital Admission and Inpatient Surgery due to any Covered Person’s giving birth within the first 9 months after the CoveredPerson’s effective date under this Plan as a result of a normal pregnancy, including cesarean section. Complications of Pregnancy will be covered to the same extentas any other Covered SicknessTreatment of a Covered Dependent Child’s Children;Sickness or Injury sustained while on active duty in the armed forces of any country. This does not include Reserve or National Guard duty for training.GP-1-HI-15Guardian Hospital Indemnity Insurance is underwritten by The Guardian Life Insurance Company of America, New York, NY and will not be effectiveuntil approved by a Guardian underwriter. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/orfeatures may incur additional costs. Plan documents are the final arbiter of coverage. This policy provides limited hospital insurance only. It does notprovide basic medical or major medical insurance as defined by the New York State Department of Financial Services.Policy Form # GP-1-HI-15, GP-1-LAH-12R41
GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of Americaguardianlife.com© Copyright 2023 The Guardian Life Insurance Company of AmericaElectronicEvidence ofInsurability(EOI)*Applicable to coverage requiring full Evidence of Insurability (not applicable to conditional issue amounts). Electronic EOI is available using most internetbrowsers.Electronic EOI keeps things simpleOur online EOI forms are an easier, quickeralternative to traditional paper forms, helpingyou get covered when you need to provideadditional information.There are a few situations where you need to answer healthquestions, enroll for higher amounts of coverage, or requestcoverage after the initial eligibility period. In all of these situations,our online EOI form keeps things simple.With Guardian’s electronic EOI forms, your data is keptsecure at every stage of the process. And with fewererrors than hand-written forms, and faster submissiondigitally, it’s easier than ever to complete it and get covered.Electronic EOI can be used for*:• Basic life• Voluntary life• Short term disability• Long term disabilityYou will receive a letter or emailfrom your employer or Guardianwith instructions and a uniquelink to submit your EOI formonline.First register and create anaccount on Guardian Anytime.Then simply ll out the form,electronically sign it, and click‘Submit.’Once we receive the form, we’llcontact you with any questions,before notifying you (andyour employerif the coverageamount changes).How it works2023-158794 (07/25)42
GuidanceResources® -Employee Assistance ProgramSometimes life can feel overwhelming.It doesn’t have to.Guardian’s Employee Assistance Program provides condentialcounseling, expert guidance, and valuable resources to help you handleany of life’s challenges, big or small.Condentialemotional support• Anxiety,depression,stressWork and lifestylesupport• Child, elder andpet careFinancial resourcesand legal guidance• Retirementplanning, taxes• Wills, trusts andestate planningHow it can helpThis service is only available if you purchase qualifying lines of coverage.See your plan administrator for more details.Legal/nancial assistance and resources services are not available in thestate of New York.The Employee Assistance Program is a suite of services solely created and oered byComPsych. Guardian is not responsible or liable for care or advice given by any provideror any service oering within the Employee Assistance Program. This information is forinformational purposes only. It is not a contract. Only the plan service agreement canprovide the actual terms, services, limitations and exclusions. Guardian and ComPsychreserve the right to discontinue the Employee Assistance Program at any time withoutnotice. Legal services provided through the Employee Assistance Program will notbe provided in connection with or any action against Guardian, ComPsych, or youremployer. The Employee Assistance Program, or any individual service oering withinthe Program, is not an insurance benet and may not be available in all states.How to access24/7 live assistanceVisitguidanceresources.comCall1 855 239 0743TRS: Dial 711App: GuidanceNowSMOrganization web ID: GuardianNote: First-time users willneed to register rst with theorganization web ID: Guardian.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of America© Copyright 2023 The Guardian Life Insurance Company of America2023-159687 (8/25)43
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Our commitment to youPlease read the documentation referenced below carefully. The notices are intended to provide youimportant information about our insurance offerings and to protect your interests. Certain ones arerequired by law.GUARDIAN® is a registered trademark of The Guardian Life Insurance Company of AmericaAccurate Utility Supply Kit created 11/17/2023All Eligible Employees Groupnumber:00058303theImportant informationNotice Informing Individuals about Nondiscrimination and Accessibility RequirementsGuardian notice stating that it complies with applicable Federal civil rights laws and does not discriminate based on race,color, national origin, age, disability, sex, or actual or perceived gender identity. The notice provides contact information forfiling a nondiscrimination grievance. It also provides contact information for access to free aids and services by disabledpeople to assist in communications with Guardian.Visit https://www.guardiananytime.com/notice48 to read more.No Cost Language ServicesGuardian provides language assistance in multiple languages for members who have limited English proficiency.Visit https://www.guardiananytime.com/notice46 to read more.Disability insuranceDisability Offset NoticeOffsets are provisions in your disability coverage that allow the insurer to deduct from your regular benefit other types ofincome you receive or are eligible to receive from other sources due to your disability.Visit https://www.guardiananytime.com/notice51 to read more.Vision insuranceGuardian's HIPAA Notice of Privacy PracticesThe notice describes how health information about you may be used and disclosed and how you can access this information.Visit https://www.guardiananytime.com/notice50 to read more.the man45