Benefit Booklet 2024
Colonial Life provides benefits that employees want for the unexpected moments in life Whether planning for retirement growing their families or saving for college they know an injury or illness won t derail their dreams For more information Will Bradfield 404 902 1525 Willie Bradfield ColonialLifeSales com Life is anything but expected That s why we re here Plan options Accident insurance Helps offset unexpected medical expenses such as emergency room fees deductibles and copayments that can result from a fracture dislocation or other covered accidental injury Hospital insurance Provides a lump sum benefit for a covered hospital confinement or outpatient surgery to help with copayments and deductibles that are not covered by most major medical plans Critical illness Cancer Supplements your major medical coverage by providing a lump sum benefit you can use to pay the direct and indirect costs related to a covered critical illness and cancer Disability Provides financial protection to cover income loss from a covered disability Dental Annual cleanings x rays basic and comprehensive services Life insurance Enables you to tailor coverage for your individual needs and helps provide financial security for your family members
Accident 1.0 -Preferred with Health Screening BenetAccidents happen in places where you and your family spend the most time – at work, in the home and on the playground – and they’re unexpected. How you care for them shouldn’t be. In your lifetime, which of these accidental injuries have happened to you or someone you know?l Sports-related accidental injuryl Broken bonel Burnl Concussionl Lacerationl Back or knee injuriesColonial Life’s Accident Insurance is designed to help you ll some of the gaps caused by increasing deductibles, co-payments and out-of-pocket costs related to an accidental injury. The benet to you is that you may not need to use your savings or secure a loan to pay expenses. Plus you’ll feel better knowing you can have greater nancial security.l Car accidentsl Falls & spillsl Dislocationl Accidental injuries that send you to the Emergency Room, Urgent Care or doctor’s oceWhat additional features are included?l Worldwide coveragel Portablel Compliant with Healthcare Spending Account (HSA) guidelinesWill my accident claim payment be reduced if I have other insurance?You’re paid regardless of any other insurance you may have with other insurance companies, and the benets are paid directly to you (unless you specify otherwise).What if I change employers?If you change jobs or leave your employer, you can take your coverage with you at no additional cost. Your coverage is guaranteed renewable as long as you pay your premiums when they are due or within the grace period. Can my premium change?Colonial Life can change your premium only if we change it on all policies of this kind in the state where your policy was issued. How do I le a claim?Visit coloniallife.com or call our Customer Service Department at 1.800.325.4368 for additional information.Accident Insurance
Your Colonial Life policy also provides benets for the following injuries received as a result of a covered accident.l Burn (based on size and degree) ....................................................................................$1,000 to $12,000l Coma .............................................................................................................................................................$10,000l Concussion .......................................................................................................................................................$150l Emergency Dental Work .......................................$75 Extraction, $300 Crown, Implant, or Denturel Lacerations (based on size) ........................................................................................................... $50 to $800Requires Surgeryl Eye Injury ...........................................................................................................................................................$300l Tendon/Ligament/Rotator Cu .......................................................... $500 - one, $1,000 - two or morel Ruptured Disc ..................................................................................................................................................$500l Torn Knee Cartilage .......................................................................................................................................$500Surgical Carel Surgery (cranial, open abdominal or thoracic) ................................................................................$1,500l Surgery (hernia) ..............................................................................................................................................$150l Surgery (arthroscopic or exploratory) ....................................................................................................$250l Blood/Plasma/Platelets ................................................................................................................................$300Benets listed are for each covered person per covered accident unless otherwise specied.Initial Carel Accident Emergency Treatment........... $150 l Ambulance .......................................$400l X-ray Benet ...................................................$50 l Air Ambulance ............................. $2,000Common Accidental InjuriesDislocations (Separated Joint) Non-Surgical SurgicalHip $6,600 $13,200 Knee (except patella) $3,300 $6,600 Ankle – Bone or Bones of the Foot (other than Toes) $2,640 $5,280 Collarbone (Sternoclavicular) $1,650 $3,300 Lower Jaw, Shoulder, Elbow, Wrist $990 $1,980 Bone or Bones of the Hand $990 $1,980 Collarbone (Acromioclavicular and Separation) $330 $660 One Toe or Finger $330 $660 Fractures Non-Surgical Surgical Depressed Skull $5,500 $11,000 Non-Depressed Skull $2,200 $4,400 Hip, Thigh $3,300 $6,600 Body of Vertebrae, Pelvis, Leg $1,650 $3,300 Bones of Face or Nose (except mandible or maxilla) $770 $1,540 Upper Jaw, Maxilla $770 $1,540 Upper Arm between Elbow and Shoulder $770 $1,540 Lower Jaw, Mandible, Kneecap, Ankle, Foot $660 $1,320 Shoulder Blade, Collarbone, Vertebral Process $660 $1,320 Forearm, Wrist, Hand $660 $1,320 Rib $550 $1,100 Coccyx $440 $880 Finger, Toe $220 $440
Transportation/Lodging AssistanceIf injured, covered person must travel more than 50 miles from residence to receive special treatment and connement in a hospital.l Transportation ............................................................................. $500 per round trip up to 3 round tripsl Lodging (family member or companion) ............................................... $125 per night up to 30 days for a hotel/motel lodging costsAccident Hospital Carel Hospital Admission* ........................................................................................................$1,500 per accidentl. Hospital ICU Admission* ................................................................................................$3,000 per accident* We will pay either the Hospital Admission or Hospital Intensive Care Unit (ICU) Admission, but not both.l Hospital Connement .........................................................$250 per day up to 365 days per accidentl Hospital ICU Connement ...................................................$500 per day up to 15 days per accidentAccident Follow-Up Carel Accident Follow-Up Doctor Visit ..........................................................$50 (up to 3 visits per accident)l Medical Imaging Study ......................................................................................................$250 per accident (limit 1 per covered accident and 1 per calendar year)l Occupational or Physical Therapy ..................................................... $35 per treatment up to 10 daysl Appliances ..........................................................................................$125 (such as wheelchair, crutches)l Prosthetic Devices/Articial Limb ....................................................$500 - one, $1,000 - more than 1l Rehabilitation Unit .................................................$100 per day up to 15 days per covered accident, and 30 days per calendar year. Maximum of 30 days per calendar yearAccidental Dismembermentl Loss of Finger/Toe .................................................................................$750 – one, $1,500 – two or morel Loss or Loss of Use of Hand/Foot/Sight of Eye .....................$7,500 – one, $15,000 – two or moreCatastrophic AccidentFor severe injuries that result in the total and irrecoverable:l Loss of one hand and one foot l Loss of the sight of both eyesl Loss of both hands or both feet l Loss of the hearing of both earsl Loss or loss of use of one arm and one leg or l Loss of the ability to speakl Loss or loss of use of both arms or both legs Named Insured ................ $25,000 Spouse ..............$25,000 Child(ren) ......... $12,500365-day elimination period. Amounts reduced for covered persons age 65 and over. Payable once per lifetime for each covered person. Accidental DeathAccidental Death Common Carrierl Named Insured $25,000 $100,000l Spouse $25,000 $100,000l Child(ren) $5,000 $20,000
EXCLUSIONS We will not pay benets for losses that are caused by or are the result of: hazardous avocations; felonies or illegal occupations; racing; semi-professional or professional sports; sickness; suicide or self-inicted injuries; war or armed conict; in addition to the exclusions listed above, we also will not pay the Catastrophic Accident benet for injuries that are caused by or are the result of: birth; intoxication.For cost and complete details, see your Colonial Life benets counselor. Applicable to policy form Accident 1.0-HS-NC. This is not an insurance contract and only the actual policy provisions will control. Colonial Life 1200 Colonial Life BoulevardColumbia, South Carolina 29210coloniallife.com71740-NC©2014 Colonial Life & Accident Insurance Company | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 6-14Health Screening Benet l $50 per covered person per calendar yearProvides a benet if the covered person has one of the health screening tests performed. This benet is payable once per calendar year per person and is subject to a 30-day waiting period.Tests include:l. Blood test for triglyceridesl. Bone marrow testingl. Breast ultrasoundl. CA 15-3 (blood test for breast cancer) l. CA125 (blood test for ovarian cancer) l. Carotid doppler l. CEA (blood test for colon cancer) l. Chest x-ray l. Colonoscopy l. Echocardiogram (ECHO) l. Electrocardiogram (EKG, ECG) l. Fasting blood glucose test l. Flexible sigmoidoscopy l. Hemoccult stool analysisl. Mammographyl. Pap smearl. PSA (blood test for prostate cancer)l. Serum cholesterol test to determine level of HDL and LDL l. Serum protein electrophoresis (blood test for myeloma) l. Stress test on a bicycle or treadmill l. Skin cancer biopsy l. Thermography l. ThinPrep pap test l. Virtual colonoscopy Accident 1.0 -Preferred with Health Screening BenetMy Coverage Worksheet (For use with your Colonial Life benets counselor) Who will be covered? (check one) Employee Only Spouse Only One Child Only Employee & Spouse One-Parent Family, with Employee One-Parent Family, with Spouse Two-Parent FamilyWhen are covered accident benets available? (check one) On and O -Job Benets O -Job Only Benets
For more information talk with your benefits counselor Hospital Confinement Indemnity Insurance Plan 2 Our Individual Medical Bridge Insurance can help with medical costs that your health insurance may not cover These benefits are available for you your spouse and eligible dependent children Hospital confinement __1_5__0_0_________ Maximum of one benefit per covered person per calendar year Observation room 100 per visit Maximum of two visits per covered person per calendar year Rehabilitation unit confinement 100 per day Maximum of 15 days per confinement with a 30 day maximum per covered person per calendar year Waiver of premium Available a er 30 continuous days of a covered hospital confinement of the named insured Outpatient surgical procedure Tier 1 ____5_0__0________ Tier 2 ____7_5__0________ Maximum of _1__5_0_0___________ per covered person per calendar year for all covered outpatient surgical procedures combined The surgeries listed below are only a sampling of the surgeries that may be covered Surgeries must be performed by a doctor in a hospital or ambulatory surgical center For complete details and definitions please refer to your policy Tier 1 outpatient surgical procedures Breast Axillary node dissection Breast capsulotomy Lumpectomy Cardiac Pacemaker insertion Digestive Colonoscopy Fistulotomy Hemorrhoidectomy Lysis of adhesions Ear nose throat mouth Adenoidectomy Removal of oral lesions Myringotomy Tonsillectomy Tracheostomy Tympanotomy Gynecological Dilation and curettage D C Endometrial ablation Lysis of adhesions Liver Paracentesis Musculoskeletal system Carpal cubital repair or release Foot surgery bunionectomy exostectomy arthroplasty hammertoe repair Removal of orthopedic hardware Removal of tendon lesion Skin Laparoscopic hernia repair Skin gra ing IMB7000 PLAN 2
Tier 2 outpatient surgical procedures Breast Breast reconstruction Breast reduction Cardiac Angioplasty Cardiac catheterization Digestive Exploratory laparoscopy Laparoscopic appendectomy Laparoscopic cholecystectomy Ear nose throat mouth Ethmoidectomy Mastoidectomy Septoplasty Stapedectomy Tympanoplasty Eye Cataract surgery Corneal surgery penetrating keratoplasty Glaucoma surgery trabeculectomy Vitrectomy Gynecological Hysterectomy Myomectomy Musculoskeletal system Arthroscopic knee surgery with meniscectomy knee cartilage repair Arthroscopic shoulder surgery Clavicle resection Dislocations open reduction with internal fixation Fracture open reduction with internal fixation Removal or implantation of cartilage Tendon ligament repair Thyroid Excision of a mass Urologic Lithotripsy ColonialLife com THIS POLICY PROVIDES LIMITED BENEFITS This coverage is a supplement to health insurance It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law Insureds in some states must be covered by comprehensive health insurance before applying for this coverage EXCLUSIONS We will not pay benefits for injuries received in accidents or for sicknesses which are caused by a alcoholism or drug addiction b dental procedures c elective procedures and cosmetic surgery d felonies or illegal occupations e pregnancy of a dependent child f psychiatric or psychological conditions g suicide or injuries which any covered person intentionally does to himself or herself or h war We will not pay benefits for hospital confinement i due to giving birth within the first nine months a er the e ective date of the policy or j for a newborn who is neither injured nor sick k The policy may have additional exclusions and limitations which may a ect any benefits payable PRE EXISTING CONDITION LIMITATION l We will not pay benefits for loss during the first 12 months a er the e ective date due to a pre existing condition m A preexisting 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 the 12 months before the e ective date of the policy n This limitation applies to the following benefits if applicable Hospital Confinement Daily Hospital Confinement Enhanced Intensive Care Unit Confinement and Rehabilitation Unit Confinement 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 a ect any benefits payable Applicable to policy form IMB7000 including state abbreviations where used for example IMB7000 TX For cost and complete details of coverage call or write your Colonial Life benefits counselor or the company This form is not complete without form 562973 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 8 23 562911 1
Disability InsuranceHow you can protect your incomeIf you become disabled, you could be out of work for a while. Without your income, how would you pay for your everyday living expenses? Fortunately, Colonial Life offers nancial protection options that can help you. What can cause a disability? Many accidents or sicknesses can lead to short term disability claims, including pregnancy and childbirth; injuries from a major accident including dislocations, sprains and fractures; back problems; side effects from medicines or medical procedures; and some mental illnesses. Regardless of your age or health, a disabling sickness or accidental injuries could keep you out of work for weeks or even months.How reliable is your safety net? While many people with disabilities look to workers’ compensation or Social Security Disability Insurance (SSDI) for help, these resources aren’t always reliable. In fact, 68% of workers who apply for SSDI are denied.1 Even if these resources can help, they might not be enough to meet your nancial obligations.How to help yourself You can be better prepared to preserve your way of life with short term disability insurance. Disability insurance features:• Benets payable directly to you in regular payments if you can’t work because of a covered accident or sickness (injury or illness).• Disability benets may be available if you return to work part time. • In most cases, you can keep your coverage even if you change jobs, as long as you pay your premiums when due.Your Colonial Life benets counselor can help you determine the amount of coverage that’s right for you.70%of Americans worry about having enough emergency savings to cover a month’s worth of living expenses.2Nearly25%of 20 year olds can expect to be out of work for at least a year for a disabling condition before they retire.3DISABILITY INSURANCE
Disability Insurance Worksheet You can tailor disability coverage to t your specic needs. Talk with your benets counselor about your expenses and other paid leave benets, such as state paid medical leave, to help determine the coverage that’s right for you.4MONTHLY EXPENSES ROUND TO THE NEAREST HUNDREDRent or mortgage (insurance, minor home repairs) $Transportation (car note, bus fare, insurance, gas, maintenance)$Utilities (cell phone, Wi-Fi, electricity/gas, water) $Food and household necessities (toiletries, cleaning supplies)$Childcare (daycare, after-school care) $Health (medical needs and prescription drugs) $Other (gym/fitness, streaming/cable, extracurricular) $Total monthly expenses (add lines 1-7 together) $Your state’s paid medical leave approximate benefits (if any):Monthly benefit: _____________ Benefit period up to: _____________Talk with your Colonial Life benets counselor to learn more about disability insurance.ColonialLife.com1. Social Security Administration, SSI Annual Statistical Report, 2021.2. Bankrate, Bankrate’s 2023 annual emergency savings report, 2023. 3. Social Security Administration, Disability and Death Probability Tables for Insured Workers, 2022.4. State paid medical leave (PML) benets fall under state-specic program names. For example, in New Jersey, it may be referred to as Temporary Disability Insurance (TDI). Not available in all states.For policies issued or delivered in the Commonwealth of Virginia, THIS IS AN EXCEPTED BENEFITS POLICY. IT PROVIDES COVERAGE ONLY FOR THE LIMITED BENEFITS OR SERVICES SPECIFIED IN THE POLICY.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 benets payable. Applicable to policy forms ISTD3000 and rider form ISTD3000-ADIB (including state abbreviations where used, for example: ISTD3000-TX and ISTD3000-ADIB-TX ), policy form DIS1000 (including state abbreviations where used, for example DIS1000-TX), policy form ED-DIS 1.0 (including state abbreviations where used, for example ED-DIS 1.0-TX), policy form ICC21-DIP3000 and rider form ICC21-DIP3000-R-DIS, policy form GDIS-P and certicate form GDIS-C (including state abbreviations where used, for example: GDIS-P-EE-TX and GDIS-C-EE-TX), and policy form VSTDMP and certicate form VSTDC (including state abbreviations where used, for example VSTDMP-TX and VSTDC-TX). Not applicable in Oregon for policy form ICC21-DIP3000 and rider form ICC21-DIP3000-R-DIS. For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company. An insurance producer may contact you.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 6-23 | 101165-10
Specified Critical Illness Insurance If you re diagnosed with a covered critical illness or cancer specified critical illness insurance from Colonial Life can help with your expenses so you can concentrate on what s most important your treatment care and recovery Face amount ___1_0_k_ _2_0_k_ _3_0_k__ Critical illness benefit FOR THE DIAGNOSIS OF THIS COVERED CRITICAL ILLNESS CONDITION THIS PERCENTAGE OF THE FACE AMOUNT IS PAYABLE Cancer 100 Heart attack myocardial infarction 100 Stroke2 100 End stage renal kidney failure 100 Major organ failure 100 Permanent paralysis due to a covered accident 100 Coma 100 Blindness 100 Occupational infectious HIV or occupational infectious hepatitis B C or D 100 Coronary artery bypass graft surgery disease3 25 Carcinoma in situ 25 The maximum benefit amount for this policy is 3x the face amount for the named insured for all covered persons combined The policy will terminate when the maximum benefit amount for specified critical illness has been paid CRITICAL ILLNESS 1 0 WITH CANCER AND SUBSEQUENT DIAGNOSIS
Specified Critical Illness Insurance Exclusions limitations and additional disclosures State specific variations on exclusions AK Alcoholism or Drug Addiction Exclusion does not apply CT Alcoholism or Drug Addiction Exclusion replaced with Intoxication or Drug Addiction Felonies or Illegal Occupations replaced with Felonies DE Alcoholism or Drug Addiction Exclusion does not apply FL Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion does not apply ID Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disorders IN Accidents or Sicknesses Occurring While the Policy is not In Force Exclusion added KY Alcoholism or Drug Addiction Exclusion does not apply Hallucinogenics added to Intoxicants and Narcotics Exclusion MD Alcoholism or Drug Addiction Exclusion does not apply Felonies or Illegal Occupations Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Suicide or Self Inflicted Injuries Exclusion replaced with Self Destruction or Self Inflicted Injuries MO Alcoholism or Drug Addiction Exclusion replaced with Drug Addiction Felonies or Illegal Occupations Exclusion replaced with Illegal Activities NH Intoxicants and Narcotics exclusion does not apply NJ Alcoholism or Drug Addiction replaced with Drug Addiction Felonies or Illegal Occupations Exclusion replaced with Felonies or Illegal Jobs Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disease or Disorder OR Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Suicide or Self Inflicted Injuries Exclusion does not apply Felonies or Illegal Occupations Exclusion replaced with Felonies SC Alcoholism or Drug Addiction Exclusion does not apply Psychiatric or Psychological Condition Exclusion replaced with Mental or Emotional Disorders SD Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply TX Alcoholism or Drug Addiction Exclusion does not apply UT Alcoholism or Drug Addiction Exclusion replaced with Alcoholism VT Alcoholism or Drug Addiction Exclusion does not apply Intoxicants and Narcotics Exclusion does not apply Psychiatric or Psychological Condition Exclusion does not apply War or Armed Conflict Exclusion replaced with War State specific pre existing condition limitations FL 12 12 Pre existing Condition means having a sickness or physical condition that during the 12 months immediately preceding the Policy Coverage Effective Date of this policy had manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice diagnosis care or treatment or for which medical advice diagnosis care or treatment was recommended or received IA 12 12 Pre existing Condition means having a condition for which medical advice or treatment or medication was recommended by a physician or received from a physician within 12 months preceding the Policy Coverage Effective Date of the covered person s policy MD 12 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within 12 months before the Policy Coverage Effective Date of this policy A condition admitted or disclosed on the application will be covered unless the disease or condition is excluded by name or specific description effective on the date of loss NC 12 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within 12 months before the Policy Coverage Effective Date of this policy If a covered person is 65 or older when this policy is issued pre existing conditions for that covered person will include only conditions specifically eliminated by rider NH 6 6 Pre existing condition means having a sickness or physical condition for which any covered person was diagnosed treated had medical testing or received medical advice within 6 months before the Policy Coverage Effective Date of this policy NJ 6 6 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within six months before the Policy Coverage Effective Date of this policy NV 6 12 Pre existing Condition means having a sickness or physical condition for which any covered person was treated had medical testing received medical advice or had taken medication within six months before the Policy Coverage Effective Date of this policy
Dental PPO InsurancePlan 2 – $1,000 | 100% | 80% | 50%Life is full of unexpected smiles, and good oral health helps maintain them. Colonial Life dental insurance helps you pay for routine and costly dental care for you and your family, so you can focus on what’s important. POLICY DETAILSThe policy year maximum benet for this policy is $1,000 per person. Class A, B and C services apply toward the maximum.This policy has a deductible of $50 per person, per policy year for class B and C services. Each covered family member pays a deductible up to a maximum of three members each policy year.The co-insurance for this policy is:NETWORK BENEFITSNetwork providers have agreed to charge discounted rates for covered services. You receive the benet of discounted services, and pay only your co-insurance portion and any applicable deductible. Plus, network providers will le your claim for you, so you don’t have to deal with the paperwork. OUT-OF-NETWORK BENEFITSOut-of-network providers haven’t agreed to discounted rates, and their fees may vary signicantly. Your policy’s co-insurance may not cover the total costs of dental care and, in addition to any deductible, you are responsible for any remaining balance. This is referred to as “balance billing” and only happens when you go out of network. CLASS TYPE OF SERVICE INSURANCE PAYSClass A Preventive services 100% Class B Basic services 80%Class C Major services 50%LARGE NATIONAL NETWORK• Save more with 120,000+ unique providers1• Claims led for members by providers• Easy provider search on ColonialLifeDental.com• In-house recruiting team dedicated to expanding the network IDN8000 - PLAN 2How does this policy pay benets for network and out-of-network care?
THIS POLICY PROVIDES LIMITED BENEFITS. A NETWORK ACCESS PLAN IS AVAILABLE.No benets will be paid for replacement of teeth missing prior to the effective date of coverage.This policy is not available in ZIP codes beginning with 025. 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 benets payable. Applicable to policy form IDN8000 (including state abbreviations where used, for example: IDN8000-TX). For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company.Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC.©2022 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company. 1-22 | 101837-41. Network360, December 2021.2. Member may have one additional periodontal maintenance in place of an additional cleaning.3. Waiting periods may be waived if takeover applies.4. No waiting periods in Maine. Six-month waiting period in Vermont.ColonialLifeDental.comCovered procedures and waiting periodsPREVENTIVE SERVICES (CLASS A): NO WAITING PERIOD• Routine exams and cleanings (twice every 12 months) ‐ One additional cleaning per 12 months if member is in second or third trimester of pregnancy2• X-rays ‐ Bitewing x-rays (up to four lms, once every 12 months)• Children’s services (up to age 14) ‐ Fluoride treatment (once every 12 months) ‐ Sealants (once every 36 months) ‐ Space maintainers (up to age 14, once every 24 months)• Oral cancer screening (for age 40 +, once every 12 months)BASIC SERVICES (CLASS B): NO WAITING PERIOD• Full mouth/panoramic x-rays (once every ve years)• Fillings• Simple extractions• Emergency treatmentMAJOR SERVICES (CLASS C): 12-MONTH WAITING PERIOD3,4• Oral surgery (extractions and impacted teeth)• Anesthesia (covered with complex oral surgery)• Repair of crowns, dentures or bridges• Periodontics (gum treatments)• Endodontics (root canals)• Inlays and onlays• Crowns• Bridges• Dentures• Endosteal implants (in place of a three-unit bridge)For more information about this dental policy, talk with your benets counselor.Oral wellness is an essential component of our overall health. Based on experience with my own patients, people who actively seek regular dental care have a greater chance to be healthier and happier than people who don’t.Jim Di MarinoDMD, Dental Director for Colonial Life
In the U S medical spending in the last 12 months of life is nearly 80 000 per person HealthAffairs org End Of Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported July 2017 Your cost will vary based on the level of coverage you select Talk with your benefits counselor for information about what level of coverage would work best for you Whole Life Insurance You 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 emergencies1 Benefit for the beneficiary that is typically tax free Benefits 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 illness2 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
Term Life Insurance Peace of mind for you and your loved ones You 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 44 of Americans say their household would face financial hardship within six months should a wage earner die unexpectedly LIMRA 2022 Life Insurance Barometer Study Benefit for the beneficiary that is typically tax free Benefits and features Stand alone spouse policy available whether or not you buy a policy for yourself GA P Guaranteed premiums that do not increase during the selected term Ability to convert all or a portion of the benefit amount into cash value life insurance 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 illness1 Premium savings for face amounts over 250 000 based on your health 54 of Americans have life insurance coverage with an average coverage gap of 200 000 LIMRA 2021 Industry Associations Unite to Help Address the Life Insurance Coverage Gap in the United States TERM LIFE ITL5000
How to File a Claim for Colonial Life Benefits FOR FASTEST RESULTS FILE ONLINE 1 Go to ColonialLife com access to login or register 2 Fill out the required information and click Submit 3 Enjoy streamlined claims management and faster service online DIGITALLY FILE ALL TYPES OF CLAIMS Disability Insurance Accident Hospital Insurance Life Insurance Critical Illness Cancer Insurance Wellness benefits for screening tests Not sure which type of claim to file No problem Just answer a few questions on the portal and we ll help you figure everything out BEFORE YOU FILE Review the appropriate claims checklist at ColonialLife com and have this information handy to make the process go smoothly Proper documentation must be submitted when filing your claim AFTER YOU FILE Check your claim status and manage your claim by logging into your account at ColonialLife com access Live chat is also available 9 a m 5 p m EST OTHER WAYS TO FILE A CLAIM Fax 1 800 880 9325 Mail P O Box 100195 Columbia SC 29202 Colonial Life is committed to providing you our valued customer a market leading claims experience We look forward to serving you on ColonialLife com On the policyholder portal you can View benefit details Here you ll find a copy of your policy to see what s covered and benefit amounts Track your claim Log in anytime to view status or opt in to receive status alerts by email or text so you know instantly if we require additional information Sign up for direct deposit to get approved payments up to a week faster than paper check Colonial Life insurance products are underwritten by Colonial Life Accident Insurance Company Columbia SC 2022 Colonial Life Accident Insurance Company All rights reserved Colonial Life is a registered trademark and marketing brand of Colonial Life Accident Insurance Company ADR 1312251
Crimson Wellness Last Name First Street Address City Phone Job Title State E mail Address Date of Hire Sex Social Security No Spouse s Name Sex Dependent 1 Name DOB Sex Dependent 3 Dependent 2 Name DOB Sex Dependent 4 Beneficiary Name Address DOB phone relationship Bi Weekly Rates M I DOB Apartment Unit ZIP Tobacco Y or N Spouse s DOB Name DOB Sex Name DOB Sex Height Weight Accident From everyday mishaps to broken bones burns cuts to more extensive accidents Colonial pays 150 for seeking treatment The more severe the accident the more money paid 50K Life insurance 50 Wellness for each family member on the plan Individual 9 76 Ind Spouse 13 37 Ind Child 15 08 Family 18 68 Hospital Colonial pays 1500 for a 24 hr hospital admission Outpatient surgical ICU Ind 17 49 13 57 50 59 18 41 60 64 23 88 65 75 34 06 Ind Sp 17 49 25 80 50 59 34 98 60 64 45 37 65 75 64 66 Ind Child 17 49 17 75 50 59 22 59 60 64 28 07 65 75 38 65 Family 17 49 29 98 50 59 39 16 60 64 49 54 65 75 69 26 Short Term Disability This provides a source of income while you re taking care of yourself 1000 monthly 3 months 0 7 Age 17 49 17 12 50 64 20 95 65 74 30 37 I would like a rate Annual or hourly income _____ Amount allowed _____ Rate ___ Critical Care Cancer 10K Lump Sum pay Ex 38 yr old 5 22 Rate request ______ Dental Ind 19 31 Ind Sp 36 85 Ind Ch 45 67 Fam 68 09 Life Pays beneficiary 25K 100K I would like a rate _______ NC DL ___________________ 10K AD D Life Insurance no cost Signature _______________________________ I choose to waive coverage