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Group Cancer 1000 Level 4 – Employer Paid for Employee Only coverage$5000 Initial Diagnosis Benefit, Specified Disease Benefit, $100 Health Screening Benefit 17-70$9.09 (Employee cost) cost) $15,000 16-29 $2.86 $4.36 $3.07 $4.5030-39 $3.97 $6.03 $4.18 $6.1640-49 $6.53 $9.83 $6.67 $9.9750-59 $10.55 $16.41 $10.69 $16.5560-74 $16.29 $25.27 $16.50 $25.41$30,000 16-29 $4.39 $6.65 $4.80 $6.9330-39 $6.60 $9.97 $7.02 $10.2540-49 $11.72 $17.59 $12.00 $17.8650-59 $19.76 $30.74 $20.03 $31.0260-74 $31.25 $48.46 $31.66 $48.74$13.78(Employer Paid)
Tobacco RatesISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY$5,000 16-29 $2.36 $3.60 $2.42 $3.6530-39 $3.12 $4.71 $3.16 $4.7640-49 $4.80 $7.25 $4.85 $7.3050-59 $7.48 $11.63 $7.52 $11.6860-74 $11.31 $17.54 $11.38 $17.59$15,000 16-29 $4.39 $6.65 $4.59 $6.7930-39 $6.67 $9.97 $6.81 $10.1140-49 $11.72 $17.59 $11.86 $17.7350-59 $19.76 $30.74 $19.89 $30.8860-74 $31.25 $48.46 $31.46 $48.60$30,000 16-29 $7.43 $11.22 $7.85 $11.5030-39 $12.00 $17.86 $12.28 $18.1440-49 $22.11 $33.10 $22.39 $33.3750-59 $38.17 $59.40 $38.45 $59.6860-74 $61.16 $94.85 $61.57 $95.13Term Life 1000 for TXApplicable to policy form Term1000l20 Year Term Base PlanNon-Tobacco RatesISSUE AGE $10,000 $15,000 $25,000 $50,000 $100,00015 $2.41 $2.69 $3.25 $4.66 $7.4725 $2.41 $2.69 $3.25 $4.66 $7.4735 $2.55 $2.91 $3.61 $5.37 $8.8945 $3.54 $4.38 $6.07 $10.29 $18.7355 $6.11 $8.25 $12.51 $23.18 $44.5065 $13.36 $19.12 $30.63 $59.40 $116.96(Continued...)Page 2 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 4 for Important NoticeApplicable to policy form Term1000l20 Year Term Base PlanTobacco RatesISSUE AGE $10,000 $15,000 $25,000 $50,000 $100,00015 $2.73 $3.17 $4.04 $6.23 $10.6225 $2.73 $3.17 $4.04 $6.23 $10.6235 $3.27 $3.97 $5.39 $8.93 $16.0145 $5.69 $7.61 $11.45 $21.06 $40.2755 $11.00 $15.58 $24.72 $47.60 $93.3565 $20.88 $30.40 $49.43 $97.02 $192.19
Whole Life 1000 for TXApplicable to policy forms ICC07-WL-NGPO-65,ICC07-WL-NGPO-95, ICC08-WL-GPO-65, ICC08-WL-GPO-95,WL-NGPO-65, WL-NGPO-95, WL-GPO-65, WL-GPO-95,ICC16-WL1000J and WL1000JlAdult Base Plan Paid-Up at Age 95Non-Tobacco RatesISSUE AGE $10,000 $15,000 $20,000 $25,000 $50,00025 $4.62 $6.24 $7.86 $9.48 $17.5935 $6.37 $8.86 $11.36 $13.85 $26.3245 $9.33 $13.31 $17.29 $21.26 $41.1555 $15.15 $22.03 $28.92 $35.80 $70.2265 $27.30 $40.26 $53.22 $66.18 $130.97Tobacco RatesISSUE AGE $10,000 $15,000 $20,000 $25,000 $50,00025 $5.99 $8.30 $10.60 $12.91 $24.4435 $8.71 $12.38 $16.05 $19.72 $38.0545 $12.53 $18.11 $23.68 $29.25 $57.1355 $22.29 $32.74 $43.20 $53.65 $105.9165 $40.75 $60.44 $80.13 $99.82 $198.26Whole Life 1000 for TXApplicable to policy forms ICC07-WL-NGPO-65,ICC07-WL-NGPO-95, ICC08-WL-GPO-65, ICC08-WL-GPO-95,WL-NGPO-65, WL-NGPO-95, WL-GPO-65, WL-GPO-95,ICC16-WL1000J and WL1000JlDependent Child Base Plan Paid-Up at Age 65ISSUE AGE $10,000 $25,000 $50,000 $100,0000 $2.87 $5.11 $8.84 $16.191 $2.88 $5.12 $8.86 $16.232 $2.89 $5.16 $8.94 $16.343 $2.92 $5.23 $9.09 $16.654 $2.96 $5.34 $9.30 $17.075 $3.03 $5.52 $9.65 $17.766 $3.10 $5.69 $10.00 $18.427 $3.17 $5.86 $10.34 $19.008 $3.24 $6.03 $10.69 $19.699 $3.32 $6.23 $11.07 $20.34(Continued...)Page 3 of 4Underwritten by Colonial Life & Accident Insurance CompanySee page 4 for Important Notice10 $3.40 $6.44 $11.50 $21.1811 $3.49 $6.66 $11.94 $21.9212 $3.59 $6.90 $12.42 $22.8813 $3.69 $7.16 $12.94 $23.9214 $3.81 $7.47 $13.55 $25.1115 $3.95 $7.80 $14.21 $26.3416 $4.08 $8.14 $14.90 $27.5717 $4.22 $8.49 $15.59 $28.65
Proposal applicable to: AL ,AR, DC, AK, AZ, DE, HI, IL, IN, KY, LA, MA, MI, MN, MO, MS, ND, NE, NM, OH, OK, OR, RI, SC, SD, TN, TX, VA ,WY PS00001 This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/13 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 Benefits Base Benefits Level 1 Level 2 Level 3 Level 4 Cancer Screening/Wellness Benefit, per calendar year $25 $50 $75 $100 Hospital Confinement/Hospital Intensive Care Unit Confinement per day for first 30 days of hospital confinement in a calendar year $100 $100 $200 $300 per day after first 30 days of hospital confinement in a calendar year $200 $200 $400 $600 per day for hospital intensive care unit confinement $200 $200 $400 $600 maximum of 180 days per calendar year for hospital and hospital intensive care unit confinement combined Hospital Confinement/Hospital Intensive Care Unit Confinement in a US Government Hospital per day for first 30 days of hospital confinement in a calendar year $100 $100 $200 $300 per day after first 30 days of hospital confinement in a calendar year $200 $200 $400 $600 per day for hospital intensive care unit confinement $200 $200 $400 $600 maximum of 180 days per calendar year for hospital and hospital intensive care unit confinement combined Private Full-Time Nursing, per day $100 $100 $200 300 Radiation/Chemotherapy, per day $75 $150 $225 $300 calendar year maximum $2,500 $5,000 $7,500 $10,000 Antinausea Medication, per day $50 $50 $50 $50 calendar year maximum $200 $200 $200 $200 Blood/Plasma/Platelets/Immunoglobulins, per day $75 $150 $225 $300 calendar year maximum $2,500 $5,000 $7,500 $10,000 Supportive or Protective Care Drugs and Colony Stimulating Factors, per day $50 $100 $150 $200 calendar year maximum $400 $800 $1,200 $1,600 Bone Marrow Stem Cell Transplant, per lifetime $10,000 $10,000 $10,000 $10,000 Peripheral Stem Cell Transplant, per lifetime $5,000 $5,000 $5,000 $5,000 Transportation (per mile) up to 700 miles per round trip $0.40 $0.40 $0.40 $0.40 Transportation for Companion (per mile) up to 700 miles per round trip $0.40 $0.40 $0.40 $0.40 Lodging, per day, up to 70 days per calendar year $50 $50 $50 $50 Surgical Procedures-Unit Value $30 $30 $60 $90 maximum per procedure $1,500 $1,500 $3,000 $4,500 Anesthesia General Anesthesia % of surgical procedure 25% 25% 25% 25% local anesthesia per procedure $25 $25 $50 $75 Group Cancer 1000Level 4 - Employer Paid
Proposal applicable to: AL ,AR, DC, AK, AZ, DE, HI, IL, IN, KY, LA, MA, MI, MN, MO, MS, ND, NE, NM, OH, OK, OR, RI, SC, SD, TN, TX, VA ,WY PS00001 This information is only intended for proposal use with employers. Colonial Life products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 11/13 Colonial Life & Accident Insurance Company 1200 Colonial Life Boulevard, Columbia, South Carolina 29210 Second Medical Opinion, per malignant condition $300 $300 $300 $300 Reconstructive Surgery-Unit Value $30 $30 $60 $90 maximum per procedure including anesthesia, limit 2 per site $1,500 $1,500 $3,000 $4,500 Outpatient Surgical Center, per day $250 $250 $500 $750 calendar year maximum $750 $750 $1,500 $2,250 Waiver of Premium Yes Yes Yes Yes Additional Benefits Ambulance, per trip, limit 2 trips per confinement $100 $100 $100 $100 Attending Physician, per day, max 180 days per calendar year $50 $50 $50 $50 Experimental Treatment, per treatment $300 $300 $300 $300 lifetime maximum $10,000 $10,000 $10,000 $10,000 Hair, External Breast, Voice Box Prosthesis, per calendar year $200 $200 $200 $200 Prosthesis, Artificial Limb per device, limit 1 per site, $4,000 lifetime maximum $2,000 $2,000 $2,000 $2,000 Skilled Nursing Care Facility, per day up to days confined $300 $300 $300 $300 Hospice, per day, no lifetime limit $300 $300 $300 $300 Home Health Care Services, per day, up to greater of 30 days/calendar year or 2x days confined $300 $300 $300 $300 NOTE: Level 1 benefits are not available with the Base Only Plan. Optional Riders A choice of optional riders is available and can be purchased at an additional cost to provide extra coverage and benefits. Specified Disease Pays up to $125,000 during the insured’s lifetime for covered specified diseases for any covered person in the following benefits: • Hospital Confinement – up to $300 per day, up to the lifetime limit.• Ambulance - $100 for each trip, up to the lifetime limit, to or from a hospital whereconfined.• Attending Physician – up to $50 per day, up to the lifetime limit, while confined to ahospitalInitial Diagnosis • Paid for the first diagnosis of internal (not skin) cancer.• Available in $1,000 units from $1,000 - $5,000• Pays 1.5 times amount for children on family coverage.Features • In multi-state enrollments, situs state rules apply for Group Cancer 1000.*• Benefits are paid directly to the insured unless they specify otherwise.• Benefits are paid in addition to other insurance your employees may have with other insurance companies.• Conversion privilege to individual cancer policy if certain criteria met.
For more information, talk with your benefits counselor.GROUP MEDICAL BRIDGE – PLAN 5Group Hospital Confinement Indemnity InsurancePlan 5Group Medical BridgeSM insurance can help with medical costs that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependent children. Hospital confinement benefit ....................................................... . . . . . . .$ 1,500 per dayMaximum of one day per covered person per calendar yearDoctor oice visit benefit ........................................................................... $25 per dayMaximum of ________ days per calendar year for ____________________ coverageEmergency room visit benefit .....................................................................$150 per dayMaximum of one day per covered person per calendar yearDiagnostic procedure benefit ....................................................... ..............$500 per dayMaximum of one day per covered person per calendar yearOutpatient surgical procedure benefit Tier 1 ..................................................................................................... $1,000 per day Tier 2 ....................................................................................... ..............$2,000 per dayMaximum of $________________ per covered person per calendar year for Tier 1 and 2 combined Maximum of one day per outpatient surgical procedureDiagnostic proceduresThe following is a list of common diagnostic procedures that may be covered. Breast– Biopsy (incisional, needle, stereotactic) Cardiac– Angiogram– Arteriogram– Thallium stress test– Transesophageal echocardiogram (TEE) Diagnostic radiology– Computerized tomography scan (CT scan)– Electroencephalogram (EEG)– Magnetic resonance imaging (MRI)– Myelogram– Nuclear medicine test– Positron emission tomography scan (PET scan) Digestive– Barium enema/lower GI series– Barium swallow/upper GI series– Esophagogastroduodenoscopy (EGD) Ear, nose, throat, mouth– Laryngoscopy Gynecological– Amniocentesis– Cervical biopsy– Cone biopsy– Endometrial biopsy– Hysteroscopy– Loop electrosurgical excisional procedure (LEEP) Liver– Biopsy Lymphatic– Biopsy Miscellaneous– Bone marrow aspiration/biopsy Renal– Biopsy Respiratory– Biopsy– Bronchoscopy– Pulmonary function test (PFT) Skin– Biopsy– Excision of lesion Thyroid– Biopsy Urinary– Cystoscopy
THIS POLICY PROVIDES LIMITED BENEFITS. EXCLUSIONS We will not pay benefits for losses which are caused by: dental procedures, elective procedures, cosmetic surgery, felonies or illegal occupations, intoxicants or narcotics, pregnancy of a dependent child, psychiatric or psychological conditions, suicide, intentional injuries, war, armed forces service or giving birth within the first nine months aer the certificate eective date. 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 number GMB1.0-P-EE-TX-R and GMB1.0-P-AU-TX-R. This is not an insurance contract and only the actual policy provisions will control.ColonialLife.com©2016 Colonial Life & Accident Insurance Company, Columbia, SC | Colonial Life insurance products are underwritten by Colonial Life & Accident Insurance Company, for which Colonial Life is the marketing brand. 7-16 | 100028-2-TX Breast– Breast reduction Cardiac– Angioplasty– Cardiac catheterization Digestive– Exploratory laparoscopy– Laparoscopic appendectomy– Laparoscopic cholecystectomy Ear, nose, throat, mouth– Ethmoidectomy– Mastoidectomy– Septoplasty– Stapedectomy– Tympanoplasty– Tympanotomy Eye– Cataract surgery– Corneal surgery (penetrating keratoplasty)– Glaucoma surgery (trabeculectomy)– Vitrectomy Tier 2 outpatient surgical procedures Gynecological– 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 massThe 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 certificate. Tier 1 outpatient surgical procedures Breast– Axillary node dissection– Breast capsulotomy– Breast reconstruction– Lumpectomy Cardiac– Pacemaker insertion Digestive– Colonoscopy– Fistulotomy– Hemorrhoidectomy (external)– Lysis of adhesions Skin– Laparoscopic hernia repair– Skin graing Ear, nose, throat, mouth– Adenoidectomy– Removal of oral lesions– Myringotomy– Tonsillectomy– Tracheostomy Gynecological– Dilation and curettage (D&C)– Endometrial ablation– Lysis of adhesions Liver– Paracentesis Musculoskeletal system– Carpal/cubital repair or release– Dislocation (closed reduction treatment) other than a finger or toe– Foot surgery (bunionectomy, exostectomy, arthroplasty, hammertoe repair)– Fracture (closed reduction treatment) other than a rib, finger or toe– Removal of orthopedic hardware– Removal of tendon lesion
For more information, talk with your benefits counselor.Group Accident InsurancePreferred PlanColonialLife.comGAC4000 – PREFERRED PLANGroup accident insurance can help with medical or other costs associated with a covered accident or injury that your health insurance may not cover. With this coverage you may not need to use your savings or secure a loan to help pay those unexpected out-of-pocket expenses. Coverage options are available for you, your spouse and eligible dependent children. Benefits are per covered person per covered accident unless stated otherwiseAccident emergency treatment ................................................................................................$150 One visit per covered person per covered accident and Up to four visits per covered person per calendar yearAccident follow-up doctor visit ..................................................................................................$50Up to four visits per covered person per covered accident andUp to 16 visits per covered person per calendar yearAccidental death Accidental deathPer covered person Accidental death common carrier¾ Named insured .....................................................................$50,000 .................. $200,000¾ Spouse ...............................................................................$50,000 .................. $200,000¾ Dependent child(ren) .............................................................. $10,000 ....................$40,000Examples of common carriers are mass transit trains, buses and planesAccidental dismembermentLoss or loss of use¾ One hand, arm, foot, leg or sight of an eye ......................................................................... $9,000¾ Both hands, arms, feet, legs or the sight of both eyes; or any combination ................................ $18,000¾ One finger or one toe ................................................................................................... $1,050¾ Two or more fingers; two or more toes; or any combination ................................................... $2,100Air ambulance .................................................................................................................. $1,500 Transportation to or from a hospital or medical facilityAmbulance (ground).............................................................................................................. $300 Transportation to or from a hospital or medical facilityAppliance aid in personal locomotion or mobility .........................................................................$100Walking boot, neck brace, back brace, leg brace, cane, crutches, walker and wheelchairBlood/plasma/platelets .........................................................................................................$400 Required during treatment of a covered accidentBurn¾ 2nd-degree burns (covering at least 36% of the body’s surface) ..................................................$1,000¾ 3rd-degree burns (based on size) ......................................................................... $2,000 – $15,000Burn–skin gra ...................................................................................50% of applicable burn benefitAs a result of 2nd-degree or 3rd-degree burns
Catastrophic accidentTotal and irrecoverable loss or loss of use¾ Both hands, arms, feet, legs or the sight of both eyes; or any combination; or¾ Loss of hearing in both ears or loss of ability to speak Subject to a 365-day elimination period; payable once per lifetime per covered person¾ Named insured ..................................................................................................................................................$50,000¾ Spouse ..................................................................................................................................................................$50,000 ¾ Dependent child(ren) ....................................................................................................................................... $25,000Coma ...............................................................................................................$10,000Lasting for 14 or more consecutive daysConcussion ............................................................................................................ $375Dislocation (separated joint) Non-surgical Surgical¾ Hip ........................................................................................$3,000 $6,000¾ Knee (except patella) ..................................................................$1,500 $3,000¾ Ankle, bone or bones of the foot (other than toes) ...............................$1,200 $2,400¾ Collarbone (sternoclavicular) ..........................................................$800 $1,600¾ Collarbone (acromioclavicular and separation) ....................................$200 $400¾ Lower jaw ..................................................................................$720 $1,440¾ Shoulder (glenohumeral) ............................................................ $1,200 $2,400¾ Elbow .......................................................................................$450 $900¾ Wrist ........................................................................................$600 $1,200¾ Bone(s) of the hand, (other than fingers) ............................................. $810 $1,620¾ Finger, toe ..................................................................................$200 $400¾ Incomplete dislocation or dislocation reduction.................................. 25% of the applicable without anesthesia non-surgical amountEmergency dental work ¾ Dental crown or denture ....................................................................................$300 ¾ Dental extraction .............................................................................................$100 Eye injury ..............................................................................................................$300 With surgical repair or removal of a foreign objectFracture (broken bone) Non-surgical Surgical¾ Skull, depressed fracture (except face/nose) ......................................$3,750 $7,500¾ Skull, simple non-depressed fracture (except face/nose) .......................$1,800 $3,600¾ Hip, thigh (femur) ......................................................................$3,150 $6,300¾ Body of vertebrae (excluding vertebral processes) ...............................$2,700 $5,400¾ Pelvis .....................................................................................$2,400 $4,800¾ Leg (tibia and/or fibula) ...............................................................$1,800 $3,600¾ Bones of the face or nose (except mandible or maxilla) ...........................$910 $1,820¾ Upper jaw, maxilla, upper arm between .......................................... $1,050 $2,100 elbow and shoulder¾ Lower jaw, mandible ................................................................. $1,200 $2,400¾ Kneecap, ankle, foot .................................................................. $1,200 $2,400¾ Shoulder blade, collarbone ......................................................... $1,200 $2,400¾ Vertebral processes ......................................................................$630 $1,260¾ Forearm, hand, wrist ................................................................. $1,200 $2,400¾ Rib ..........................................................................................$375 $750¾ Coccyx .....................................................................................$320 $640¾ Finger, toe .................................................................................$200 $400¾ Chip fracture .................................................25% of the applicable non-surgical amountAlex was cleaning out the gutters when he fell. ALEX’S BENEFITS Ambulance $300Emergency room visit $150X-ray $60Hospital admission $1,000Hospital confinement $750Leg fracture (surgical) $3,600Physical therapy $360Appliance (crutches) $100Doctor’s follow-up oice visit $150$6,470EMERGENCY ROOM VISITAlex was taken by ambulance to the nearest emergency room and received immediate care.The doctor ordered an X-ray and discovered Alex had fractured his leg.DIAGNOSTIC PROCEDUREOver the next several weeks, he had three follow-up appointments with his doctor.DOCTORʼS OFFICE VISITAlex had eight sessions of PT to help him regain the strength in his leg.PHYSICAL THERAPYAlex was admitted to the hospital for surgery on his leg. He was confined for three days.HOSPITAL CONFINEMENTFor illustrative purposes only.Benefit amounts may vary and may not cover all expenses. The certificate has exclusions and limitations.ALEXʼS OUT-OF-POCKET EXPENSESWhen Alex totaled up the bills, he had to pay his annual deductible, as well as co-payments for the ambulance, emergency room, hospital, surgery, physical therapy and follow-up visits. Luckily, Alex had accident coverage to help with these expenses.Alex used crutches.APPLIANCE FOR MOBILITY
For more information, talk with your benefits counselor.GAC4000 – PREFERRED PLANHospital admission .............................................................................................................$1,000Per covered person per covered accidentHospital confinement .................................................................................................. $250 per dayUp to 365 days per covered person per covered accidentHospital intensive care unit admission .................................................................................... $1,750 Per covered person per covered accidentHospital intensive care unit confinement ........................................................................ $400 per day Up to 15 days per covered person per covered accident Knee cartilage (torn) .............................................................................................................$750 Laceration (no repair, without stitches) ..........................................................................................$50 Laceration (repaired by stitches)¾ Total of all lacerations is less than two inches long ................................................................... $150¾ Total of all lacerations is at least two but less than six inches long ................................................. $300 ¾ Total of all lacerations is six inches or longer ........................................................................... $600 Lodging (companion) ..................................................................................................$200 per day Up to 30 days per covered person per covered accident Medical imaging study (CT, CAT scan, EEG, MR or MRI) .....................................................................$200 One benefit per covered person per covered accident per calendar yearOccupational or physical therapy ....................................................................................$45 per day Up to 10 days per covered person per covered accident Pain management for epidural anesthesia .................................................................................. $150 Prosthetic device/artificial limb One benefit per covered person per covered accident¾ One ....................................................................................................................... $1,250 ¾ More than one ........................................................................................................... $2,500 Rehabilitation unit confinement ....................................................................................$150 per day Immediately aer a period of hospital confinement due to a covered accident; up to 15 days per covered person per covered accident, not to exceed 30 days per covered person per calendar yearRuptured disc with surgical repair ............................................................................................$900 Surgery¾ Cranial, open abdominal and thoracic .............................................................................. $1,500 ¾ Hernia with surgical repair ...............................................................................................$300Surgery (exploratory and arthroscopic) ....................................................................................... $225Tendon/ligament/rotator cu¾ One with surgical repair ..................................................................................................$900 ¾ Two or more with surgical repair ..................................................................................... $1,800 Transportation for hospital confinement ...................................................................$600 per round tripUp to three round trips for more than 50 miles from home per covered person per covered accidentX-ray ...................................................................................................................................$60
For more information, talk with your benefits counselor.Group Critical Illness InsurancePlan 3 FullColonialLife.comIf you’re diagnosed with a covered critical illness, group 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.*The policy name is Critical Illness Group Specified Disease Insurance.For the diagnosis of this covered critical illness condition:1This percentage of the face amount is payable:Heart attack (myocardial infarction) 100%Stroke 100%End-stage renal (kidney) failure 100%Major organ failure 100%Coma 100%Permanent paralysis due to a covered accident 100%Blindness 100%Occupational infectious HIV or occupational infectioushepatitis B, C or D100%Coronary artery bypass gra surgery/disease225%GROUP CRITICAL CARE PLAN 3 FULLFace amount: $_______________ Critical illness benefitSubsequent diagnosis of a dierent critical illness3If you receive a benefit for a critical illness, and later you are diagnosed with a dierent critical illness, the original percentage of the face amount is payable for that particular critical illness.Subsequent diagnosis of the same critical illness3If you receive a benefit for a critical illness, and later you are diagnosed with the same critical illness, 25% of the original face amount is payable. Critical illness conditions that do not qualify are: coronary artery bypass gra surgery/coronary artery disease2 and occupational infectious HIV or occupational infectious hepatitis B, C or D.
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 a policy for yourself 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 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 eective 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 suer 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)HealthAairs.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 is nearly $80,000 per person.$
£ 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 eective 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 suer 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 dierent 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.
Juvenile Whole Life Plus InsuranceA lower rate for lifeBy purchasing Juvenile Whole Life Plus insurance for a child or grandchild, you can begin a lifetime of protection at affordable rates. The younger the child is when you purchase coverage, the lower the rate will be for the life of the policy.Also, if an unexpected accident or illness makes life insurance more expensive — or even unavailable — for them later on, they’ll have this whole life coverage to help protect their loved ones. ADVANTAGES OF JUVENILE WHOLE LIFE PLUSAvailable for your children or grandchildren through age 17 (dependent students ages 18–26 may be eligible for an adult plan)Accumulates cash value based on a non-forfeiture interest rate of 3.75%1 Paid-Up at Age 70 and stays in force as long as you continue making payments Coverage can be purchased without purchasing employee coverageAbility to pass ownership or enhance coverage with optional riders after your child’s or grandchild’s 18th birthdayADDITIONAL FEATURES$3,000 immediate claim paymentThis payment can help meet immediate needs, such as funeral costs, by providing an initial death benet payment of $3,000 to the designated beneciary.Terminal illness accelerated death benetIf the insured child is diagnosed with a terminal illness, you can request up to 75% of the policy’s death benet, up to $150,000.2Guaranteed purchase optionAdditional whole life coverage may be purchased on the child — without health questions — at ages 18, 21 and 24. Coverage up to the initial face amount may be purchased, not to exceed a total combined maximum of $100,000 for all options. 40%of people who own life insurance wish they had purchased policies at a younger ageScanlon, James T., Leyes, Maggie and Wood, Steve. LIMRA 2020 Insurance Barometer Study, May 2020HOW MUCH COVERAGE DO YOU NEED?FACE AMOUNT $ ___________________Your cost will vary based on the amount of coverage you select.JUVENILE WHOLE LIFE PLUS (IWL5000)
ADDITIONAL COVERAGE OPTIONAccidental death benet riderMay be added at any time. When you purchase this rider, it pays an additional benet if the insured child or grandchild dies as a result of an accident before age 70. The benet 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% of the accidental death benet will be payable if the injury is sustained while driving or riding in a private passenger vehicle and wearing a seat belt.ADDITIONAL OPTIONS AVAILABLE AT AGE 18 (and after policy ownership has been passed to the insured child)Chronic care accelerated death benet rider (living benet)If a licensed health care practitioner certies the insured has a chronic illness, the policy owner may receive an advance on all or a portion of the death benet, available in a one-time lump sum or monthly payments.2 A chronic illness means substantial supervision is required due to a severe cognitive impairment or the inability to perform at least two of the six Activities of Daily Living (bathing, continence, dressing, eating, toileting and transferring). Premiums are waived during the benet period.Critical illness accelerated death benet riderIf the insured suffers a heart attack (myocardial infarction), stroke or end-stage renal (kidney) failure, a $5,000 benet is payable.2 A subsequent diagnosis benet is included.Spouse term life riderThe policy owner can purchase term life coverage for a spouse, with a maximum death benet of up to $50,000. 10-year and 20-year coverage periods are available. Coverage may be converted to a cash value policy within certain time periods later on — without having to answer health questions.Children’s term life riderThe policy owner may purchase up to $20,000 in term life coverage for all eligible dependent children and pay one premium. Each eligible child can later convert this coverage to a cash value life insurance policy — without having to answer health questions — upon the parent’s or grandparent’s 70th birthday or the child’s 25th birthday, whichever comes rst.Give a gift that lasts a lifetimeChildhoodThey grow up so fast. Get them off to a great start.18th BirthdayGive them ownership of their policy as they take more control of their future.First JobProvide a base to build on as they establish themselves.WeddingThey can purchase coverage on a new spouse.ChildrenThey can extend coverage as their family grows.RetirementAs years go by, know they’re protected by the coverage you purchased.To learn more, talk with your benets counselor.ColonialLife.com1. Accessing the accumulated cash value reduces the death benet by the amount accessed, unless the loan is repaid. Cash value will be reduced by any outstanding loans against the policy. 2. Any payout would reduce the death benet. Benets may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benets.EXCLUSIONS AND LIMITATIONS: If the insured dies by suicide, whether sane or insane, within two years (one year in ND) from the coverage effective date or the date of reinstatement, we will not pay the death benet. We will terminate this policy and return the premiums paid without interest, minus any loans and loan interest to you. 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 ICC19-IWL5000J/IWL5000J, rider forms ICC19-RIWL5000-STR/RIWL5000 STR, ICC19-R-IWL5000-CTR/R-IWL5000-CTR, ICC19-R-IWL5000-ACCD/R-IWL5000-ACCD, ICC19-RIWL5000-CI/R-IWL5000-CI, ICC19-R-IWL5000-CC/R-IWL5000-CC. 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.© 2021 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 6-21 | 642446