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Voluntary Benefits Booklet
Choose the benets that are right for youDouble Eagle Interiors is pleased to offer a variety of benets during your upcoming enrollment. You will have the opportunity to speak with a benets counselor during open enrollment to nd out about all of your benet options.Double Eagle InteriorsThe following Voluntary benets will be offered during enrollment:Group Term Life Insurance provides money to your family if you die within a certain time period, or “term.” It can help them with nal arrangements, living expenses, tuition and more.Disability Insurance helps replace a portion of your income to help make ends meet if you become disabled from a covered accident or sickness.Group Hospital Indemnity Insurance provides a benet for hospital connement or outpatient surgery to help with deductibles.Group Accident Insurance can provide a benet for a range of accidental injuries and treatments. You can use the money however you choose.Group Critical Illness Insurance provides a benet to help you manage the nancial impacts of a critical illness.ColonialLife.comPolicy forms marketed by the company vary by product and are too numerous to list in the advertisement, but a list can be provided upon request. Colonial Life Insurance products are 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. 9-23 | NS-15156
Group Term Life InsuranceVoluntary coverageOur group term life insurance can help increase nancial security for your family if something were to happen to you. You can also apply for coverage for your spouse and eligible dependent children without health questions.1 How much group term coverage do I need?You:$ _____________________• Available in $1,000 increments• Minimum of $10,000 increments to a maximum of ve times your salary to $500,000Your spouse:$ _____________________• Available in $1,000 increments• Minimum of $5,000 to a maximum of $500,000• Spouse coverage cannot exceed your coverage amount2Your dependent children(up to age 26):$ _____________________• Available in $1,000 increments• Minimum of $1,000 to a maximum of $10,000 per dependent child• Each dependent child is covered for the same amount, except children from live birth to six months for whom the death benet is $1,000Why group term life insurance is a good option• Death benet• Lower premiums• Coverage during high-need years• Benet payment typically tax-freeVOLUNTARY GROUP TERM LIFE
Additional benets and servicesBuilt-in accelerated death benet provides an advance of up to 75% of the death benet, to a maximum of $150,000, if diagnosed with a terminal illness.3Health Advocate Employee Assistance Program (EAP) provides 24-hour personal support and referral service, including a medical bill saver service. Face-to-face sessions and video counseling with mental health professionals are available.4• Online: ColonialLife.com/EAP• Telephone: 1-888-645-1772Life planning services offer nancial and legal counseling services, as well as grief support and referral for up to 12 months after a claim.4Get the most out of your coveragePortability: You may be able to continue your coverage if you change jobs or retire. Conversion: After the group term period ends, you may be eligible to convert to a whole life policy without health questions. Waiver of premium: Your premium payments may be eligible for waiver if you become disabled. To learn more, talk with your Colonial Life benets counselor.1 Spouse and dependent coverage will not be effective if they are currently totally disabled. Being totally disabled means the inability to perform two or more activities of daily living, being conned to a hospital or similar institution, or being unable to attend school outside the home (for a dependent child age 5 up to age 26). In ID, NH and TX, the denition of total disability does not include Activities of Daily Living (ADL) requirements. The ability to work does not determine disability. You can pay premiums on insurance for your dependents with no health questions asked. Coverage isn’t effective until the earlier of the date they are no longer totally disabled or two years after the date that coverage would have otherwise become effective for the spouse or dependent child. This provision does not apply to newborn children born while dependent insurance is in effect.2 The maximum benet is 50% of your benet in NE.3 Terminal illness means an injury or sickness that results in the covered person having a life expectancy of 12 months or less and from which there is no reasonable prospect of recovery. A life expectancy of 24 months or less in IL, KS, MA, TX and WA. Accelerated death benet payments will reduce the amount the policy pays upon the recipient’s death, may adversely affect the recipient’s eligibility for Medicaid or other government benets or entitlements, and may be taxable. Recipients should consult their tax attorney or advisor before utilizing accelerated benet payments.4 The Employee Assistance Program and Life Planning Services, provided by Health Advocate, are available with Colonial Life & Accident Insurance Company Group Term Life offering. Terms and availability of service are subject to change. The service provider does not provide legal advice; please consult your attorney for guidance. Services are not valid after coverage terminates. State-mandated limitations for legal services in WA apply. Please contact the company for full details.BENEFIT AGE REDUCTION SCHEDULEWhen a covered person reaches age 70, but not 75, the amount of insurance will be:• 65% of the amount of insurance prior to age 70; or• 65% of the amount of insurance applied for on or after age 70 but before age 75.When a covered person reaches age 75 or more, the amount of insurance will be:• 50% of the amount of insurance prior to the rst reduction; or• 50% of the amount of insurance the employee applied for on or after age 75.Once the benet reduction schedule begins, there will be no further increases in insurance for a covered person. If the proposed insured is age 70, but not age 75 at the time of enrollment, the amount of insurance applied for will be reduced by 65%. If the proposed insured is age 75 or older at the time of enrollment, the amount applied for will be reduced by 50%.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 form GTL1.0-P and certicate form GTL1.0-C (including state abbreviations where used, for example: GTL1.0-P-TX and GTL1.0-C-TX). For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company.ColonialLife.comUnderwritten 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 3-24 | 100272-7
Individual Short Term Disability Insurance*If a covered accident or covered sickness prevents you from earning a paycheck, Short Term Disability Insurance can provide a monthly benet to help you cover your ongoing expenses. Use the worksheet on this page to see how this coverage can help ll gaps so you can focus on recovery.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.1MONTHLY 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: _____________DISABILITY INSURANCE: WHAT’S RIGHT FOR ME?1. How much disability coverage do I need? Monthly benet amount for off-job accident and off-job sickness: $ Choose a monthly benet amount between $400 and $6,500. Subject to income requirements. If your plan includes on-job accident/sickness benets, the on-job benet is 50% of the off-job amount.2. How long do I want benetscoverage? Benet period: months The partial disability benet period is three months.3. When would I like my totaldisabilitybenets to start? After an accident: days After a sickness: daysISTD 3000 DISABILITY INSURANCE
Frequently asked questions Whatisthedenitionoftotaldisability?“Totally disabled” or “total disability” means you are unable to perform the material and substantial duties of your occupation, not working at any occupation, for which you are qualied by reason of education, training or experience and under the regular and appropriate care of a physician.How does partial disability work? If you are able to return to work part time after at least 14 days of being paid for a total disability, you may be able to still receive 50% of your total disability benet.What is waiver of premium? We will waive your premium payments after 90 consecutive days of a covered disability.What are the age guidelines to qualify for this coverage? Coverage is available from ages 17 to 74.Can I keep my coverage if I change jobs or employers? You can keep your coverage to age 75, even if you change jobs, as long as you pay your premiums when they are due.What happens if I am disabled while traveling outside of the country? If you are disabled while outside of the United States, Canada, Mexico, Puerto Rico, Bahama Islands, Virgin Islands, Bermuda or Jamaica, you may receive benets for up to 60 days before you have to return to the U.S. in order to continue receiving benets.To learn more, talk with your benetscounselor.ColonialLife.com*A policy with a benet period of 3 months is considered Limited Benet Health Insurance Coverage.1. State paid medical leave (PML) benets fall under state-specic program names. For example, in Washington, it may be referred to as Paid Family and Medical Leave. Not available in all states.EXCLUSIONS AND LIMITATIONSWe will not pay benets for losses that are caused by, contributed to by or occur as the result of: alcoholism or drug addiction, aviation, cosmetic surgery, felonies, riots or insurrections, mental or nervous disorders, substance abuse, suicide or injuries which you intentionally do to yourself, war or armed conict. We will not pay for losses due to you giving birth within the rst nine months after the coverage effective date of the policy. We will not pay for loss when the disability is a pre-existing condition as described in the policy.Pre-existing condition means the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care or treatment within 12 months preceding the Policy Coverage Effective Date or a condition for which medical advice or treatment was recommended by a physician or received from a physician within 12 months preceding the Policy Coverage Effective Date.After this policy has been in force for 12 months from the policy coverage effective date shown on the policy schedule, we will pay benets for any pre-existing condition not excluded by name or specic description if the covered disability began at least 12 months after the policy coverage effective date and the elimination period has been satised.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 ISTD3000-WA and rider form ISTD3000-ADIB-WA. 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.© 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 8-23 | 101629-3-WA
For more information, talk with your benefits counselor.Group Hospital Confinement Indemnity InsurancePlan 1 with Accident Only Emergency Room Visit BenefitTHIS POLICY PROVIDES LIMITED BENEFITS. EXCLUSIONS We will not pay benefits for sicknesses which are caused by alcoholism or drug addiction. We will not pay benefits for injuries received in accidents which are caused by: dental procedures, elective procedures, cosmetic surgery, felonies or illegal occupations, pregnancy of a dependent child, psychiatric or psychological conditions, suicide, intentional injuries, war or armed forces service. We will not pay benefits for hospital confinement of a newborn who is neither injured nor sick. We will not pay benefits for loss during the first 12 months aer the eective date due to a pre-existing condition, which means 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 certificate eective date.For cost and complete details, see your Colonial Life benefits counselor. Applicable to policy form GMB1.0-P-WA-R and certificate form GMB1.0-C-WA-R. This is not an insurance contract and only the actual certificate provisions will control.GROUP MEDICAL BRIDGE PLAN 1 – WITH ACCIDENT ONLY ER VISIT BENEFIT | 4-18 | 100031-4-WAGroup Medical BridgeSM 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 benefit .......................................................$_______________ per dayMaximum of one day per covered person per calendar yearAccident only emergency room visit benefit ...................................................$150 per dayMaximum of one day per covered person per calendar yearHealth savings account (HSA) compatibleThis plan is compatible with HSA guidelines. This plan may also be oered to employees who do not have HSAs.Colonial Life & Accident Insurance Company’s Group Medical Bridge oers an HSA compatible plan in most states.ColonialLife.comUnderwritten 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.1500
Imagine while cleaning the gutters, you fall from the ladder and break your leg.These are out-of-pocket expenses you may encounter: $100 Emergency room copay $250 Deductible (copays do not count toward deductible) $35 Specialist visit copay – orthopedic physician $350 Specialist visit copay – occupational/physical therapy for 10 days $735 Out-of-pocket expensesAnd here is a sample of benets you may be eligible for with Colonial Life’s Group Accident Insurance: $125 Accident Emergency Treatment $150 Accident Follow-up Doctor Visit ($50 per visit, up to 3 per accident) $100 Appliance (crutches) $1,125 Fracture (broken leg) $250 Occupational/Physical Therapy ($25/day for 10 days) $30 X-Ray (for diagnosis of broken leg) $1,780 of benefits paid to you in addition to other coverage you may have with other insurance companies. The claims example above is based on a covered person aged 41 who receives a complete fracture of the leg and requires non-surgical repair. The policy has exclusions and limitations. Costs of treatment and benet amounts may vary. Group Accident Plan 2- WA Group Accident Plan 2- WAYou can’t predict when or where an accident will strike. But you can make sure you have a safety net of nancial protection to help if an accidental injury occurs.Accidents can happen anytime, anywhere—at home or at work, on the playground or on the road. Some of the most common injuries include:l Broken bonesl Burnsl Concussionsl LacerationsColonial Life’s Group Accident Insurance helps you ll some of the gaps caused by increasing deductibles, co-payments and out-of-pocket costs related to an accidental injury. With this coverage you may not need to use your savings or secure a loan to help pay those unexpected out-of-pocket expenses associated with a covered accident. Here’s how it works...l Back or knee injuries l Accidental injuries that send you to the Emergency Room, Urgent Care or a doctor’s oce.Group Accident Insurance
Your Colonial Life certicate 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 Burn - Skin Graft for 2nd or 3rd degree burns ........................................................50% of Burn benetl Coma ..............................................................................................................................................................$10,000l Concussion ........................................................................................................................................................$150l Emergency Dental Work ......................................$100 Extraction, $300 Crown, Implant, or Denturel Lacerations (based on size) ............................................................................................................$25 to $600Requires Surgeryl Eye Injury ............................................................................................................................................................ $300l Ruptured Disc ...................................................................................................................................................$500l Tendon/Ligament/Rotator Cu ............................................................. $500 - one, $750 - two or morel Torn Knee Cartilage ........................................................................................................................................$500Surgical Carel Blood/Plasma/Platelets .................................................................................................................................$300l Surgery (arthroscopic or exploratory) .....................................................................................................$150l Surgery (cranial, open abdominal or thoracic) ................................................................................. $1,500 l Surgery (hernia) ...............................................................................................................................................$200Benets listed are for each covered person per covered accident unless otherwise specied.Initial Carel Accident Emergency Treatment ..............$125lAir Ambulance ............................................ $1,500Common Accidental InjuriesDislocation (Separated Joint) Non-Surgical SurgicalHip $3,000 $6,000Knee$1,500 $3,000Ankle – Bone or Bones of the Foot$1,200 $2,400Collarbone (sternoclavicular)$750 $1,500Lower Jaw, Shoulder, Elbow, Wrist $450 $900Bone or Bones of the Hand $450 $900Collarbone (acromioclavicular and separation)$150 $300One Toe or Finger $150 $300Fracture (Broken Bone) Non-Surgical Surgical Depressed Skull $3,750 $7,500 Non-Depressed Skull $1,500 $3,000 Hip, Thigh $2,250 $4,500 Body of Vertebrae, Pelvis, Leg $1,125 $2,250 Bones of Face or Nose $525 $1,050 Upper Jaw, Maxilla $525 $1,050 Upper Arm between Elbow and Shoulder $525 $1,050 Lower Jaw, Mandible; Kneecap, Ankle, Foot $450 $900 Shoulder Blade, Collarbone, Vertebral Process $450 $900 Forearm, Wrist, Hand $450 $900 Rib $375 $750 Coccyx $300$600 Finger, Toe $150 $300 l Ambulance .......................................................$200l X-Ray Benet .....................................................$30
Transportation/Lodging AssistanceIf injured, the covered person must travel more than 50 miles from residence to receive special treatment and connement in a hospital. l Lodging (family member or companion) .................................................$150 per night up to 30 days for ............................................................................................a hotel/motel lodging costs l Transportation ...............................................................................$500 per round trip up to 3 round tripsAccident Hospital Carel Hospital Admission1 ............................................................................................................$1,000 per accidentl Hospital ICU Admission1 ....................................................................................................$1,500 per accident 1 We will not pay the hospital admission benet and the hospital intensive care unit (ICU) admission benet for the same covered accident simultaneously.l Hospital Connement2 ...........................................................$200 per day up to 365 days per accidentl Hospital ICU Connement2 ..................................................... $400 per day up to 15 days per accident 2 We will not pay the hospital connement benet and the hospital ICU connement benet simultaneously.Accident Follow-Up Carel Accident Follow-Up Doctor Visit .............................................................$50 (up to 3 visits per accident)l Appliances .............................................................................................. $100 (such as wheelchair, crutches)l Medical Imaging Study ......................................................................................................... $150 per accident (limit 1 per covered accident and 1 per calendar year)l Occupational or Physical Therapy ......................................................................$25 per day up to 10 daysl Pain Management (Epidural Anesthesia) ......................................$100 (limit 1 per covered accident)l Prosthetic Devices/Articial Limb ....................................................... $500 - one, $1,000 - two or morel Rehabilitation Unit Connement 3 ..................... $100 per day up to 15 days per covered accident, ................................................................................................................................and 30 days per calendar year 3 We will not pay the hospital connement benet and the rehabilitation unit connement benet simultaneously.Accidental Dismembermentl Loss of Finger/Toe .................................................................................... $750 – one, $1,500 – two or more l 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 l Loss of the ability to speakl Loss or loss of use of both arms or both legs Named Insured ................ $50,000 Spouse ..............$50,000 Child(ren) .........$25,000365-day elimination period. 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 $20,000Benets listed are for each covered person per covered accident unless otherwise specied.
My Coverage Worksheet (For use with your Colonial Life benets counselor)Who will be covered? (check one) Employee Only Employee & Spouse One-Parent Family Two-Parent FamilyWhen are covered accident benets available? (check one) On and O-Job Benets O-Job Only BenetsColonial 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.3-13Will I have to answer health questions to receive coverage?Coverage is Guaranteed Issue. No health questions will be asked.What additional features are included?l Worldwide coveragel Portablel Compliant with Health Savings Account (HSA) guidelinesHow do I know how much a benet pays?Benet amounts are preset and not based on the medical expenses you are charged. You get a lump sum payment that is specic to the injury or treatment required.Will 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).How do I le a claim?Visit coloniallife.com or call our Customer Service Department at 1.800.325.4368 for additional information.EXCLUSIONS AND LIMITATIONS We will not pay any benets for losses that are caused by, contributed to by or occur as a result of: felonies; sickness; suicide or injuries which any covered person intentionally does to himself; 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 injuries to a dependent child received during his birth. The covered person must incur a charge and the certicate must be in force for benets to be payable.For cost and complete details, see your Colonial Life benets counselor. Applicable to policy number GACC1.0-P-WA and certicate number GACC1.0-C-WA. This is not an insurance contract and only the actual policy provisions will control. 101157Group Accident Plan 2- WA Group Accident Plan 2- WA
Group Critical Illness and Cancer Insurance* Plan 2When life takes an unexpected turn, your focus should be on recovery — not nances. Colonial Life’s group critical illness and cancer insurance helps relieve nancial worries by providing a lump-sum benet payable directly to you to use as needed.Coverage amount: ____________________________Critical illness and cancer benetsCOVERED CONDITION1PERCENTAGE OF APPLICABLE COVERAGE AMOUNTBenign brain tumor 100%Coma 100%End stage renal (kidney) failure 100%Heart attack (myocardial infarction) 100%Loss of hearing 100%Loss of sight 100%Loss of speech 100%Major organ failure requiring transplant 100%Occupational infectious HIV or occupational infectious hepatitis B, C, or D100%Permanent paralysis due to a covered accident2100%Stroke 100%Sudden cardiac arrest 100%Coronary artery disease 25%COVERED CANCER CONDITION¹PERCENTAGE OF APPLICABLE COVERAGE AMOUNTInvasive cancer (including all breast cancer) 100%Non-invasive cancer 25%Skin cancer initial diagnosis ............................$400 per lifetimeBENEFITS STORYPreparing for a lifelong journeyRebecca was born with Down syndrome. Her parents’ critical illness and cancer coverage provided a benet that can help cover expenses related to Rebecca’s care and her changing needs. How their coverage helpedA hospital stay and treatment for corrective heart surgeryPhysical therapy to build muscle strengthSpecial needs daycareFor illustrative purposes only.GCI6000 – PLAN 2 Elect from $5,000 to $25,000
Key benets• Available coverage for spouse and eligible dependent children at 50% of your coverage amount • Cover your eligible dependent children at no additional cost • Receive coverage regardless of medical history, within specied limits• Works alongside your health savings account (HSA)• Benets payable regardless of other insuranceSubsequent diagnosis of a different critical illness3If you receive a benet for a critical illness, and are later diagnosed with a different critical illness, 100% of the coverage amount may be payable for that particular critical illness.Subsequent diagnosis of the same critical illness3If you receive a benet for a critical illness, and are later diagnosed with the same critical illness,4 25% of the coverage amount is payable for that critical illness. Reoccurrence of invasive cancer (including all breast cancer)If you receive a benet for invasive cancer and are later diagnosed with a reoccurrence of invasive cancer, 25% of the coverage amount is payable if treatment-free for at least 12 months and in complete remission prior to the date of reoccurrence; excludes non-invasive or skin cancer.Additional covered conditions for dependent childrenCOVERED CONDITION1PERCENTAGE OF APPLICABLE COVERAGE AMOUNTCerebral palsy 100%Cleft lip or palate 100%Cystic fibrosis 100%Down syndrome 100%Spina bifida 100%For more information, talk with your benets counselor.1. Please refer to the certicate for complete denitions of covered conditions. 2. In WA, the covered condition is called Permanent Paralysis.3. Dates of diagnoses of a covered critical illness must be separated by more than 180 days. 4. Critical illnesses that do not qualify include: coronary artery disease, loss of hearing, loss of sight, loss of speech, and occupational infectious HIV or occupational infectious hepatitis B, C, or D.* The led product name in FL and VT is Group Critical Illness and Cancer Limited Benet Insurance.THIS INSURANCE PROVIDES LIMITED BENEFITS.This coverage is a supplement to health insurance. It is not a substitute for essential health benets or minimum essential coverage as dened in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this insurance.EXCLUSIONS AND LIMITATIONS FOR CRITICAL ILLNESS We will not pay the Critical Illness Benet, Benets Payable Upon Subsequent Diagnosis of a Critical Illness or Additional Critical Illness Benet for Dependent Children that occurs as a result of a covered person’s: alcoholism or drug addiction; felonies or illegal occupations; intoxicants and narcotics; suicide or injuring oneself intentionally, whether sane or not; war or armed conict; or pre-existing condition, unless the covered person has satised the pre-existing condition limitation period shown on the Certicate Schedule on the date the covered person is diagnosed with a critical illness.EXCLUSIONS AND LIMITATIONS FOR CANCER We will not pay the Invasive Cancer (including all Breast Cancer) Benet, Non-Invasive Cancer Benet, Benet Payable Upon Reoccurrence of Invasive Cancer (including all Breast Cancer) or Skin Cancer Initial Diagnosis Benet for a covered person’s invasive cancer or non-invasive cancer that: is diagnosed or treated outside the territorial limits of the United States, its possessions, or the countries of Canada and Mexico; is a pre-existing condition, unless the covered person has satised the pre-existing condition limitation period shown on the Certicate Schedule on the date the covered person is initially diagnosed as having invasive or non-invasive cancer. No pre-existing condition limitation will be applied for dependent children who are born or adopted while the named insured is covered under the certicate, and who are continuously covered from the date of birth or adoption.PRE-EXISTING CONDITION LIMITATION We will not pay a benet for a pre-existing condition that occurs during the 12-month period after the coverage effective date. Pre-existing condition means 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 effective date.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 form GCI6000-P and certicate form GCI6000-C (including state abbreviations where used, for example: GCI6000-C-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. FOR EMPLOYEES 11-22 | 387100-2ColonialLife.com
Group Critical Illness Insurance* Exclusions and limitationsState-specic exclusions AK: Alcoholism or Drug Addiction Exclusion does not apply.CA: Alcoholism or Drug Addiction Exclusion does not apply; Intoxicants and Narcotics replaced with Intoxicants or Controlled Substances. Insureds must be covered by comprehensive health insurance before applying for insurance.CO: Suicide exclusion: whether sane or not replaced with while sane.CT: Alcoholism or Drug Addiction Exclusion replaced with Intoxication or Drug Addiction; Felonies or Illegal Occupations Exclusion replaced with Felonies; Intoxicants and Narcotics Exclusion does not apply.DC: Alcoholism or Drug Addiction Exclusion does not apply. Insureds must be covered by comprehensive health insurance before applying for insurance.DE: Alcoholism or Drug Addiction Exclusion does not apply.GA: Insureds must be covered by comprehensive health insurance before applying for insurance.IA: Exclusions and Limitations headers renamed to Exclusions and Limitations for Critical Illness Covered Conditions and Critical Illness Cancer Covered Conditions.ID: War or Armed Conict Exclusion replaced with War; Felonies and Illegal Occupations Exclusion replaced with Felonies; Intoxicants and Narcotics Exclusion does not apply; Domestic Partner added to Spouse.IL: Alcoholism or Drug Addiction Exclusion replaced with Alcoholism or Substance Abuse Disorder.KS: Alcoholism or Drug Addiction Exclusion does not apply.KY: Alcoholism or Drug Addiction Exclusion does not apply; Intoxicants and Narcotics Exclusion replaced with Intoxicants, Narcotics and Hallucinogenics. Premium will vary based on the coverage selected and the age of the named insured. For attained age rates, premiums will increase on the account anniversary date once the named insured reaches the next age band. Premium may increase if coverage is ported. Waiting Period If included, the Wellbeing Assistance Benet is subject to a 30-day waiting period. Waiting period means the rst 30 days following each covered person’s effective date during which no benets are payable. Termination of the Named Insured’s Coverage The coverage on a named insured under the policy will terminate on the earliest of the following dates: • the date the policy terminates; • your policyholder cancels the policy and does not offer replacement coverage; • the end of the grace period following the premium due date and we do not receive the required premium for the named insured; • the date the named insured is no longer in an eligible class; • the date the named insured’s class is no longer included for insurance; or • the date the next premium is due after the named insured asks us to end coverage. We will provide coverage for a claim for which we are liable under the terms of this certicate if the loss occurs while you are covered.LA: Alcoholism or Drug Addiction Exclusion does not apply; Domestic Partner added to Spouse.MA: Exclusions and Limitations headers renamed to Limitations and Exclusions for critical illness and cancer. Insureds must be covered by comprehensive health insurance before applying for insurance.MD: Alcoholism or Drug Addiction Exclusion does not apply; Felonies or Illegal Occupations Exclusion does not apply; Intoxicants and Narcotics Exclusion does not apply; Prohibited Practitioner Referral added as an additional exclusion for cancer.MI: Intoxicants and Narcotics Exclusion does not apply; Suicide Exclusion does not apply.MN: Alcoholism or Drug Addiction Exclusion does not apply; Suicide Exclusion does not apply; Felonies and Illegal Occupations Exclusion replaced with Felonies or Illegal Jobs; Intoxicants and Narcotics Exclusion replaced with Narcotic Addiction. Insureds must be covered by comprehensive health insurance before applying for insurance.MO: Alcoholism or Drug Addiction Exclusion replaced with Drug Addiction; Felonies or Illegal Occupations Exclusion replaced with Illegal Activities.MS: Alcoholism or Drug Addiction Exclusion does not apply.ND: Alcoholism or Drug Addiction Exclusion does not apply.NV: Intoxicants and Narcotics Exclusion does not apply; Domestic Partner added to Spouse.PA: Alcoholism or Drug Addiction Exclusion does not apply; Suicide Exclusion: whether sane or not removed.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; Doctor or Physician Relationship added as an additional exclusion.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; Suicide Exclusion: whether sane or not removed. Insureds must be covered by comprehensive health insurance before applying for insurance.WA: Intoxicants and Narcotics Exclusion does not apply.
State-specic pre-existing condition limitationsCA: Pre-existing Condition means a sickness or physical condition for which a covered person was diagnosed or treated within 12 months before the coverage effective date shown on the Certicate Schedule.FL: Pre-existing is 6/12; Pre-existing Condition means 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 effective date shown on the Certicate Schedule. Genetic information is not a pre-existing condition in the absence of a diagnosis of the condition related to such information.GA: Pre-existing Condition means the existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care, or treatment, or a condition for which medical advice or treatment was recommended by or received within 12 months preceding the coverage effective date.ID: Pre-existing is 6 months/12 months; Pre-existing Condition means a sickness or physical condition which caused a covered person to seek medical advice,diagnosis, care or treatment during the six months immediately preceding the coverage effective date shown on the Certicate Schedule.IL: Pre-existing Condition means a sickness or physical condition for which a covered person was diagnosed, treated, had medical testing by a legally qualied physician, received medical advice, produced symptoms or had taken medication within 12 months before the coverage effective date shown on the Schedule of Benets.IN: Pre-existing is 6 months/12 months.MA: Pre-existing is 6 months/12 months; Pre-existing Condition means a sickness or physical condition for which a covered person was treated, had medical testing, or received medical advice within six months before the coverage effective date shown on the Certicate Schedule.MD: Pre-existing Condition means 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 effective date shown on the Certicate Schedule. Pre-existing condition does not include a condition revealed on the application unless excluded by a signed waiver rider.ME: Pre-existing is 6 months/6 months; Pre-existing Condition means a sickness or physical condition for which a covered person was treated, had medical testing, or received medical advice within six months before the coverage effective date shown on the Certicate Schedule.MI: Pre-existing is 6 months/6 months.NC: Pre-existing Condition means those conditions for which medical advice, diagnosis, care, or treatment was received or recommended within the one-year period immediately preceding the effective date of a covered person. If a covered person is 65 or older when this certicate is issued, pre-existing conditions for that covered person will include only conditions specically eliminated.NV: Pre-existing is 6 months/12 months; Pre-existing Condition means 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 effective date. Pre-existing Condition does not include genetic information in the absence of a diagnosis of the condition related to such information.PA: Pre-existing is 90 days/12 months; Pre-existing Condition means a disease or physical condition for which you received medical advice or treatment within 90 days before the coverage effective date shown on the Certicate Schedule.SD: Pre-existing is 6 months/12 months.TX: Pre-existing condition means a sickness or physical condition for which a covered person received medical advice or treatment within 12 months before the coverage effective date shown on the Certicate Schedule.UT: Pre-existing is 6 months/6 months.WY: Pre-existing is 6 months/12 months.*The led product name in IA, PA, and WY is Group Critical Illness Specied Disease Insurance. In FL and VT, the led product name is Group Critical Illness Limited Benet Insurance.THIS INSURANCE PROVIDES LIMITED BENEFITS. This coverage is a supplement to health insurance. It is not a substitute for essential health benets or minimum essential coverage as dened in federal law. Insureds in some states must be covered by comprehensive health insurance before applying for this insurance.This information is not intended to be a complete description of the insurance coverage available. The insurance, its name 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 form GCI6000-P and certicate form GCI6000-C (including state abbreviations where used, for example: GCI6000-C-TX). For cost and complete details of coverage, call or write your Colonial Life benets counselor or the company. This form is not complete without base form 385403, 387100, 387169, 402383, 402558 or 387238, and rider form 387307, 387381, 387452, 387523, 387594, 387665, 402605 or 402671.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. FOR EMPLOYEES 12-22 | 388113-6ColonialLife.com
Filing online means never waiting for mail or dealing with fax machines and complex paper forms . Our guided question wizard walks you through the process and checks for missing information that could cause delays. Opting for direct deposit can also get approved payments to you up to a week faster than paper check. NEED TO FILE A CLAIM?Here’s what you can do on Colonial Life for Policyholders:Update yourpersonal info& preferencesFile claimswith a simple,guided form Opt for instant alerts by email or textView claim statusor policy details anytimeCheck your claim status by logging into your account at ColonialLife.com/access. You can also sign up for text or email alerts so you know instantly if status changes or more information is needed. For your convenience, you can login anytime with a mobile device to photograph and upload documents with your camera.AFTER YOU FILE:Find out how simple your claims and benefits experience can be by learning more about the Colonial Life for Policyholders portal. Just visit ColonialLife.com to see what this online account administration platform can do for you.LEARN MOREBECOME A MEMBER TODAY:Go to ColonialLife.com/access to register.Click “create an account”, fill out the required information and click Submit.Enjoy faster service and improved benefits awareness.123THE PORTALOFFERS YOU:Faster service than calling/emailingConfirmation when a claim has been submittedSimplified bill payment and managementAnswers to frequently asked questions and live chat assistance if you don’t see what you are looking for.Colonial Life for Policyholders PortalA faster, simpler way to manage your benefitsColonial Life for Policyholders is an online portal created with you in mind. It’s the most convenient and ecient way to file a claim and manage your benefits. Colonial Life 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.43233-41Set up directdeposit forapproved payments