Return to flip book view

Message 025-2026 1

$5000Deductible Individual$10000Deductible Family$7000OOPM Individual$14000OOPM FamilyDeductible Individual OON$10000OOPM Individual OON $14000Deductible Family OON $20000OOPM Family OON $28000Coinsurance OON 50%Deductible Embedded YesWeekly RatesEmployee Only$49.00Employee + Spouse$169.70Employee + Child(ren)$100.75Employee + Family$228.00Services Cost Share Deductible AppliesPrimary Care (Office) $25.00 NoSpecialist (Office) $75.00 NoVirtual Care $0.00 NoPreventive Care $0.00 NoUrgent Care $85.00 NoEmergency Room $300.00✔✔YesInpatient Facility 20%✔✔YesGenerics $20.00 NoPreferred Brand $60.00 NoNon-Preferred Brand $85.00 NoSpecialty High-Cost 20%✔✔YesInternational Rx Sourcing 0% NoOutpatient Professional 20%✔✔YesSpeech Therapy - OP Prof. $75.00 NoPhysical / Occupational Therapy - OP Prof. $75.00 NoIndependent Laboratory $25.00 NoOutpatient Facility 20%✔YesImaging - OP Facility 20%✔✔YesSkilled Nursing Facility 20%✔✔YesPLANS

$2000Deductible Individual$4000Deductible Family$4000OOPM Individual$8000OOPM FamilyDeductible Individual OON$5000OOPM Individual OON $10000Deductible Family OON $10000OOPM Family OON $20000Coinsurance OON 50%Deductible Embedded YesWeelky RatesEmployee Only$59.00Employee + Spouse$188.26 Employee + Child(ren)$111.78Employee + Family$252.97Services Cost Share Deductible AppliesPrimary Care (Office) $20.00 NoSpecialist (Office) $50.00 NoVirtual Care $0.00 NoPreventive Care $0.00 NoUrgent Care $75.00 NoEmergency Room $250.00✔✔YesInpatient Facility 20%✔✔YesGenerics $20.00 NoPreferred Brand $60.00 NoNon-Preferred Brand $85.00 NoSpecialty High-Cost 20%✔✔YesInternational Rx Sourcing 0% NoOutpatient Professional 20%✔✔YesSpeech Therapy - OP Prof. $50.00 NoPhysical / Occupational Therapy - OP Prof. $50.00 NoIndependent Laboratory $20.00 NoOutpatient Facility 20%✔YesImaging - OP Facility 20%✔✔YesSkilled Nursing Facility 20%✔✔YesPLANS

Financial protection When life is anything but expectedNew this year, we are excited to offer some Voluntary Benefits to supplement the medical insurance. This suite of voluntary insurance products can often help fill the gap, providing more financial security. When you meet with a benefit counselor they will be able to explain and see if any would be a fit for you and your family. You can review the benefits and weekly costs in this guide.All benefits are guaranteed issue and all pre-existing conditions are waived. That means everyone who is interested can qualify.Accident Insurance helps offset unexpected medical expenses that can result from a fracture, dislocation or other covered accidental injury.Critical Illness Insurance can help supplement major medical coverage with a lump-sum benet that can be used to pay for the direct and indirect costs related to a covered critical illness.Dental Insurance provides coverage for a variety of dental procedures, from routine cleanings to major services. Additional savings are available by visiting a network dentist.Disability Insurance replaces a portion of an employee’s income to help make ends meet if he or she becomes disabled from a covered accident or sickness.Hospital Indemnity Insurance provides a lump-sum benet for a covered hospital connement or outpatient surgery to help with co-payments and deductibles.Life Insurance helps provide nancial security for the people who matter to your employees, with exibility to update coverage at each stage of life.

WEEKLY EMPLOYEE RATES

WEEKLY EMPLOYEE RATES

WEEKLY EMPLOYEE RATES

WEEKLY EMPLOYEE RATES

Individual Dental InsuranceVision Rider Our vision coverage helps you and your family maintain your vision wellness, with coverage for eye exams and optical materials, such as eyeglasses or contact lenses. This benet summary provides a quick reference to the rider’s benets.Co-pays (per insured)1Benefits (once per 12 months) In-network2Out-of-network3Vision exam $10 N/AContact lenses fitting $25 N/AMaterials $25 N/ABenets and allowances1Benets, after co-pay In-network2Out-of-network3Vision exam Covered in full $35 allowanceContact lenses fitting, after co-payStandard4Up to $60 allowance Up to $45 allowanceSpecialty5Up to $100 allowance Up to $75 allowanceMaterials: Eyeglass lenses and frames, after co-pay6Single vision Covered in full Up to $25 allowanceBifocals Covered in full Up to $40 allowanceTrifocals Covered in full Up to $50 allowanceLenticular Up to $120 allowance Up to $50 allowanceProgressives Up to $70 allowance Up to $40 allowancePolycarbonate lenses (for children to age 19 only)Covered in full Up to $30 allowanceFrames Up to $170 allowance Up to $50 allowanceMaterials: Contact lenses, after co-pay7Elective Up to $170 allowance Up to $100 allowanceNon-elective Up to $210 allowance Up to $210 allowanceMAXIMIZE YOUR BENEFITS Maximize your vision benets with any provider in our large, nationwide network, including independent eye doctors, and retail stores such as: • Walmart and Sam’s Club Optical• Target Optical• Pearle Vision• VisionworksYou can choose different providers for eye exams, eyeglasses and contact lenses.ID CARDS• Vision ID cards are mailed toyour home address within 10business days of enrolling,separate from dental ID cards.• Digital ID cards are available on the policyholders portal whenyour coverage starts.• Only the primary insured’s name will be listed.INDIVIDUAL DENTAL - VISION RIDER

1 You are responsible for paying the provider directly for any co-pays, amounts over your allowance, and for any services or materials that are not covered under this rider.2 In-network benets are for covered vision care services or materials provided by a participating ophthalmologist, optometrist (including a therapeutic optometrist), or optician, provided at an agreed-to cost. Most in-network providers take care of claims submission and administrative services. Note exception: If you use the services of an in-network provider but take advantage of a sale, coupon, or other in-store special, the provider may require that you pay in full and submit your receipt for reimbursement. A provider’s status may occasionally change. You may change providers at any time without notice to us. 3 Out-of-network benets are for covered vision care services or materials provided by a non-participating ophthalmologist, optometrist (including a therapeutic optometrist), or optician, who have not agreed to provide covered services or materials at an agreed-to cost. For covered services or materials received from an out-of-network provider, benets are payable up to the amount of out-of-network benets shown in the benets and allowances section of your policy rider. You must pay the provider in full and send us a claim for benets by submitting the itemized invoice or receipt to us. (See the Filing a Claim provision in the policy or rider.)4 The standard contact lenses tting exam fee applies to a new or existing contact lens user who wears spherical disposable, daily wear, or extended wear lenses only. This includes follow-ups. 5 The specialty contact lenses tting exam fee applies to a new or existing contact lens user who wears toric, gas-permeable, mono-t or multi-focal lens. This includes follow-ups. 6 Eyeglass lenses and frames are paid in lieu of the contact lenses benet.7 The contact lenses benet is paid in lieu of eyeglass lenses and frames.THIS POLICY PROVIDES LIMITED BENEFITS. A NETWORK ACCESS PLAN IS AVAILABLE.This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may affect any benets payable. Applicable to policy form IDN8100-TX and rider form R-VSN8100-TX. For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company.Insurance products are underwritten by Colonial Life & Accident Insurance Company, Columbia, SC. © 2024 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. FOR EMPLOYEES 5-24 | 1820767-TXColonialLife.com

Group Accident InsurancePremier PlanIf you are in an accident, your focus should be on recovery, not how you’re going to pay your bills. Colonial Life accident insurance can pay benets directly to you to use however you like — from medical costs to everyday expenses. Whether you’ve had a fall or a car accident, these benets can offer nancial support when you need it.Our coverage includes:• Benets payable directly to you• No medical questions to qualify for coverage• Coverage for simple and complex injuries• Benets payable regardless of other insurance• Worldwide coverage• Works alongside your Health Savings Account (HSA)BENEFITS STORY Milo was working in his yard when he tripped and injured his hand.With Colonial Life accident benets, Milo was able to pay the annual deductible and co-payments for his health insurance plan without using his savings or taking on debt.MILO’S ACCIDENT BENEFITSMilo went to an urgent care facility and received immediate care.Treatment in a physician’s office or urgent care facility$150The doctor ordered an X-ray and discovered Milo had fractured his hand.• X-ray• Fracture (hand)$60$1,200The doctor also found that Milo had a cut on his hand but did not require stitches. Laceration (no repair) $75Milo was discharged with a splint. Durable medical equipment $65Over the next several weeks, Milo had two follow-up appointments with his doctor. Physician follow-up visits (2 visits)$50 x 2 = $100Total $1,650For illustrative purposes only. Benet amounts may vary and may not cover all expenses. GROUP ACCIDENT (GAC4100) — PREMIER PLAN

Give your benets a boostWe know that more complicated or severe accidents result in more expensive medical bills and more disruption in your life. Group Accident includes a Benet Booster* to provide additional nancial support for serious accidents. If you have more than $5,000 in payable benets for a covered accident, we will give you a $500 boost to your benets to help you with whatever expenses you have. *Payable once per Insured per covered accidentBENEFITS STORY Olivia was driving to the store when she got into a car accident.Olivia’s benets helped her cover her medical expenses when she was injured in a car accident, helping her to focus on her recovery.OLIVIA’S ACCIDENT BENEFITSOlivia arrived by ambulance at the nearest emergency room and received immediate care.• Ambulance• Emergency department visit• Injury due to auto accident$400$250 $250The doctor ordered an X-ray and discovered Olivia had fractured her thigh (femur). He also ordered a CT scan of her head to check for brain injury.• X-ray• Medical imaging• Fracture (thigh)$60$400 $4,200Olivia required surgery for her leg.• Surgical repair (thigh fracture)• General anesthesia$4,200 $300Olivia boarded her pet for two nights after her surgery. Pet boarding (2 days) $20 x 2 = $40Olivia had eight sessions of physical therapy to help regain the strength in her leg and two follow-up appointments with her doctor.• Therapy services (8 sessions)• Physician follow-up visits (2 visits)$55 x 8 = $440$50 x 2 = $100Olivia’s benefits for this accident totaled more than $5,000.Benefit Booster $500Total $11,140For illustrative purposes only. Benet amounts may vary and may not cover all expenses. Benets are per covered person per covered accident unless stated otherwiseInjury benets • Burns (based on size and degree) ............. $750–$21,000• Concussion ........................................ $500• Connective tissue damage ......................$100–$200• Eye injury .......................................... $400 • Hearing loss injuries ..................................$120(Maximum once per lifetime per ear per insured)• Injury due to auto accident ........................... $250 • Internal injuries ..................................... $200 • Knee cartilage (meniscus) injury ...................... $200 • Lacerations ...................................$75–$1,200• Loss of a digit — partial .........................$400–$800• Loss of a digit ..............................$1,000–$3,000• Ruptured or herniated disc ......................$200–$400

Fracture benets• Injury .......................................$200–$5,000 Examples: nger: $200 | wrist: $1,200 | hip: $4,200• Surgical repair of fracture ............................100%(Payable as an additional % of the applicable fractures benet)• Chip fracture ........................................25%(Payable as a % of the applicable fractures benet)Dislocation benets• Injury .......................................$260–$4,000 Examples: elbow: $600 | ankle: $1,600 | hip: $4,000• Surgical repair of dislocation ..........................100%(Payable as an additional % of the applicable dislocations benet)• Incomplete dislocation ................................25%(Payable as a % of the applicable dislocations benet)Treatment benets• Air ambulance .....................................$2,000 • Ambulance (ground or water) ......................... $400 • Durable medical equipment ......................$65–$250• Emergency dental repair ........................$200–$600• Emergency department .............................. $250(Maximum 4 per year) • Family care ................................... $50 per day(Maximum of one benet per day for all insureds combined, up to a maximum of three days per covered accident, regardless of the number of children)• Injections to prevent or limit infection ...................$50 • Lodging ..................................... $250 per day(Maximum 30 days)• Medical imaging ..................................... $400• Pain management injections ..........................$150 • Pet boarding .................................. $20 per day (Maximum of one benet per day for all insureds combined, up to a maximum of three days per covered accident, regardless of the number of pets that are boarded)• Prosthetic device or articial limb ............$1,750–$3,500• Skin grafts (due to burns) .............................50%(Payable as a % of the applicable burn benet)• Skin grafts (not due to burns) ....................$375–$750• Transfusions ........................................ $500 • Transportation ............................... $200 per trip (Maximum 6 one-way trips)• Treatment in a physician’s oce or urgent care facility ...$150(Maximum 4 per year) • X-ray or ultrasound ....................................$60Surgery benets• Anesthesia ....................................$150–$300• Connective tissue surgery ..................... $150–$2,200• Eye surgery .........................................$400• General surgery –Abdominal, thoracic, or cranial ...................$2,000 –Exploratory surgery ...............................$275 • Hernia surgery ......................................$400 • Knee cartilage (meniscus) surgery ..............$150–$1,050• Outpatient surgical facility ............................$400 • Ruptured or herniated disc surgery ............ $150–$2,000Recovery care benets• At-home care ................................ $125 per day(Maximum 5 days) • Benet Booster .....................................$500• Physician follow-up visits ............................. $50(Maximum 6 days per covered accident and 24 days per calendar year)• Rehabilitation or sub-acute rehabilitation unit connement .............................$200 per day (Maximum 15 days per covered accident and 30 days per calendar year)• Therapy services (speech, physical therapy, occupational therapy) ..........................$55 per day(Maximum 15 days)Options checked below have been chosen by your employer to enhance your Group Accident Coverage.  Recovery Plus package• Behavioral health therapy ...................$55 per day (Maximum 15 days)• Post-traumatic stress disorder (PTSD) ............ $200 • Prescription drug .................................$25 • Additional therapy services (chiropractic, acupuncture, alternative therapy) ......$55 (Existing therapy services benet maximum applies to additional therapy services, maximum 15 days)• Injury due to felonious act of violence or sexual assault ................................ $250(Maximum once per insured per calendar year, with an accompanying police report) Gunshot wound benetThis benet can help pay your medical expenses if you receive a non-fatal gunshot wound. It offers you a lump sum for a covered injury regardless of any other insurance you may have and includes on/off-job coverage.• Gunshot wound .............................$_________This benet covers a non-fatal gunshot wound from a conventional rearm that requires treatment by a doctor and overnight hospitalization within 24 hours of the injury. If you are shot more than once in a 24-hour period, we can pay benets only for the rst wound.

Contact your Colonial Life benets counselor to learn more.CT: We will pay the air ambulance or ambulance benets directly to the licensed professional ambulance company. CT includes a benet for “outpatient emergency medical care for accidental ingestion of a controlled substance.” The at-home care benet maximum is 80 days. KS: Chiropractic therapy is not available. NH: NH includes a burn benet for 2nd degree burns under 5% of skin surface. The minimum benet for the loss or partial loss of a digit is $1,000.MD: The prescription drug benet is not available.PA: The pet boarding benet is not available. TN: The therapy services benet includes chiropractic. TX: The concussion benet is replaced by the “concussion and acquired brain injuries” benet. The therapy services benet includes the following services: cognitive communication therapy; cognitive rehabilitation therapy; community reintegration services; neurobehavioral; neurocognitive therapy and rehabilitation; neurofeedback therapy; neurophysiological; neuropsychological; post-acute transition services; psychophysiological testing or treatment; and remediation.HEALTH SAVINGS ACCOUNT (HSA) COMPATIBLEThis plan is compatible with HSA guidelines and any other HSA plan in which a covered family member may participate.It may also be offered to employees who do not have HSAs.THIS INSURANCE PROVIDES LIMITED BENEFITS.This coverage is a supplement to health insurance. It is not a substitute for essential health benets or minimum essential coverage as dened in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this insurance.EXCLUSIONSWe will not pay benets for claims that are caused by, contributed to by, or resulting from elective procedures, felonies or illegal occupations, hazardous avocations, impaired driving, incarceration, racing, semi-professional or professional sports, sickness, suicide or self-inicted injuries, war, or armed conict. ID: ”Semi-professional sports or professional sports” exclusion is replaced by “professional sports” exclusion. IL: We will not pay benets for claims that are caused by or resulting from Exclusions.MD: Includes an exclusion for “Prohibited referrals.” The “felonies or illegal occupations” and “impaired driving” exclusions apply only to Accidental Death and Dismemberment benets.MI: “Impaired driving” and “suicide or self-inicted injuries” exclusions do not apply. MN: “Suicide or self-inicted injuries” exclusion does not apply.NH: “Incarceration” and “racing” exclusions do not apply.UT: We will not pay benets for claims that are caused by or resulting from Exclusions.VT: “Impaired driving” exclusion does not apply. This information is not intended to be a complete description of the insurance coverage available. The insurance or its provisions may vary or be unavailable in some states. The insurance has exclusions and limitations which may affect any benets payable. Applicable to policy form GAC4100-P and certicate form GAC4100-C (including state abbreviations where used, for example: GAC4100-P-TX and GAC4100-C-TX). For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.© 2023 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.FOR EMPLOYEES 3-23 | 1212553ColonialLife.com

15,000 & 30,000

For more information, talk with your benefits counselor.ColonialLife.comGroup Hospital Indemnity InsurancePlan 1 (HSA-Compliant)PA: “Hospital Confinement Admission” benefit replaces the “Hospital Confinement” benefitTHIS POLICY PROVIDES LIMITED BENEFITS.EXCLUSIONSWe will not pay any benefits for injuries received in accidents or for sicknesses which are caused by, contributed to by or occur as a result of the following exclusions and limitations. (a) alcoholism or drug addiction; (b) dental procedures; (c) elective procedures and cosmetic surgery; (d) felonies or illegal occupations; (e) mental or nervous disorders; (f) pregnancy of a dependent child; (g) suicide or injuries which any covered person intentionally does to himself or herself; (h) war, or (i) giving birth within the first nine months aer the eective date of the certificate. (j) We will not pay benefits for hospital confinement or daily hospital confinement, if included, of a newborn child following his birth unless he is injured or sick. (k)The policy may have additional exclusions and limitations which may aect any benefits payable.PRE-EXISTING CONDITION LIMITATIONS(l) We will not pay benefits for loss during the first 12 months aer the certificate eective date due to a pre-existing condition.(m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, received medical advice or had taken medication within the 12 months before the certificateeective date. (n) This limitation applies to the following benefits, if applicable: Hospital Confinement and Daily Hospital Confinement.This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy form GMB7000-P and certificate form GMB7000-C (including state abbreviations where applicable, such as policy forms GMB7000-P-AU-TX and GMB7000-P-EE-TX, and certificate forms GMB7000-C-AU-TX and GMB7000-C-EE-TX). Coverage may vary by state and may not be available in all states. This form is not complete without form #101733.GMB7000 – PLAN 1 | 11-18 | 101917Group Medical BridgeSM insurance can help with medical costs associated with a hospital stay that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children. Hospital confinement ............................................................... $_______________ per dayMaximum of one day per covered person per calendar yearWaiver of premiumAvailable aer 30 continuous days of a covered confinement of the named insured£ Daily hospital confinement ....................................................................$100 per dayMaximum of 365 days per covered person per confinement. Re-confinement for the same or related condition within 90 days of discharge is considered a continuation of a previous confinement.Health savings account (HSA) compatibleThis plan is compatible with HSA guidelines and any other HSA plan that a covered family member may participate in. It may also be oered to employees who do not have HSAs.Colonial Life & Accident Insurance Company’s Group Medical Bridge oers an HSA-compatible plan in most states.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC©2018 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

Group Hospital Indemnity InsuranceExclusions and LimitationsGMB7000 – EXCLUSIONS AND LIMITATIONSSTATE-SPECIFIC EXCLUSIONSAK: (a) Replaced by intoxicants and narcotics CA: (k) Additional exclusions include intoxicants and controlled substancesCT: (a) Replaced by intoxication or drug addiction; (d) Replaced by felonies; (f) Exclusion does not applyDE: (a) Exclusion does not apply IL: (a) Replaced by alcoholism, intoxication, or drug addiction; (f) Exclusion does not apply; (g) Exclusion does not applyKS: (a) Replaced by intoxicants and narcotics; (h) Replaced by war or armed conflict; (i) Exclusion does not applyKY: (a) Replaced by intoxicants, narcotics and hallucinogenics LA: (a) Replaced by intoxicants and narcotics MI: (g) Exclusion does not applyMO: (a) Replaced by drug addiction; (d) Replaced by illegal activitiesMS: (a) Replaced by intoxicants and narcoticsNC: (i) Exclusion does not applyND: (a) Exclusion does not apply; (e) Exclusion does not applyNV: (a) Exclusion does not apply OH: (f) Exclusion does not apply; (i) Replaced by 270 daysPA: (a) Replaced by intoxicants and narcotics; (c) Replaced by cosmetic surgery; (e) Replaced by mental, nervous or emotional disorders; (h) Replaced by war or armed conflictSD:(a) Exclusion does not apply TN: (f) Exclusion does not applyTX: (a) Replaced by intoxicants and narcotics VA: (i) Pregnancy resulting from the rape of any covered person, which was reported to the police within seven days following its occurrence, will be covered to the same extent as any other covered accident. The seven-day requirement will be extended to 180 days in the case of an act of rape or incest of a female under 13 years of age.STATE-SPECIFIC PRE-EXISTING CONDITION LIMITATIONSIN, SD, and WY: (m) applies within the six months before the certificate eective date.CA: (m) A pre-existing condition is a sickness or physical condition for which a covered person was diagnosed or treated within 12 months before the coverage eective date.FL: (m) A pre-existing condition is a sickness or physical condition for which a covered person was treated, had medical testing, received medical advice or had taken medication within six months before the coverage eective date. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information. IL: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing by a legally qualified physician or, received medical advice, produced symptoms or had taken medication within 12 months before the coverage eective date.KS: (n) Surgical Procedure replaces Outpatient Surgical Procedure ME: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, or received medical advice within 12 months before the coverage eective date.MI: (l) Applies during the first six months aer the certificate eective date (m) applies within the six months before the certificate eective date.MO: (m) A pre-existing condition means having a sickness or physical condition, whether diagnosed or not, for which a covered person was treated, had medical testing, received medical advice or had taken medication within 12 months before the coverage eective date of this certificate.NC: (m) A pre-existing condition is those conditions, whether diagnosed or not, for which a covered person received medical advice, diagnosis, care or treatment that was received or recommended within the one-year period immediately preceding the coverage eective date. If you are 65 or older when this certificate is issued, pre-existing conditions will include only conditions specifically eliminated by a rider.ND: (m) A pre-existing condition is a sickness or physical condition for which a covered person was treated, had medical testing, received medical advice or had taken medication within 12 months before the coverage eective date.NV: (m) applies within the six months before the certificate eective date. Additionally, pre-existing condition does not include genetic information in the absence of a diagnosis of the condition related to such information.OR: (m) A pre-existing condition is a sickness or physical condition, whether diagnosed or not, for which a covered person was treated by a doctor, received advice from a physician or had taken medication prescribed by a doctor within the 12 months period immediately preceding the coverage eective date.PA: (m) A pre-existing condition is a disease or physical condition for which you received medical advice or treatment within 90 days before the coverage eective date. (n) Hospital Confinement Admission replaces Hospital Confinement. CA Lic # (if applicable): _________________11-18 | 101733-2This information is not intended to be a complete description of the insurance coverage available. This coverage has exclusions and limitations that may aect benefits payable. For cost and complete details, see your Colonial Life benefits counselor. This brochure is applicable to policy form GMB7000-P and certificate form GMB7000-C (including state abbreviations where applicable, such as policy forms GMB7000-P-AU-TX and GMB7000-P-EE-TX, and certificate forms GMB7000-C-AU-TX and GMB7000-C-EE-TX). Coverage may vary by state and may not be available in all states.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2018 Colonial Life & Accident Insurance Company. All rights reserved.Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

Group Disability Income InsuranceThere is a 33 percent chance someone will be disabled for at least six months during their working years.11 Charles River Associates (prepared for Unum), Financial Security for Working Americans: An Economic Analysis of Insurance Products in Workplace Benets Programs (2011).2 Lusardi, Annamarie, et. al, “Financially Fragile Households: Evidence and Implications,” National Bureau of Economic Research Working Paper 17072, May 2011.Group Disability Base – TXHere’s how it worksMark and his wife had a second child and bought a new house to accommodate their growing family. Mark’s occupation enabled him to pay for his family’s expenses, such as gas, groceries and mortgage payments. Then the unexpected happened. An accident left Mark disabled and unable to work for several months. Before his disability, Mark had an annual salary of $50,000 and brought home $2,500 a month after taxes and benet contributions. Fortunately, he had disability insurance and received a $2,500 monthly benet.Disability insurance helped Mark cover his family’s expenses. He was prepared for the unexpected. Are you?Your bills keep coming, even when your paycheck doesn’t.Like most of us, you likely depend on your paycheck to maintain your current quality of life. If you got sick or hurt and couldn’t work, how long could you go without a paycheck? Half of households say they couldn’t raise $2,000 within a month, if needed. 2Would you be nancially prepared?Protect your incomeColonial Life’s Disability Insurance oers a monthly benet to replace a portion of your income if you are disabled and can’t work due to a covered accident or covered sickness. You can use this benet however you need. It can help you cover expenses like: O Mortgage or rent paymentsO Credit card billsO Utility bills, such as electricity, gas, water, cable TV and InternetO Car payments, gas and other transportation costsO Food, clothing and other necessitiesWith Colonial Life’s Disability Insurance:1. You’re paid regardless of any other insurance you may havewith other insurance companies.2. Benets are paid directly to you (unless you specify otherwise).3. At enrollment, you may choose the amount of your disabilitybenets to meet your needs (subject to income).4. Your coverage is available through convenientpayroll deduction.

Colonial Life 1200 Colonial Life BoulevardColumbia, South Carolina 29210coloniallife.com©2013 Colonial Life & Accident Insurance Company. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand.613 101296Group Disability Base – TXProduct OptionsTotal Disability Benet Period This is the maximum amount of time you can receive benets for a covered total disability.Totally Disabled or Total Disability means you are: unable to perform the material and substantial duties of your occupation; not, in fact, working at any occupation; and under the regular and appropriate care of a doctor.Monthly Benet Amounts Choose a monthly benet amount between $400 and $7,500 (subject to income requirements).Important featuresPartial Disability If you are able to return to work part-time, you may be able to still receive 50 percent of your total disability benet. Partial disability is based on your inability to perform your occupation or any other occupation for at least half of your normal working hours and being under the regular and appropriate care of a doctor.Waiver of Premium We will waive your premium payments after 90 consecutive days of a covered disability.Geographical Limitations If you are disabled while outside the United States or covered geographical areas, we can pay up to 60 days before you have to return to the U.S. or a covered geographical area to receive any remainder of your benets.Issue Age Coverage is available from ages 17 to 74.Portability You may be able to keep your coverage even if you change occupations. Premium Your premium is based on your current age and the amount of coverage you are eligible to buy. Your premium will not change because you age. Talk with a Colonial Life benets counselor today to learn more about how you can help protect your nances with disability insurance.Benets Worksheet(For use with your Colonial Life benets counselor)How much coverage do I need?Monthly Benet Amount for O-Job Accident & O-Job Sickness: ________________If your plan includes On-Job Accident/On-Job Sickness benets, the benet is 50% of the O-Job amount.How long will I receive benets?Benet Period: ________ months The Partial Disability Benet Period is three months. When will my benets start?Elimination Period After an accident: ______ days After a sickness: ______ days Elimination Period means a period of total disability during which no benets are payable.EXCLUSIONS We will not pay benets for losses that are caused by, contributed to by or occur as the result of: alcoholism or drug addiction; felonies or illegal occupations; ying; hazardous avocations; intoxicants and narcotics; psychiatric or psychological conditions; racing; semi-professional or professional sports; suicide or injuries which you intentionally do to yourself; war or armed conict. State versions apply.LIMITATIONS We will not pay for losses due to you giving birth within the rst nine months after the coverage eective date of the certicate. We will not pay for loss when the disability is a pre-existing condition as described in the certicate. This product is underwritten by Colonial Life & Accident Insurance Company. For cost and complete details applicable to policy form GDIS-P-EE-TX and certicate form GDIS-C-EE-TX, see your Colonial Life benets counselor. This is not an insurance contract and only the actual policy provisions will control.

Term Life InsurancePeace of mind for you and your loved onesYou want what’s best for your family, and that includes making sure they’re prepared for the future. With term life insurance from Colonial Life & Accident Insurance Company, you can provide financial security to help them cover their ongoing living expenses.Advantages of term life insurance  Lower cost when compared to cash value life insurance  Same benefit payout throughout the duration of the policy  Several term period options for flexibility during high-need years  Benefit for the beneficiary that is typically tax-freeBenefits and features  Stand-alone spouse policy available whether or not you buy apolicy for yourself  Guaranteed premiums that do not increase during the selected term  Ability to convert all or a portion of the benefit amount into cashvalue life insurance  Flexibility to keep the policy if you change jobs or retire  Built-in terminal illness accelerated death benefit that provides up to75% of the policy’s death benefit (up to $150,000) if you’re diagnosedwith a terminal illness  Premium savings for face amounts over $250,000 based on your healthTERM LIFE (ITL5000)LIMRA, 2017 Insurance Barometer Study.of Americans would have trouble paying living expenses immediately or within several months if the primary wage-earner died.54%married/partnered consumersLIMRA, 2018 Insurance Barometer Study.1-in-3wish their spouse or partner would purchase more life insurance.

How much coverage do you need?To learn more, talk with your Colonial Life benefits counselor.EXCLUSIONS AND LIMITATIONSIf the insured dies by suicide, whether sane or insane, within two years (one year in ND) from the coverage eective date or the date of reinstatement, we will not pay the death benefit. We will terminate this policy and return the premiums paid, without interest. Product may vary by state. For cost and complete details of the coverage, call or write your Colonial Life benefits counselor or the company. This brochure is applicable to policy forms ICC18-ITL5000/ITL5000 and rider forms ICC18-R-ITL5000-STR/R-ITL5000-STR, ICC18-R-ITL5000-CTR/R-ITL5000-CTR, ICC18-R-ITL5000-WP/R-ITL5000-WP, ICC18-R-ITL5000-ACCD/R-ITL5000-ACCD, ICC18-R-ITL5000-CI/R-ITL5000-CI, ICC18-R-ITL5000-CC/R-ITL5000-CC and applicable state variations. Spouse term life riderYour spouse may receive a maximum death benefit of $50,000; 10-year and 20-year spouse term riders are available. Children’s term life riderYou can purchase up to $20,000 in term life coverage for all of your eligible dependent children and pay one premium. The children’s term life rider may be added to either your policy or your spouse’s policy – not both.Accidental death benefit riderThe beneficiary may receive an additional benefit if the covered person dies as a result of an accident before age 70. The benefit doubles if the accidental bodily injury occurs while riding as a fare-paying passenger using public transportation, such as ride-sharing services. An additional 25% will be payable if the injury is sustained while driving or riding in a private passenger vehicle and wearing a seatbelt.Chronic care accelerated death benefit riderIf a licensed health care practitioner certifies that you have a chronic illness, you may receive an advance on all or a portion of the death benefit, available in a one-time lump sum or monthly payments. A chronic illness means you require substantial supervision due to a severe cognitive impairment or you may be unable to perform at least two of the six Activities of Daily Living. Premiums are waived during the benefit period. Critical illness accelerated death benefit riderIf you suer a heart attack (myocardial infarction), stroke or end-stage renal (kidney) failure, a $5,000 benefit is payable. A subsequent diagnosis benefit is included.Waiver of premium benefit riderPremiums are waived (for the policy and riders) if you become totally disabled before the policy anniversary following your 65th birthday and you satisfy the six-month elimination period. 6-19 | 101895-1ColonialLife.com1 Any payout would reduce the death benefit. Benefits may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits.2 Activities of daily living are bathing, continence, dressing, eating, toileting and transferring.3 You must resume premium payments once you are no longer disabled.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC©2019 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.Optional ridersAt an additional cost, you can purchase the following riders for even more financial protection.£ YOU $ ___________________ Select the term period:£ 10-year£ 15-year£ 20-year£ 30-year£ SPOUSE $ ___________________ Select the term period:£ 10-year£ 15-year£ 20-year£ 30-yearSelect any optional riders:£ Spouse term life rider $ _____________ face amount for ________-year term period£ Children’s term life rider $ _____________ face amount£ Accidental death benefit rider£ Chronic care accelerated death benefit rider£ Critical illness accelerated death benefit rider£ Waiver of premium benefit rider

Your cost will vary based on the level of coverage you select. Whole Life InsuranceYou can’t predict your family’s future, but you can be prepared for it.You like to think that you’ll be there for your family in the years to come. But if something happened to you, would your family have the income they need?It’s not easy to think about such serious circumstances, but it’s important to make sure your family is financially protected. You can gain peace of mind with whole life insurance from Colonial Life.Advantages of whole life insurance  Permanent coverage that stays the same throughout the life of the policy  Guaranteed level premiums that do not increase because of changes in health or age  Access to the policy’s cash value through a policy loan for emergencies  Benefit for the beneficiary that is typically tax-freeBenefits and features  Two plan options to choose what age your premium payments will end – Paid-Up at Age 70 or Paid-Up at Age 100  Stand-alone spouse policy available whether or not you buy a policy for yourself  Flexibility to keep the policy if you change jobs or retire  Built-in terminal illness accelerated death benefit that provides up to 75% of the policy’s death benefit (up to $150,000) if you’re diagnosed with a terminal illness  Immediate $3,000 claim payment that can help your designated beneficiary pay for funeral costs or other expenses  Pays cash surrender value at age 100 (when the policy endows)WHOLE LIFE (IWL5000)HealthAairs.org, End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported, July 2017.Talk with your benefits counselor for information about what level of coverage would work best for you.In the U.S., medical spending in the last 12 months of life isnearly $80,000 per person.$

£ YOU $ ___________________ Select the option:£ Paid-Up at Age 70£ Paid-Up at Age 100£ SPOUSE $ _______________ Select the option:£ Paid-Up at Age 70£ Paid-Up at Age 100EXCLUSIONS AND LIMITATIONSIf the insured dies by suicide, whether sane or insane, within two years (one year in ND) from the coverage eective date or the date of reinstatement, we will not pay the death benefit. We will terminate this policy and return the premiums paid without interest, minus any loans and loan interest to you. Product may vary by state. For costs and complete details of the coverage, call or write your Colonial Life benefits counselor or the company.This brochure is applicable to policy forms ICC19-IWL5000-70/IWL5000-70, ICC19-IWL5000-100/IWL5000-100, ICC19-IWL5000J/IWL5000J and rider forms ICC19-R-IWL5000-STR/R-IWL5000-STR, ICC19-R-IWL5000-CTR/R-IWL5000-CTR, ICC19-R-IWL5000-WP/R-IWL5000-WP, ICC19-R-IWL5000-ACCD/R-IWL5000-ACCD, ICC19-R-IWL5000-CI/R-IWL5000-CI, ICC19-R-IWL5000-CC/R-IWL5000-CC, ICC19-R-IWL5000-GPO/R-IWL5000-GPO and applicable state variations.Additional coverage optionsSpouse term life riderCover your spouse up to a maximum death benefit of $50,000; 10-year and 20-year spouse term riders are available.Juvenile whole life policyYou can purchase a policy while children are young and premiums are low – whether or not you buy a policy on yourself. You may also increase the coverage when the child is 18, 21 and 24 without providing proof of good health. The plan is paid-up at age 70.Children’s term life riderYou may purchase up to $20,000 in term life coverage for all of your eligible dependent children and pay one premium. The children’s term life rider may be added to either your policy or your spouse’s policy – not both.Accidental death benefit riderThe beneficiary may receive an additional benefit if the covered person dies as a result of an accident before age 70. The benefit doubles if the accidental bodily injury occurs while riding as a fare-paying passenger using public transportation, such as ride-sharing services. An additional 25% will be payable if the injury is sustained while driving or riding in a private passenger vehicle and wearing a seatbelt.Chronic care accelerated death benefit riderIf a licensed health care practitioner certifies that you have a chronic illness, you may receive an advance on all or a portion of the death benefit, available in a one-time lump sum or monthly payments. A chronic illness means you require substantial supervision due to a severe cognitive impairment or you may be unable to perform at least two of the six Activities of Daily Living (bathing, continence, dressing, eating, toileting and transferring). Premiums are waived during the benefit period.Critical illness accelerated death benefit riderIf you suer a heart attack (myocardial infarction), stroke or end-stage renal (kidney) failure, a $5,000 benefit is payable. A subsequent diagnosis benefit is included.Guaranteed purchase option riderIf you are age 50 or younger when you purchase the policy, you can add the rider, which allows you to purchase additional whole life coverage – without having to answer health questions – at three dierent points in the future. You may purchase up to your initial face amount, not to exceed a total combined maximum of $100,000 for all options.Waiver of premium benefit riderPremiums are waived (for the policy and riders) if you become totally disabled before the policy anniversary following your 65th birthday and you satisfy the six-month elimination period. Once you are no longer disabled, premium payments will resume.Benefits worksheetFor use with your benefits counselorSelect any optional riders:£ Spouse term life rider $ _____________ face amount for ________-year term period£ Children’s term life rider $ _____________ face amount£ Accidental death benefit rider£ Chronic care accelerated death benefit rider£ Critical illness accelerated death benefit rider£ Guaranteed purchase option rider£ Waiver of premium benefit riderHOW MUCH COVERAGE DO YOU NEED?To learn more, talk with your benefits counselor.ColonialLife.com6-19 | 101935£ DEPENDENT STUDENT $____________£ Paid-Up at Age 70 £ Paid-Up at Age 100 1 Loan should be repaid to protect the policy’s value. 2 Any payout would reduce the death benefit. Benefits may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benefits.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2019 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.

Why won’t they pay my claim? Services denied?! How can my claim still be “in process”? It’s been two months! I called my insurance carrier, but now I’m just more confused. Do I have mail-order prescription benefits? Call the Benefit Resource Center (“BRC”), We’re Here To Help! We speak insurance. Our Benefits Specialists can help you with: ▪ Deciding which plan is the best for you ▪ Medicare basics with your employer plan ▪ Benefit plan & policy questions ▪ Coordination of benefits ▪ Eligibility & claim problems with carriers ▪ Finding in-network providers ▪ Information about claim appeals & process ▪ Access to care issues ▪ Allowable family status election changes ▪ Obtaining case management services ▪ Transition of care when changing carriers ▪ Group disability claims ▪ Claim escalation, appeal & resolution ▪ Filing claims for out-of-network services Benefit Resource Center BRC.Southwest@usi.com | Toll Free: 855-874-0110 Monday through Friday 8:00am to 5:00pm Eastern & Central Standard Time