2025 Employee Benefits Guide Amarillo, Boerne, Breckenridge, Georgetown, Houston, Lake Conroe, La Marque, Lubbock, Medina, Odessa, Rockport, San Antonio & Seabrook locations
Table of ContentsPage 3. Introduction to Benefit Guide, General Disclaimers, & information needed to enrollPage 4. Carrier Contact InformationPage 5. Benefit Information, Eligibility, Waiting Period, Etc.Page 6. Making coverage changes and continuing your coveragePage 7. Who pays for your Coverage?Page 8-12. Medical InformationPage 13-16. Dental InformationPage 17-18. Vision InformationPage 19-22. Accident I nsurance InformationPage 23-25. Critical Illness InformationPage 26. Be Well Benefit for Critical I llness, Accident & HospitalPage 27-30. Voluntary Term Life / AD&DPage 31-33. Hospital Indemnity I nformationPage 34-36. Long Term Disability InformationPage 37-38. MASA Medical TransportationPage 39-42. Short Term DisabilityPage 43-44. Whole Life
Welcome to your Benefits Guide! We are delighted to provide you with this benefits guide, offering an overview of your employer's benefit program. As valued members of our team, your well-being and satisfaction are paramount to us. This guidebook aims to empower you with valuable information to make informed decisions about your benefits and ensure you get the most out of your employment package. About this Benefit Guidebook This Benefits Guidebook describes the highlights of your employer’s benefits program in non-technical language. Your specific rights to benefits under the plan are governed solely, and in every respect, by the official plan documents and not the information in this Guidebook. If there is any discrepancy between the description of the program elements as contained in this Benefits Guidebook and the official plan documents, the language in the official plan documents shall prevail as accurate. Please refer to the plan-specific documents published by each of the respective carriers for detailed plan information. Any and all elements of our benefits program may be modified in the future, at any time, to meet Internal Revenue Service Rules or otherwise as decided by us. Please note that while we strive to provide accurate information, the rates listed in this guide are subject to underwriting review and can change upon submission. If rates change, you will be notified. We hope you find this guide helpful in navigating your benefits and understanding the support available to you. Before you Enroll Please have the following information ready when enrolling. • Dependents Names • Birth Dates • Social Security Numbers • Address • Email • Phone Number Page 3
Contents & Contact Information Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources. Medical Contact: United Healthcare Policy # 0934507 Phone: 866-801-4409 Website: www.myuhc.com Telehealth Contact: Doctor on Demand *This is only available if you enrolled in the UHC medical plan Website: www.myuhc.com/virtualvisits or use the United Healthcare App Dental Contact: Unum Phone: 888-400-9304 Website: www.bcbstx.com Voluntary Term Life/AD&D, LTD, Accident, Hospital, Critical Illness Contact: UNUM Phone: 888-400-9304 Website: www.unum.com Short Term Disability, Whole Life: Colonial Phone: Website: Emergency Transportation Contact: MASA Phone: 800-643-9023 Website: masaaccess.com/member Safe4R App Website: www.safe4r.com download the app from GooglePlay or AppStore Page 4
Benefit Information: Your benefits plan: We offer a variety of benefits allowing you the opportunity to customize a benefits package that meets your personal needs. You have the option to enroll in any or all of the benefit plans, each benefit is independent of the others, and you may choose any combination you like. In the following pages, you’ll learn more about the benefits offered. You’ll also see how choosing the right combination of benefits can help protect you and your family’s health and finances – and your family’s future. Choosing your benefits: You must actively choose any benefit that you pay for or share in the cost with. The premium for elected coverages are taken from your paycheck automatically. There are two ways that the money can be taken out, pre-tax or post –tax. Why do I pay for benefits with Pre-Tax money? There is a definite advantage to paying for some benefits with pre-tax money. Taking the money out before your taxes are calculated lowers the amount of your pay that is taxable. Therefore, you pay less in taxes. Which benefit premiums are taken before tax? PRE-TAX: Medical, Dental, Vision POST-TAX: Critical Illness, Accident Life, & Disability Example Pre-Tax Post-Tax Gross Salary 50k 50k Health Premium 5k 5k Taxable Wages 45k 50k Income Tax on Wages 5,800 6,900 FICA Tax on Wage 3,433 3,825 Net Employee Pay $35,757 $34,275 Eligibility: You are considered an eligible employee if you are a regular full-time employee scheduled to work at least 30 hours each week. Waiting Period: Newly hired employees are eligible for benefits on the first of the month following 30 days of hire. *Restrictions apply to part-time employees. Page 5
Making Changes Generally, you can only change your benefit choices during the annual Benefits Enrollment Period. However, you can change your benefit choices during the year if you experience a life event change. Life event changes include but are not limited to: • Marriage • Divorce • Birth, adoption, or placement for adoption of an eligible child • Death of your spouse or covered child • Change in you or your spouse’s work status that results in the cancellation of your benefits • Becoming eligible for Medicare or Medicaid during the year If you have a life event change, you must notify Human Resources within 30 days of the change (for example, supply HR with your marriage or newborn's birth certificate). If you do not notify Human Resources within 30 days, you will have to wait until the next annual open enrollment period to make benefits changes unless you experience another life event change. Any changes you make to your benefit choices must be directly related to the life event change. When Coverage Ends Benefits end on the last day of the month following termination or when you cease to meet eligibility guidelines. Portability If you leave the company, some of your benefits are portable. This means you can take them with you if you leave, as long as you continue to pay the premiums yourself. The benefits that are portable include: • Voluntary Group Term Life • Universal Life / Whole Life • Accident Insurance • Critical Illness Continuing Your Coverage Under certain circumstances, you may continue your health care coverage when it would otherwise end. This is called COBRA. COBRA applies to these plans: • Medical • Dental • Vision You and/or your dependents are eligible to continue health care coverage if coverage is lost because: • Your employment ends for any reason other than “gross misconduct.” Page 6
• Your work hours are significantly reduced. • You die. • You become entitled to and enroll in Medicare prior to losing coverage. • You divorce or become legally separated from your spouse. • Your dependent loses dependent status. Who pays the cost for your coverage? Looking Ahead Now, let's delve into each benefit that constitutes your comprehensive benefits program. In the following pages, you'll discover more about the invaluable benefits your employer provides. You'll also understand how selecting the right combination of benefits can safeguard the health and well-being of you and your family. Medical Employer Shared Dental Employee Paid Vision Employee Paid Accident Employee Paid Critical Illness Employee Paid Voluntary Term Life / AD&D Employee Paid Hospital Indemnity Employee Paid Long Term Disability / Short Term Disability Employee Paid Whole Life Employee Paid MASA Emergency Transport – New! Employee Paid Safe4R – New! Employer Paid Page 7
Emergency Room or Urgent Care? How to Choose More than 10 percent of all emergency room visits could have been addressed in an urgent care facility or solved in a doctor’s office. But how can you determine which is more appropriate for your condition? Emergency Room / Urgent Care Tips • Freestanding ERs are not In-Network with most carriers. • Go to ERs affiliated with In-Network hospitals. • Ask: “Are you contracted and In-Network?” and “Is this an Urgent Care or ER?” • Use your carrier app or call the member number on your card for an In-Network Facility. Suggestions on when to Use the ER Emergency rooms are equipped to handle life-threatening injuries and illnesses and other serious medical conditions. An emergency is a condition that may cause loss of life or permanent or severe disability if not treated immediately. You should go directly to the nearest Emergency Room if you experience any of the following: • Chest pain • Shortness of breath • Severe abdominal pain following an injury • Uncontrollable bleeding • Confusion or loss of consciousness • Poisoning or suspected poisoning • Serious burns, cuts, or infections • Inability to swallow • Seizures • Paralysis • Broken bones Patients at the emergency room are sorted according to the seriousness of their condition. For example, a patient with severe injuries from a car accident would likely be seen before a child with an ear infection, even if the child was brought in first. Suggestions on when to Use Urgent Care Urgent care centers are usually located in clinics or hospitals and, like emergency rooms, offer after-hours care. Unlike emergency rooms, they are not equipped to handle life-threatening situations. Rather, they handle conditions that require immediate attention—those where delaying treatment could cause serious problems or discomfort. Some examples of conditions that require urgent care are: • Ear infections • Sprains • Vomiting • High fever Urgent care centers are usually more cost-effective than ERs for these conditions. In addition, the waiting time in urgent care centers is usually much shorter. Page 8
Reduce your Prescription Drug Costs You can cut costs by up to 90 percent by becoming an informed consumer and using the same buying techniques that you use when shopping for other goods and services. Prescription Tips • Ask your doctor for samples. • Look for manufacturer coupons/programs. • Shop at different pharmacies. • Request generic medications. • Visit GoodRx—Use it to price-shop but cannot be combined with your Health/RX plan. Price Comparisons Drug prices are not uniform; you can save a considerable amount of money by shopping around. Drug Substitution When your doctor prescribes a drug, ask if a cheaper alternative is available. Mail-Order Pharmacies Mail-order and Internet pharmacies offer the best deals on prescription drugs, especially for patients with chronic conditions. Over-the-Counter Drugs (OTC) Ask your doctor if an OTC drug will work just as well as a prescription drug. Today, there are hundreds of OTC drugs that were previously only available by prescription. Generic Medications Generic medications work as well as brand-name drugs and can cost 20 to 80 percent less. This applies to both prescription and OTC drugs. Pharmaceutical Company Assistance Programs/State Drug Assistance Many drug companies and states offer drug assistance programs for the elderly, low-income individuals, and/or people with disabilities. Medicare Drug Plans Seniors can combine smart shopping techniques with the Medicare drug plan. All the information you need is available at Medicare.gov. Samples Drug companies provide thousands of samples to doctors every year. Your doctor may be able to provide you with weeks’ worth of medication at no charge. Staying on Your Medication If you take medication regularly, do not skip doses or stop taking your meds to save money. Sticking to your medication schedule will help you avoid health complications that could cost more money in the future. Discount Prescription Cards Look into a discount card, either through a drugstore chain or a national plan. They can provide additional discounts on your prescriptions for a small monthly or annual fee. Page 9
Important Compliance Documents To ensure you are fully informed about your health benefits and compliance requirements, please review the following important documents. These documents provide essential information on your rights, plan details, and responsibilities. You can access all the compliance documents by clicking the link below: Click here to Access Compliance Documents POP / SPD Compliance Document WRAP Compliance Document The documents included are: • HIPAA Notice for Non-Grandfathered Plans: Privacy rights and protections for non-grandfathered health plans. • Women's Health and Newborn Notices: Information about your rights and benefits related to women's health and newborn care. • CHIP Notice: Information about the Children’s Health Insurance Program and how it may affect your coverage. • Privacy Practices Notice: Details on how your health information is used and protected. • Health Insurance Marketplace Coverage: Information on options and coverage available through the Health Insurance Marketplace. • Emergency Evacuation Instructions: Instructions on what to do in the event of an emergency evacuation. • Spouse Eligibility Verification Form: Form required to verify the eligibility of a spouse for coverage. Make sure to review these documents carefully. If you have any questions or need further assistance, please contact HR. Page 10
Plan NameNetworkCoverageOutDeductible$5,000Family Deductible$10,00050%Coinsurance (% that UHC Pays)Out-Of-Pocket$10,000 / $20,000Preventative Care50% After Ded.Virtual Care50% After Ded.50% After Ded.Child Office Vision (Under Age 19)Adult Office Visit50% After Ded.50% After Ded.Specialty Doctor Office Visit50% After Ded.Inpatient Hospital ServicesLab & X-Ray (Routine)50% After Ded.Advanced Imagining50% After Ded.Urgent Care50% After Ded.Emergency Room As INNRX$10 / $35 / $75Not CoveredAssign PCPAdditional NotesPer PaycheckEmployee OnlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyBi-Weekly$35.94$440.89$266.94$700.40Bi-Weekly*You will pay less if you go to a designated provider.*You will pay less if you go to a designated provider.NO100% After Ded.$50 Copay$300 Copay + 100% After Ded.$10 / $35 / $70YES100% After Ded.In$5,000$10,00080%$7,900 / $15,800No ChargeNo Charge$40 Copay$40 Copay$100 Copay$500 Copay + 80% After Ded.DQ85 (last year CGGX plan)DQ4K (last year BCYX plan)HMO - NexusACO-OAPPO - Choice Plus$76.14$597.15$373.33$931.04Page 11 $500 Copay + 70% After Ded. In$3,000$6,00070%$6,000 / $12,00No ChargeNo ChargeNo Charge$30 Copay$60 Copay70% After Ded.70% After Ded.70% After Ded.$50 Copay
Plan NameNetworkCoverageInOutInOutDeductible$1,500$5,000$2,000$5,000Family Deductible$3,000$10,000$4,000$10,000Coinsurance (% that UHC Pays)70%100%50%80%Out-Of-Pocket$5,000 / $10,000$10,000 / $20,000$3,500 / $7,000$10,000 / $20,000Preventative CareNo charge50% After Ded.No Charge70% After Ded.Virtual CareNo charge50% After Ded.No Charge70% After Ded.Child Office Vision (Under Age 19)70% After Ded.No Charge50% After Ded.No chargeAdult Office Visit$25 Copay50% After Ded.$30 Copay70% After Ded.70% After Ded.$60 Copay50% After Ded.$50 CopaySpecialty Doctor Office Visit70% After Ded.100% After Ded.50% After Ded.80% After Ded.Inpatient Hospital ServicesLab & X-Ray (Routine)80% After Ded.50% After Ded.100% After Ded.70% After Ded.Advanced Imagining80% After Ded.50% After Ded.100% After Ded.70% After Ded.Urgent Care50% After Ded.70% After Ded.Emergency Room As INN As INNRX$10 / $35 / $75Not Covered$10 / $35 / $75Not CoveredAssign PCPAdditional NotesPer PaycheckEmployee OnlyEmployee + SpouseEmployee + Child(ren)Employee + FamilyDQ33 (last year BCYE plan)DQ3U (last year BCX7 plan)PPO - Choice PlusPPO - Choice PlusNONO*You will pay less if you go to a designated provider.*You will pay less if you go to a designated provider.Bi-WeeklyBi-Weekly$111.91$664.06$426.87$1,017.90$131.16$710.64$461.71$1,081.99Page 12 $500 Copay + 80% After Ded.$50 Copay $50 Copay$500 Copay
EN-2026 FOR EMPLOYEES (2-23) Unum | Dental InsuranceRon Hoover Companies IncorporatedWhat else is included?Pregnancy benefitAn extra cleaning for expecting mothers in their 2nd or 3rd trimester.Wellness benefitsOral cancer screenings for patients 40 and older with high risk factors.Unumdentalcare.comUse unumdentalcare.com to search for providers, manage your benefits and learn about good dental health. Features include easy access to ID Cards, claims history and coverage information.Virtual Dental Visits24/7 dental care for dental emergencies when an in-person visit isn’t an option. Available for active dental members*.Visit unumdentalcare.com and click Virtual Dental Visits to get started. Carryover benefitsMembers who take care of their teeth, but use only part of their annual maximum benefit during a benefit period are rewarded with extra benefits in future years! Carryover benefits will be accrued and stored in the insured’s carryover account to be used in the next benefit year.The limits for this policy/certificate are:Passive PPO Passive PPOCarryover benefit $400 $250Threshold limit $800 $500Carryover account limit$1,500 $1,000Unum Dental™Dental Insurance can help you pay for dental exams, cleanings and other services.Why is this coverage so valuable?Routine dental care keeps your mouth and whole body healthy.Your plan is backed by Unum’s commitment to excellence in customer service.Personalized website to manage your benefits including claims information, ID cards and more.There’s no waiting period for preventive and basic services.How does it work?Good dental care is critical to your overall well-being. With Unum Dental insurance, you can get the attention your teeth need — at a cost you can afford.Unum Dental allows you to see any dentist you choose. To get the most from your benefits and reduce out-of-pocket costs, choose an in-network provider by utilizing our large national network. These providers have agreed to file your claims and uphold the highest quality standards. You can find in-network providers at unumdentalcare.com.*Virtual dental visits are a preventiveservice and subject to policy year benefit maximum.Page 13
EN-2026 FOR EMPLOYEES (2-23) Unum | Dental InsuranceDental carryover benet and how it worksEach benefit year a member must have: • One cleaning, • One regular exam, and • Total dental claims for preventive, basic and major covered procedures paid during the year below the threshold limit. • If all three criteria above are met, a portion of the annual maximum will carry over to the next year.Other Specifications: • Each covered family member receives their own carryover benefit. • Group carryover benefit rider must be in effect for one benefit year before any members can utilize carryover benefits. • A member must be on the plan for a minimum of three months before accruing carryover benefits. • Carryover benefit may be used toward preventive, basic and major covered services only • A member’s carryover account will be eliminated, and the accrued carryover benefits lost if the insured has a break in coverage for any length of time or any reason.Dependent childrenDependent age guidelines vary by state. Please refer to your policy certificate or call our Contact Center at (888) 400-9304.Services not listedIf you expect to require a dental service not included on this brochure, it may still be covered. Please call our Contact Center at (888) 400-9304 to confirm your exact benefits.Alternate treatmentUnum covers the least expensive most commonly used and accepted American Dental Association treatments. Plan members may elect a more expensive treatment, but will be responsible for the cost difference resulting from the more expensive procedure.Coverage details and costsOverview Passive PPO Passive PPOBenefit Year Maximum*$5,000 $1,000Deductible**$50 in-network and out-of-network Maximum 3 per family$50 in-network and out-of-network Maximum 3 per familyPlan CoinsuranceIn- networkOut-of-NetworkIn- networkOut-of-NetworkClass A Preventive100% 100% 100% 100%Class B Basic80% 80% 80% 80%Class C Major50% 50% 50% 50%Class D Orthodontics50% 50% N/A N/A*Applies to Class A, B and C Services, if applicable **Waived for Class A (applies to Class B and C Services) Dental CoveragePassive PPO Passive PPOMonthly cost† Monthly cost†You$37.49 $23.86You and your spouse$77.45 $47.01You and your children$92.88 $56.68Family$141.01 $85.89†Rates guaranteed for 24 months from the effective date.Page 14
EN-2026 FOR EMPLOYEES (2-23) Unum | Dental InsuranceCovered Procedures & Waiting PeriodsPassive PPO Passive PPOCLASS A PREVENTIVE SERVICESWaiting Period: None Waiting Period: None • Routine exams (2 per 12 months) • Routine exams (2 per 12 months) • Prophylaxis (2 per 12 months) – (1 additional cleaning or periodontal maintenance per 12 months, if member is in 2nd or 3rd trimester of pregnancy) • Prophylaxis (2 per 12 months) – (1 additional cleaning or periodontal maintenance per 12 months, if member is in 2nd or 3rd trimester of pregnancy) • Bitewing x-rays (maximum of 4 films; 1 per 12 months) • Bitewing x-rays (maximum of 4 films; 1 per 12 months) • Fluoride treatment for children up to age 16 (1 per 12 months) • Fluoride treatment for children up to age 16 (1 per 12 months) • Sealants for children up to age 16 (permanent molars, 1 per 36 months) • Sealants for children up to age 16 (permanent molars, 1 per 36 months) • Space Maintainers • Space Maintainers • Emergency Treatment (1 per 12 months) • Adjunctive pre-diagnostic oral cancer screening (1 per 12 months for ages 40+) • Full mouth/panoramic x-rays (1 per 36 months) • Adjunctive pre-diagnostic oral cancer screening (1 per 12 months for ages 40+)CLASS B BASIC SERVICESWaiting Period: None Waiting Period: None • Simple restorative services (fillings) – Posterior composite restorations • Emergency Treatment (1 per 12 months) • Simple extractions • Full mouth/panoramic x-rays (1 per 36 months) • Oral Surgery (extractions and impacted teeth) • Simple restorative services (fillings) – Posterior composite restorations • Anesthesia (subject to review, covered with complex oral surgery) • Simple extractions • Repair of crown, denture or bridge • Non-Surgical periodontics • Surgical periodontics (gum treatments) • Periodontal maintenance (2 per 12 month in combination with prophylaxis) • Endodontics (root canals)CLASS C MAJOR SERVICESWaiting Period: None Waiting Period: None • Inlays and onlays • Oral Surgery (extractions and impacted teeth) • Crowns, bridges, dentures and implants • Anesthesia (subject to review, covered with complex oral surgery) • Repair of crown, denture or bridge • Inlays and onlays • Non-Surgical periodontics • Surgical periodontics (gum treatments) • Periodontal maintenance (2 per 12 month in combination with prophylaxis) • Endodontics (root canals) • Crowns, bridges, dentures and implantsCLASS D ORTHODONTICSWaiting Period: NonePage 15
Exclusions and LimitationsThe following dental services are not covered unless stated otherwise in the Certificate of Coverage:• any treatment which is elective or primarily cosmetic in nature and not generally recognized as a generally accepted dental practice by the American Dental Association, as well as any replacement of prior elective or cosmetic restorations;• replacement of a removable device or appliance that is lost, missing or stolen, and for the replacement of removable appliances that have been damaged due to abuse, misuse, or neglect. This may include but not be limited to removable partial dentures or dentures;• replacement of any permanent or removeable device or appliance unless the device or appliance is no longer functional and is older than the limitation in the Schedule of Covered Procedures. This may include but not be limited to bridges, dentures and crowns;• any appliance, service, or procedure performed for the purpose of splinting, to alter vertical dimension or to restore occlusion;• any appliance, service or procedure performed for the purpose of correcting attrition, abrasion, erosion, abfraction, bite registration, or bite analysis;• charges for implants (except noted above), removal of implants, precision or semi-precision attachments, denture duplication, or dentures and any associated surgery, or other customized services or attachments;• services provided for any type of temporomandibular joint (TMJ) dysfunction, muscular, skeletal deficiencies involving TMJ or related structures, myofascial pain.Limitations:• Multiple restorations on one surface are payable as one surface. Multiple surfaces on a single tooth will not be paid as separate restorations. On any given day, more than 8 periapical x-rays or a panoramic film in conjunction with bitewings will be paid as a full mouth radiograph. Pre-estimates are recommended for any treatment expected to exceed $300.Takeover benefits:Takeover benefits apply if we are taking over a comparable benefits plan from another carrier and only if there is no break in coverage between the original plan and the takeover date. Takeover is available to those individuals insured under the employer’s dental plan in effect at the time of the employer’s application. If takeover benefits are included in your benefits, then waiting periods for service will be waived for the individuals currently insured under the employer’s previous plan during the month prior to coverage moving to us. Application of takeover benefits is subject to Underwriting review and approval. New hires with prior-like dental coverage (lapse in coverage must be less than 63 days) will receive takeover credit for the length of time they had with the prior carrier and must provide proof of coverage (including coverage dates) to receive takeover credit (i.e. one page benefit summary, Certificate of Creditable Coverage, etc.). A Network Access plan is available. THIS POLICY PROVIDES LIMITED BENEFITS This brochure is not intended to be a complete description of the insurance coverage available. The policies or their provisions may vary or be unavailable in some states. The policies have exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form Series Dental 20-GDN or contact your Unum Dental representative. Underwritten by Starmount Life Insurance Company, Baton Rouge, LA.© 2023 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. EN-2026 FOR EMPLOYEES (2-23)unum.comCovered Procedures & Waiting PeriodsPassive PPO Passive PPO • Separate Lifetime Maximum: $2,000 • Up to 25% of lifetime allowance may be payable on initial banding • All Insureds Refer to your certificate of coverage for the services covered under your plan.Page 16
EN-376255 FOR EMPLOYEES (1-23) Unum | Vision Insurance Ron Hoover Companies IncorporatedUnum Vision® How much does it cost? Monthly premiumYou $5.87You and your spouse $11.72You and your children $12.39Family $19.46Plan features: • Our network offers members access to a large national network, including independent optometrists and retail stores like Walmart, Sam’s Club, Target Optical, America’s Best and many more. • Search for providers and manage your benefits online at unumvisioncare.com.Covered benets:Exam: Each member is entitled to a comprehensive vision exam. An exam co-pay applies and is outlined in the grid at right.Materials: Each member has coverage for covered services and materials. Purchases are subject to benefit frequencies and co-pays. Plan features include: • Frame benefit: You may choose any frame within a provider’s collection, subject to the retail frame allowance listed at right. If the cost is greater than the plan’s benefits, you are responsible for the difference. • Eyeglass lens benefit: Standard plastic (CR-39 Plastic Material) single vision, bifocal, trifocal, and specialty lenses are generally covered after any applicable materials copay. If covered by plan allowance, you are responsible for any cost greater than the plan’s benefit. • Contact lens benefit: Members electing contact lenses instead of eye glass lenses may apply the contact lens allowance to any lenses in the provider’s collection. If the cost is greater than the plan’s benefits, you are responsible for the difference.Laser vision correction: Discounts are available with participating surgery providers across the country. (not an insured benefit)Unum Vision benefits:Vision Care ServicesIn-network ProvidersOut-of-network AllowancesExam (1 per 12 months)$10 co-pay Up to $35Materials$25 co-pay See allowances belowStandard Plastic Lenses (1 per 12 months)Single VisionCovered by co-pay Up to $25BifocalCovered by co-pay Up to $40TrifocalCovered by co-pay Up to $50LenticularCovered by co-pay Up to $50Progressive $70 allowance Up to $40Lens OptionsScratch Resistant CoatingCovered by co-pay (at Walmart only)Not coveredPolycarbonate Lenses for children to age 19Covered by co-pay Not coveredFrames (1 per 24 months)Members choose from any frame available at provider locations.$150 allowance Up to $50Contact Lenses (1 per 12 months) In lieu of eyeglass lenses & frames (Includes fit*, follow-up and materials)No co-paySee allowances belowElective$150 allowance Up to $100Medically NecessaryCovered Up to $210*Some providers, such as Walmart, may charge for a contact lens fit and evaluation separately from your contact lens allowance, leaving the entire allowance for materials.Page 17
EN-376255 FOR EMPLOYEES (1-23) Unum | Vision Insurance Laser Vision Correction Network Membership provides access to preferred pricing. Transactions are handled directly between members and providers. Refractive surgery is an elective procedure and may involve potential risks to patients. This is not an insured benefit. Unum cannot and does not guarantee the outcome of any refractive surgical procedure or a total elimination of the need for glasses or contacts. Providers may not be available in all metropolitan areas. Search for participating laser vision correction providers at unumvisioncare.com.Hearing Savings PlanUnum offers a Hearing Savings Plan at no additional cost, to all of its Unum Dental and Unum Vision members. Partnering with EPIC Hearing Healthcare, the Hearing Savings Plan provides: • 30-60% discounts off MSRP on name brand hearing instruments. • 40% savings on hearing aid batteries shipped directly to members’ homes. • On-call support for member questions, managed by professional hearing counselors.Other Unum Vision SpecicationsDependent children: Dependent age guidelines vary by state. Please refer to your policy certificate or call our Contact Center at 888-400-9304.Services not listed: If you expect to require a vision service not included on this brochure, it may still be covered. Please call our Contact Center at 888-400-9304, to confirm your exact benefits.This is a primary vision care benefit and is intended to cover only eye examinations and corrective eyewear. Medical or surgical treatment of eye disease or injury is not provided under this plan. Coverage may not exceed the lesser of actual cost of covered services and materials or the limits of the policy.Some providers at optical and/or retail chains, such as Walmart, may charge for a contact lens fit and evaluation separately and apart from your contact lens allowance, leaving the entire allowance for materials.Covered materials that are lost or broken will be replaced only at normal service intervals indicated in the Plan Design; however, these materials and any items not covered below may be purchased at Preferred Pricing from a Participating Provider. In addition, benefits are payable only for expenses incurred while the Group and individual Member coverage is in force.This plan will not cover:Orthoptics or vision training and any supplemental testing; Plano (non-prescription) lenses; or two pair of eyeglasses in lieu of bifocals or trifocals; Medical or surgical treatment of the eyes; An eye exam or corrective eye wear required by an employer as a condition of employment; Any injury or illness covered under Workers’ Compensation or similar law, or which is work related; Plain or prescription sunglasses or tinted lenses, and no-line bifocals and blended lenses (subject to allowance); Sub-normal vision aids; Services rendered or materials purchased outside the U.S. or Canada, unless: the insured resides in the U.S. or Canada, and the charges are incurred while on a business or pleasure trip; Charges in excess of Usual and Customary for services and materials; Experimental or non-conventional treatments or devices; Safety eyewear; Spectacle lens styles, materials, treatments or “add-ons” not shown in the Schedule of Benefits.A Network Access plan is available.THIS POLICY PROVIDES LIMITED BENEFITSThis brochure is not intended to be a complete description of the insurance coverage available. The policies or their provisions may vary or be unavailable in some states. The policies have exclusions and limitations which may affect any benefits payable. For complete details of coverage and availability, please refer to Policy Form Series VI-2002, VI-2007 and VI-2019 or contact your Unum Vision representative.Vision plans are underwritten by Starmount Life Insurance Company, Baton Rouge, LA.© 2023 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. Page 18
EN-2073 FOR EMPLOYEES (8-23) Unum | Group Accident InsuranceRon Hoover Companies IncorporatedWho can get coverage? Group Accident InsuranceHow does it work?Accident Insurance provides a set benefit amount based on the type of injury you have and the type of treatment you need. It covers accidents that occur off the job. And it includes a range of incidents, from common injuries to more serious events.Why is this coverage so valuable?It can help you with out-of-pocket costs that your medical plan doesn’t cover, like co-pays and deductibles. You’ll have base coverage without medical underwriting. The cost is conveniently deducted from your paycheck. You can keep your coverage if you change jobs or retire. You’ll be billed directly.YouIf you’re actively at work*Your spouseCan get coverage as long as you have purchased coverage for yourself.Your childrenDependent children from birth until their 26th birthday, regardless of marital or student status.*Employees must be legally authorized to work in the United States and actively working at a U.S. location to receive coverage. See Schedule of benefits for a complete listing of what is covered. What’s included?Be Well BenefitEvery year, each family member who has Accident coverage can also receive $50 for getting a covered Be Well screening test, such as: • Annual exams by a physician include sports physicals, well-child visits, dental and vision exams • Screenings for cancer, including pap smear, colonoscopy • Cardiovascular function screenings • Screenings for cholesterol and diabetes • Imaging studies, including chest X-ray, mammography • Immunizations including HPV, MMR, tetanus, influenzaOrganized Sports BenefitEach family member that has Accident coverage is eligible for a 25% increase in payable benefits within the Injury and Treatment schedule of benefit categories. See disclosures and schedule of benefits for more information.How much does it cost?Your monthly premium Option 1You$11.89You and your spouse$18.06You and your children$23.30Family$29.47Page 19
Unum | Group Accident InsuranceEN-2073 FOR EMPLOYEES (8-23)SCHEDULE OF BENEFITSAccidental Death and DismembermentAD&D Employee $50,000Spouse $25,000Children $12,500Common Carrier Benefit can pay if the insured individual is injured as a fare-paying passenger on a common carrier (examples include mass transit trains, buses and planes) Employee $50,000Spouse $25,000Children $12,500Dismemberment Both Feet $50,000Both Hands $50,000One Foot $25,000One Hand $25,000Thumb and Index Finger of the same Hand $12,500Coma Coma $10,000Home & Vehicle Modifications Home & Vehicle Modifications $1,500Loss of Use Hearing (one ear) $12,500Hearing $12,500Sight of one Eye $25,000Sight of both Eyes $50,000Speech $25,000Paralysis Uniplegia $12,500Hemi/Paraplegia $25,000Triplegia $37,500Quadriplegia $50,000HospitalizationAdmission $1,200Admission – Hospital ICU (added to Admission)$1,200Daily Stay (365 days) $350Daily Stay – Hospital ICU (added to Daily Stay)$350Short Stay $200InjuryInjury due to felony & sexual assault$200Organized Sports 25%BurnsInjury2nd Degree Burns - At least 5%, but less than 20% of skin surface$7502nd Degree Burns - 20% or greater of skin surface$1,5003rd Degree Burns - Less than 5% of skin surface$3,0003rd Degree Burns - At least 5%, but less than 20% of skin surface$7,5003rd Degree Burns - 20% or greater of skin surface$15,000ConcussionConcussion $200Connective Tissue DamageOne Connective Tissue (tendon, ligament, rotator cuff, muscle)$90Two or more Connective Tissues (tendon, ligament, rotator cuff, muscle)$150DislocationsKnee joint (other than patella)$2,000Ankle bone or bones of the foot (other than toes)$2,000Hip joint $4,125Collarbone (sternoclavicular)$1,000Elbow joint $600Hand (other than Fingers) $600Lower Jaw $600Shoulder $600Wrist joint $600Collarbone (acromioclavicular and separation)$400Finger or Toe (Digit) $200Kneecap (patella) $600Incomplete Dislocation - Payable as a % of the applicable Dislocations benefit25%Eye InjuryEye Injury $200FracturesSkull (except bones of Face or Nose), Depressed$5,500Hip or Thigh (femur) $4,125Skull (except bones of Face or Nose), Non-depressed$2,750Vertebrae, body of (other than Vertebral Processes)$1,650Leg (mid to upper tibia or fibula)$1,650Pelvis $1,650InjuryBones of the Face or Nose (other than Lower Jaw, Mandible or Upper Jaw, Maxilla)$825Upper Arm between Elbow and Shoulder (humerus)$825Upper Jaw, Maxilla (other than alveolar process)$825Ankle (lower tibia or fibula)$550Collarbone (clavicle, sternum) or Shoulder Blade (scapula)$550Foot or Heel (other than Toes)$550Forearm (olecranon, radius, or ulna), Hand, or Wrist (other than Fingers)$550Kneecap (patella) $550Lower Jaw, Mandible (other than alveolar process)$550Vertebral Processes $550Rib $550Tailbone (coccyx), Sacrum $550Finger or Toe (Digit) $275Chip Fracture - Payable as a % of the applicable Fractures benefit25%Same bone maximum incurred per accident1 FractureMaximum payable multiplier for multiple bones2 TimesInternal InjuriesInternal Injuries $200LacerationsNo Repair $65Repair Less than 2 inches $200Repair At least 2 inches but less than 6 inches$400Repair 6 inches or greater $800Loss of a DigitOne Digit (other than a Thumb or Big Toe)$1,000One Digit (a Thumb or Big Toe)$1,500Two or more Digits $2,000Knee CartilageKnee Cartilage (Meniscus) Injury$200Ruptured or Herniated DiscOne Disc $180Two or more Discs $300RecoveryAcquired Brain Injury $25At-Home Care $125Physician Follow-Up Visits $150Page 20
Unum | Group Accident InsuranceEN-2073 FOR EMPLOYEES (8-23)SCHEDULE OF BENEFITSRecoveryPhysician Follow-Up Maximum Visits2Prescription Drug $25Prescription Benefit Incidence per covered accident1 Per InsuredRehabilitation or Subacute Rehabilitation Unit$150Behavior Health Therapy $25Behavior Health Therapy visits15Telehealth Service $25Telemedicine Medical Service$25Therapy Services (chiro, speech, PT, occ, acupuncture/alternative)$100Therapy Services Maximum Days15SurgeryDislocationsDislocation, Surgical Repair - Payable as a % of the applicable Injury benefit100%AnesthesiaEpidural or Regional Anesthesia$120General Anesthesia $300Connective TissueExploratory without Repair $125Repair for One Connective Tissue$1,000Repair for Two or more Connective Tissues$1,500Eye SurgeryEye Surgery, Requiring Anesthesia$400FracturesFractures, Surgical Repair - Payable as a % of the applicable Injury benefit100%Surgical Repair same bone maximum incurred per accident1 FractureSurgical Repair same bone maximum payable multiplier for multiple bones2 TimesGeneral SurgeryAbdominal, Thoracic, or Cranial$2,000Exploratory $200Incidence per covered accident1 Per InsuredHernia SurgeryHernia Surgery $200Knee CartilageSurgeryKnee Cartilage (Meniscus) Exploratory without Repair$200Knee Cartilage (Meniscus) with Repair$1,000Outpatient Surgical FacilityOutpatient Surgical Facility$400Ruptured or Herniated Disc SurgeryExploratory without Repair $150One Disc $800Two or more Discs $1,200TreatmentOrganized Sports 25%AmbulanceAir $1,200Ground $400Durable Medical EquipmentTier 1 (arm sling, cane, medical ring cushion)$65Tier 2 (bedside commode, cold therapy system, crutches)$125Tier 3 (back brace, body jacket, continuous passive movement, electric scooter)$250Emergency Dental RepairDental Crown $450Dental Extraction $150Filling or Chip Repair $115ImagingTier 1: X-rays or Ultrasound$300Tier 2: Bone Scan, CAT, CT, EEG, MR, MRA, or MRI$300Medical Imaging Incidence allowance covered accident per Tier1 Per Insured Per TierLodgingLodging (per night) $200Prosthetic DeviceOne Device or Limb $1,000Two or more Devices or Limbs$2,000Skin GraftsFor Burns - Payable as a % of the applicable Burn benefit50%Not Burns - Less than 20% of skin surface$375Not Burns - 20% or greater of skin surface$750TreatmentEmergency Room Treatment $300TreatmentInjections to Prevent or Limit Infection (tetanus, rabies, antivenom, immune globulin)$50Pain Management Injections (epidural, cortisone, steroid)$150Transfusions $500Transportation (per trip) $150Family Care $50Pet Boarding (per day) $30Treatment in a Physician’s Office or Urgent Care Facility (initial)$200•Page 21
EN-2073 FOR EMPLOYEES (8-23)Unum | Group Accident InsuranceOrganized Sports BenefitThis increased benefit payment will be applied if the covered Accident occurs while playing an organized sport that required formal registration to participate and is officiated by someone certified to act in that capacity. Active employmentYou are considered in active employment if, on the day you apply for coverage, you are being paid regularly for the required minimum 20 hours each week and you are performing the material and substantial duties of your regular occupation. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. New employees have a 30 day waiting period to be eligible for coverage. Please contact your plan administrator to confirm your eligibility date. If enrolling, and eligible for Medicare (age 65+; or disabled) the Guide to Health Insurance for People with Medicare is available at https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdfEffective date of coverageCoverage becomes effective on the first day of the month in which payroll deductions begin.Exclusions and limitations We will not pay benefits for a claim that is caused by, contributed to by, or occurs as the result any of the following:• committing or attempting to commit a felony;• being engaged in an illegal occupation or activity;• injuring oneself intentionally or attempting or committing suicide, whether sane or not;• active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, Injury as an innocent bystander, or Injury for self-defense;• participating in war or any act of war, whether declared or undeclared;• combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations;• a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution;• elective procedures, cosmetic surgery, or reconstructive surgery unless it is a result of trauma, infection, or other diseases;• an occupational injury; • any Sickness, bodily infirmity, or other abnormal physical condition or Mental or Nervous Disorders, including diagnosis, treatment, or surgery for it;• Infection. This exclusion does not apply when the infection is due directly to a cut or wound sustained in a Covered Accident;• experimental or investigational procedures;• operating any motorized vehicle while intoxicated;• operating, learning to operate, serving as a crew member of any aircraft or hot air balloon, including those which are not motor-driven, unless flying as a fare paying passenger;• jumping, parachuting, or falling from any aircraft or hot air balloon, including those which are not motor-driven;• travel or flight in any aircraft or hot air balloon, including those which are not motor-driven, if it is being used for testing or experimental purposes, used by or for any military authority, or used for travel beyond the earth’s atmosphere;#practicing for or participating in any semi-professional or professional competitive athletic contests for which any type of compensation or remuneration is received;• riding or driving an air, land or water vehicle in a race, speed or endurance contest; and• engaging in hang-gliding, bungee jumping, sail gliding, parasailing, parakiting, or BASE jumping.The Accidental Death and Dismemberment Benefits are also subject to the following Exclusions. We will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following:• being intoxicated; and• voluntary use of or treatment for voluntary use of any prescription or non-prescription drug, intoxicant, poison, fume, or other chemical substance unless taken as prescribed or directed by the Insured’s PhysicianAdditionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date.End of CoverageIf you choose to cancel your coverage your coverage ends on the first of the month following the date you provide notification to your employer. Otherwise, your coverage ends on the earliest of the:• the date this policy is canceled by Unum or your employer;• the date you are no longer in an eligible group;• the date your eligible group is no longer covered;• the date of your death;• the last day of the period any required premium contributions are made;• the last day you are in active employment. However, as long as premium is paid as required, coverage will continue• in accordance with the Continuation of your Coverage during Absences provision; or• if you elect to continue coverage for you, your Spouse, and Children under Portability of Accident Insurance. We will provide coverage for a Payable Claim that occurs while you are covered under this certificateTHIS IS A LIMITED BENEFITS POLICYThis 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.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 benefits payable. For complete details of coverage and availability, please refer to certificate form GAC16-1 et al. and GAC16-2 and Policy Form GAP16-1 et al. in all states or contact your Unum representative.Unum complies with state civil union and domestic partner laws when applicable.Underwritten by: Unum Insurance Company, Portland, Maine© 2023 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 22
Unum | Group Critical Illness Insurance EN-1717552 FOR EMPLOYEES (9-23) Ron Hoover Companies IncorporatedWhy is this coverage so valuable? • The money can help you pay out-of-pocket medical expenses, like deductibles. • You can use this coverage more than once. Even after you receive a payout for one illness, you’re still covered for the remaining conditions and for the reoccurrence of any critical illness with the exception of skin cancer. The reoccurrence benefit can pay 100% of your coverage amount. Diagnoses must be at least 180 days apart or the conditions can’t be related to each other.What’s covered?Critical Illnesses• Heart attack• Stroke• Major organ failure• End-stage kidney failure• Sudden cardiac arrest• Coronary artery disease Major (50%): Coronary artery bypass graft or valve replacement Minor (10%): Balloon angioplasty or stent placementCancer conditions• Invasive cancer — all breast cancer is considered invasive• Non-invasive cancer (25%)• Skin cancer — $500Progressive diseases Supplemental conditions• Amyotrophic Lateral Sclerosis (ALS)• Dementia, including Alzheimer’s disease• Multiple Sclerosis (MS)• Parkinson’s disease• Functional loss• Huntington’s Disease• Lupus• Muscular Dystrophy• Myasthenia Gravis• Systemic Sclerosis (Scleroderma)• Addison’s Disease• Loss of sight, hearing or speech• Benign brain tumor• Coma• Permanent Paralysis• Occupational HIV, Hepatitis B, C or D• Occupational PTSDPaid at 25%• Infectious Diseases• Pulmonary Embolism• Transient Ischemic Attack (TIA)• Bone Marrow/Stem CellPlease refer to the certificate for complete definitions of these covered conditions. Coverage may vary by state. See exclusions and limitations. How does it work?If you’re diagnosed with an illness that is covered by this insurance, you can receive a lump sum benefit payment. You can use the money however you want.Why should I buy coverage now? • It’s more accessible when you buy it through your employer and the premiums are conveniently deducted from your paycheck. • Coverage is portable. You may take the coverage with you if you leave the company or retire. You’ll be billed at home. Be Well BenefitEvery year, each family member who has Critical Illness coverage can also receive $50 for getting a covered Be Well Benefit screening test, such as:• Annual exams by a physician include sports physicals, well-child visits, dental and vision exams• Screenings for cancer, including pap smear, colonoscopy• Cardiovascular function screenings• Screenings for cholesterol and diabetes• Imaging studies, including chest X-ray, mammography• Immunizations including HPV, MMR, tetanus, influenzaWho can get coverage?You:Your spouse:Spouses can only get 50% of the employee coverage amount as long as you have purchased coverage for yourself.Your children:Children from live birth to age 26 are automatically covered at no extra cost. Their coverage amount is 50% of yours. They are covered for all the same illnesses plus these specific childhood conditions: cerebral palsy, cleft lip or palate, cystic fibrosis, Down syndrome, spina bifida, type 1 diabetes, sickle cell anemia and congenital heart disease. The diagnosis must occur after the child’s coverage effective date.Group Critical Illness InsuranceChoose from $10,000 to $40,000 of coverage in increments of $10,000 with no medical underwriting to qualify if you apply during thisenrollment.Page 23
Unum | Group Critical Illness Insurance EN-1717552 FOR EMPLOYEES (9-23) Active employment: You are considered in active employment if, on the day you apply for coverage, you are being paid regularly for the required minimum 20 hours each week and you are performing the material and substantial duties of your regular occupation. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. New employees have a 30 day waiting period to be eligible for coverage. Please contact your plan administrator to confirm your eligibility date.If enrolling, and eligible for Medicare (age 65+; or disabled) the Guide to Health Insurance for People with Medicare is available at https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdfMonthly rates per $1,000 of coverageAge Employee Spouseunder 25 $0.34 $0.3625 - 29 $0.41 $0.4230 - 34 $0.50 $0.5235 - 39 $0.61 $0.6640 - 44 $0.81 $0.9345 - 49 $1.13 $1.3150 - 54 $1.65 $1.8655 - 59 $2.20 $2.5660 - 64 $3.90 $3.1565 - 69 $5.27 $4.2170 - 74 $7.18 $5.6575 - 79 $9.09 $7.6780 - 84 $9.09 $7.6785+ $9.09 $7.67Calculate your costChoose the rate for your current age:$ ___________ ÷ $1,000 x ______Amount of coverage you want Rate Actual billed amounts may vary. For illustrative purposes only.= $ ___________Page 24
Unum | Group Critical Illness Insurance EN-1717552 FOR EMPLOYEES (9-23) Your paycheck deduction will include the cost of coverage and the Be Well Benefit. Actual billed amounts may vary.Exclusions and limitationsWe will not pay benefits for a claim that is caused by, contributed to by, or occurs as a result of any of the following: • committing or attempting to commit a felony; being engaged in an illegal occupation or activity; injuring oneself intentionally or attempting or committing suicide, whether sane or not; active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, injury as an innocent bystander, or injury for self-defense; participating in war or any act of war, whether declared or undeclared; combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations; voluntary use of or treatment for voluntary use of any prescription or non-prescription drug, alcohol, poison, fume, or other chemical substance unless taken as prescribed or directed by the Insured’s Physician; being intoxicated; and a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution.Additionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date.Continuity of coverageWe will provide coverage for an Insured if the Insured was covered by a similar prior policy on the day before the Policy Effective Date. Coverage is subject to payment of premium and all other terms of the certificate. If an employee is on a temporary Layoff or Leave of Absence on the Policy Effective Date of this certificate, we will consider your temporary Layoff or Leave of Absence to have started on that date and coverage will continue for the period provided temporary Layoff or Leave of Absence under Continuation of your Coverage During Extended Absences in the certificate. If you have not returned to Active Employment before any Insured’s Covered Loss, any benefits payable will be limited to what would have been paid by the prior carrier.Covered Loss must be after the coverage effective date.End of employee coverageIf you choose to cancel your coverage your coverage ends on the first of the month following the date you provide notification to your employer. Otherwise, your coverage ends on the earliest of the: date this policy is canceled by Unum or your employer; date you are no longer in an eligible group; date your eligible group is no longer covered; date of your death; last day of the period any required premium contributions are made; or last day you are in active employment. However, as long as premium is paid as required, coverage will continue in accordance with the Continuation of your Coverage during Absences provision or if you elect to continue coverage for you, your Spouse, and Children under Portability of Critical Illness Insurance.Unum will provide coverage for a payable claim that occurs while you are covered under this certificate.Unum complies with applicable civil union and domestic partner laws.THIS INSURANCE PROVIDES LIMITED BENEFITSThis 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.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 benefits payable. For complete details of coverage and availability, please refer to Certificate Form UIC-GCIC16-2 and Policy Form UIC-GCIP16-2 or contact your Unum representative.Underwritten by: Unum Insurance Company, Portland, Maine© 2023 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 25
unum.comFor more information, please contact your HR representative.Each year, you can earn a valuable incentive just for taking care of your health. And so can each of your covered family members. Online: www.unum.comApp: MyUnum for MembersPhone: 1-800-635-5597You will need to provide the following: HOW TO FILE A CLAIM You can receive a benet for tests that are performed after your initial coverage date. Follow these steps: • First and last names of the employee and claimant (the employee might not be the claimant)• Employee’s Social Security number or policy number• Name and date of the test• Name of physician and the facility where the test was performed.Your Unum plan pays a Be Well Benet for one Be Well screening each year.With the Unum Be Well Benet, you and other covered family members can receive a valuable incentive for important tests and screenings. Many of these tests are routinely performed, so it’s easy to take advantage of this benet.Your Critical Illness Insurance Be Well benet is $50.Your Accident Insurance Be Well benet is $50.Your Hospital Insurance Be Well benet is $50.BE WELL SCREENINGS• Annual exams by a physician including sports physicals and well-child visits, dental and vision exams• Cancer screenings including pap smear, colonoscopy• Cardiovascular function screenings• Cholesterol and diabetes screenings• Imaging studies, including chest X-ray, mammography• Immunizations including HPV, MMR, tetanus, inuenzaUnum will pay Be Well benefits for all eligible policies according to policy terms. THESE POLICIES PROVIDE LIMITED BENEFITSThe policies or their provisions may vary or be unavailable in some states. The policies have exclusions and limitations which may affect any benefits payable. See the actual policy or your Unum representative for specific provisions and details of availability.In New Hampshire, Be Well is referred to as Health Screening. In Washington, Be Well on the Accident product is referred to as Health Screening Benefit rider. In Kansas, Be Well is not available on the Hospital product and immunizations are not covered on the Accident or Critical Illness products.Underwritten by: Unum Insurance Company, Portland, Maine; In New Jersey and New York, underwritten by: Provident Life and Casualty Insurance Company, Chattanooga, Tennessee© 2024 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. EN-1911-Be Well FOR EMPLOYEES (2-24) Learn more about your annual Be Well BenetRon Hoover Companies IncorporatedPage 26
Must be actively at work during the annual enrollment to apply for or increase coverage. Some restrictions may apply. Please refer to your policy contract or see your plan administrator for an explanation of the delayed eective date provision that applies to your plan. The policy or its provisions may vary or be unavailable in some states. The policy has exclusions and limitations which may aect any benets payable. See the actual policy or your Unum representative for specic provisions and details of availability. Applicable to policy form C.FP-1 et. al. Underwritten by Unum Life Insurance Company of America, Portland, Maine. In New York, underwritten by First Unum Life Insurance Company, Garden City, New Yorkunum.com© 2024 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries. EN-1970 FOR EMPLOYEES (5-24)Ron Hoover Companies IncorporatedHow it works If you enroll now You can select a coverage amount up to 5 times your annual earnings to a maximum of $500,000 in increments of $10,000. Get up to the non-medical maximum of $200,000, with no medical questions or health exams. Can I increase my coverage at a future enrollment?If you elected at least the minimum benefit amount of $10,000 at your initial enrollment, you can increase your coverage up to $200,000, the non-medical maximum amount, at future enrollments with no health-related questions. Health-related questions are required for coverage beyond that amount.If you declined coverage when initially eligibleIf you declined coverage during your initial eligibility window, you can apply for Term Life Insurance during future annual enrollments, however, you will have to answer health-related questions for any amount to determine eligibility.DependentsSpouse coverageYou can enroll your spouse in life insurance coverage in increments of $5,000, with no medical questions or health exams, up to the non-medical maximum of $50,000.Coverage for childrenYou can purchase coverage for your children in increments of $1,000, with no medical questions or health exams, up to the non-medical maximum of $10,000. One policy covers all your children.You must purchase coverage for yourself to purchase coverage for your dependents. The coverage amount you choose for your spouse or child cannot exceed 50% of the coverage you purchase for yourself.Need life insurance? Now is the time to get coverageTerm Life Insurance allows you to purchase a level of coverage without having to answer health-related questions.As life changes, your financial obligations to provide for your family increase. Adding life insurance coverage can help offset unexpected costs and provide the safety net your loved one’s need to take care of your end-of-life expenses. Your Term Life Insurance plan allows you to purchase up to a specified amount of coverage without answering health-related questions. This amount is called the non-medical maximum. Enrolling during your initial enrollment allows you to apply for coverage up to $200,000, the non-medical maximum, without the need to answer health exams or medical questions.Here’s how Joyce manages her life insurance coverage During benefits enrollment, Joyce was offered a plan with a non-medical maximum of $200,000 • She enrolled for the minimum amount of coverage of $10,000 the first year. • Two years later, after having twins and purchasing a new home, she decided to increase her coverage. • Without medical questions or health exams, she was able to increase her coverage during annual enrollment to the non-medical maximum of $200,000. For illustrative purposes only. Non-medical maximum amounts vary based on case-specic oering.Page 27
Unum | Term Life Insurance EN-1976 FOR EMPLOYEES (6-22) Ron Hoover Companies IncorporatedWho can get Term Life coverage?If you are actively at work at least 30 hours per week, you may apply for coverage for:You: Choose from $10,000 to $500,000 in $10,000 increments, up to 5 times your earnings.You can get up to $200,000. This is the amount of coverage you can qualify for with no medical underwriting.Your spouse:Get up to $250,000 of coverage in $5,000 increments. Spouse coverage cannot exceed 50% of the coverage amount you purchase for yourself.Your spouse can get up to $50,000 with no medical underwriting, if eligible (see delayed effective date).Your children:Get up to $10,000 of coverage in $1,000 increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday.The maximum benefit for children live birth to 6 months is $1,000.How does it work?You choose the amount of coverage that’s right for you, and you keep coverage for a set period of time, or “term.” If you die during that term, the money can help your family pay for basic living expenses, final arrangements, tuition and more.AD&D Insurance is also available, which pays a benefit if you survive an accident but have certain serious injuries. It pays an additional amount if you die from a covered accident.Why is this coverage so valuable?If you buy a minimum of $10,000 of coverage now, you can increase your coverage in the future up to $200,000 to meet your growing needs. There would be no medical underwriting to qualify for coverage.What else is included?A ‘Living’ Benefit — If you are diagnosed with a terminal illness with less than 12 months to live, you can request 75% of your life insurance benefit (up to $500,000) while you are still living. This amount will be taken out of the death benefit, and may be taxable. These benefit payments may adversely affect the recipient’s eligibility for Medicaid or other government benefits or entitlements, and may be taxable. Recipients should consult their tax attorney or advisor before utilizing living benefit payments.Waiver of premium — Your cost may be waived if you are totally disabled for a period of time.Portability — You may be able to keep coverage if you leave the company, retire or change the number of hours you work.Employees or dependents who have a sickness or injury having a material effect on life expectancy at the time their group coverage ends are not eligible for portability.Voluntary Term Life Insurance and Accidental Death & Dismemberment (AD&D)Who can get Term Life coverage?If you are actively at work at least 30 hours per week, you may apply for coverage for:You:Choose from $10,000 to $500,000 in $10,000 increments, up to 5 times your earnings.You can get up to $200,000. This is the amount of coverage you can qualify for with no medical underwriting.Your spouse:Get up to $250,000 of coverage in $5,000 increments. Spouse coverage cannot exceed 50% of the coverage amount you purchase for yourself.Your spouse can get up to $50,000 with no medical underwriting, if eligible (see delayed effective date).Your children:Get up to $10,000 of coverage in $1,000 increments if eligible (see delayed effective date). One policy covers all of your children until their 26th birthday.The maximum benefit for children live birth to 6 months is $1,000.Who can get Accidental Death & Dismemberment (AD&D) coverage?You:Get up to $500,000 of AD&D coverage for yourself in $10,000 increments to a maximum of 5 times your earnings.Your spouse:Get up to $250,000 of AD&D coverage for your spouse in $5,000 increments, if eligible (see delayed effective date).Your children:Get up to $10,000 of coverage for your children in $1,000 increments if eligible (see delayed effective date).No medical underwriting is required for AD&D coverage.Page 28
Unum | Term Life Insurance EN-1976 FOR EMPLOYEES (6-22) 1. Enter the coverage amount you want.2. Divide by the amount shown.3. Multiply by the rate. Use the rate table (at right) to find the rate based on age.(Choose the age you will be when your coverage becomes effective on 01/01/2025. To determine your spouse rate, choose the age the spouse will be when coverage becomes effective on 01/01/2025.)4. Enter your cost.Billed amount may vary slightly.If you apply for coverage above the guaranteed issue amount, you may be subject to medical underwriting which may affect your ability to get the larger coverage amount. In order to purchase coverage for your dependents, you must buy coverage for yourself. Coverage amounts cannot exceed 50% of your coverage amounts. Calculate your costs1 2 3 4Employee$______,000 ÷ $10,000 = $________ X $______ = $_______Spouse $______,000 ÷ $5,000 = $________ X $______ = $_______Child $______,000 ÷ $1,000 = $________ X $______ = $_______Total costSpouse monthly ratePer $5,000 of coverageCost$0.250$0.300$0.450$0.600$0.850$1.400$1.950$2.750$3.850$6.350$10.300$30.450Employee monthly rateAgePer $10,000 of coverageCost15-24 $0.50025-29 $0.60030-34 $0.90035-39 $1.20040-44 $1.70045-49 $2.80050-54 $3.90055-59 $5.50060-64 $7.70065-69 $12.70070-74 $20.60075+ $60.900How much coverage can I get?Child monthly rate$0.200 per $1,000 of coverage1. Enter the AD&D coverage amount you want.2. Divide by the amount shown.3. Multiply by the rate. Use the AD&D rate table (at right) to find the rate.4. Enter your cost.AD&D monthly ratesCoverage amount RateEmployeeper $10,000 of coverage $0.300Spouse per $5,000 of coverage $0.150Child per $1,000 of coverage $0.050AD&D1 2 3 4Employee$______,000 ÷ $10,000 = $________ X $0.300 = $_______Spouse $______,000 ÷ $5,000 = $________ X $0.150 = $_______Child $______,000 ÷ $1,000 = $________ X $0.050 = $_______Total costPage 29
Unum | Term Life Insurance EN-1976 FOR EMPLOYEES (6-22) Exclusions and limitationsActively at workEligible employees must be actively at work to apply for coverage. Being actively at work means on the day the employee applies for coverage, the individual must be working at one of his/her company’s business locations; or the individual must be working at a location where he/she is required to represent the company. If applying for coverage on a day that is not a scheduled workday, the employee will be considered actively at work as of his/her last scheduled workday. Employees are not considered actively at work if they are on a leave of absence or lay off.An unmarried handicapped dependent child who becomes handicapped prior to the child’s attainment age of 26 may be eligible for benefits. Please see your plan administrator for details on eligibility.Employees must be U.S. citizens or legally authorized to work in the U.S. to receive coverage. Employees must be actively employed in the United States with the Employer to receive coverage. Employees must be insured under the plan for spouses and dependents to be eligible for coverage.Exclusions and limitationsLife insurance benefits will not be paid for deaths caused by suicide occurring within 24 months after the effective date of coverage. The same applies for increased or additional benefits.AD&D specific exclusions and limitations:Accidental death and dismemberment benefits will not be paid for losses caused by, contributed to by, or resulting from:• Disease of the body; diagnostic, medical or surgical treatment or mental disorder as set forth in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM)• Suicide, self-destruction while sane, intentionally self-inflicted injury while sane or self-inflicted injury while insane• War, declared or undeclared, or any act of war• Active participation in a riot• Committing or attempting to commit a crime under state or federal law• The voluntary use of any prescription or non-prescription drug, poison, fume or other chemical substance unless used according to the prescription or direction of your or your dependent’s doctor. This exclusion does not apply to you or your dependent if the chemical substance is ethanol.• Intoxication – ‘Being intoxicated’ means your or your dependent’s blood alcohol level equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where the accident occurred.Delayed effective date of coverageInsurance coverage will be delayed if you are not an active employee because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.Delayed Effective Date: if your spouse or child has a serious injury, sickness, or disorder, or is confined, their coverage may not take effect. Payment of premium does not guarantee coverage. Please refer to your policy contract or see your plan administrator for an explanation of the delayed effective date provision that applies to your plan.Age ReductionCoverage amounts for Life and AD&D Insurance for you and your dependents will reduce to 65% of the original amount when you reach age 65, and will reduce to 50% of the original amount when you reach age 70. Coverage may not be increased after a reduction.Termination of coverageYour coverage and your dependents’ coverage under the policy ends on the earliest of:• The date the policy or plan is cancelled• The date you no longer are in an eligible group• The date your eligible group is no longer covered• The last day of the period for which you made any required contributions• The last day you are actively employed (unless coverage is continued due to a covered layoff, leave of absence, injury or sickness), as described in the certificate of coverageIn addition, coverage for any one dependent will end on the earliest of:• The date your coverage under a plan ends• The date your dependent ceases to be an eligible dependent• For a spouse, the date of a divorce or annulment• For dependents, the date of your deathUnum will provide coverage for a payable claim that occurs while you and your dependents are covered under the policy or plan.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 benefits payable. For complete details of coverage and availability, please refer to Policy Form C.FP-1 et al or contact your Unum representative.Life Planning Financial & Legal Resources services, provided by HealthAdvocate, are available with select Unum insurance offerings. Terms and availability of service are subject to change. Service provider does not provide legal advice; please consult your attorney for guidance. Services are not valid after coverage terminates. Please contact your Unum representative for details.Unum complies with state civil union and domestic partner laws when applicable.Underwritten by:Unum Life Insurance Company of America, Portland, Maine© 2022 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 30
IMPORTANT: This is a xed indemnity policy, NOT health insurance This xed indemnity policy may pay you a limited dollar amount if you’re sick or hospitalized. You’re still responsible for paying the cost of your care.• The payment you get isn’t based on the size of your medical bill. • There might be a limit on how much this policy will pay each year. • This policy isn’t a substitute for comprehensive health insurance. • Since this policy isn’t health insurance, it doesn’t have to include most Federal consumer protections that apply to health insurance. Looking for comprehensive health insurance? • Visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to nd health coverage options. • To nd out if you can get health insurance through your job, or a family member’s job, contact the employer. Questions about this policy? • For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (naic.org) under “Insurance Departments.” • If you have this policy through your job, or a family member’s job, contact the employer.AE-1277-UICUnum Insurance Company2211 Congress StreetPortland, ME 04122services.unum.comUnum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 31
EN-372230 FOR EMPLOYEES (8-23) Unum | Group Hospital Insurance Ron Hoover Companies IncorporatedWho can get coverage?You:If you’re actively at work.Your spouse:Can get coverage as long as you have purchased coverage for yourself.Your children:Dependent children newborn until their 26th birthday, regardless of marital or student statusEmployee must purchase coverage for themselves in order to purchase spouse or child coverage. Employees must be legally authorized to work in the United States and actively working at a U.S. location to receive coverage. Coverage may vary by state. See exclusions and limitations.The plan does not include a pre-existing condition limitation. You are covered from day one.If enrolling, and eligible for Medicare (age 65+; or disabled) the Guide to Health Insurance for People with Medicare is available at https://www.medicare.gov/publications/02110-medigap-guide-health-insurance.pdfHow does it work?Group Hospital Insurance helps covered employees and their families cope with the financial impacts of a hospitalization. You can receive benefits when you’re admitted to the hospital for a covered accident, illness or childbirth.Why is this coverage so valuable? • The money is payable directly to you — not to a hospital or care provider. The money can also help you pay the out-of-pocket expenses your medical plan may not cover, such as co-insurance, co-pays and deductibles. • You get accessible rates when you buy this coverage at work. • The cost is conveniently deducted from your paycheck. • The benefits in this plan are compatible with a Health Savings Account (HSA). • You may take the coverage with you if you leave the company or retire. You’ll be billed directly.Be Well BenefitEvery year, each family member who has Hospital coverage can also receive $50 for getting a covered Be Well screening test, such as: • Annual exams by a physician include sports physicals, wellchild visits, dental and vision exams • Screenings for cancer, including pap smear, colonoscopy • Cardiovascular function screenings • Screenings for cholesterol and diabetes • Imaging studies, including chest X-ray, mammography • Immunizations including HPV, MMR, tetanus, influenzaSince our founding in 1848, Unum has been a leader in the employee benefits business. Innovation, integrity and an unwavering commitment to our customers has helped us become a global leader in financial protection benefits.Group Hospital InsuranceGroup Hospital Insurance can pay benefits that help you with the costs of a covered hospital visit.How much does it cost?Your monthly premiumYou$11.74You and your spouse$25.94You and your children$17.80Family$32.00Page 32
EN-372230 FOR EMPLOYEES (8-23)Unum | Group Hospital Insurance HospitalHospital AdmissionPayable for a maximum of 1 day per year$1,000ICU AdmissionPayable for a maximum of 1 day per year$1,000Hospital Daily StayPayable per day up to 365 days $100ICU Daily Stay Payable per day up to 30 days $100Short StayPayable for a maximum of 1 day per year$250Other BenefitsWell Child BenefitPayable for maximum of 4 days per child before child reaches age 1$50Exclusions and LimitationsHospital insurance filed policy name is Group Hospital Indemnity Insurance Policy. The definition of hospital does not include certain facilities. See your contract for details.Active employmentYou are considered in active employment if, on the day you apply for coverage, you are being paid regularly for the required minimum 20 hours per week and you are performing the material and substantial duties of your regular occupation. Insurance coverage will be delayed if you are not in active employment because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective. New employees have a 30 day waiting period to be eligible for coverage. Please contact your plan administrator to confirm your eligibility date.Continuity of coverageWe will provide coverage for an Insured if the Insured was covered by a similar prior policy on the day before the Policy Effective Date of this certificate.Coverage is subject to payment of premium and all other terms of the certificate. If an employee is on a temporary Layoff or Leave of Absence on the Policy Effective Date of this certificate, we will consider your temporary Layoff or Leave of Absence to have started on that date and coverage will continue for the period provided temporary Layoff or Leave of Absence under Continuation of your Coverage During Extended Absences in the certificate.If you have not returned to Active Employment before any Insured’s covered loss, any benefits payable will be limited to what would have been paid by the prior carrier.Childbirth LimitationWe will pay benefits due to Childbirth for any Insured after the Insured’s Coverage Effective Date.Childbirth or Complications of Pregnancy will be covered to the same extent as any other Covered Sickness.Exclusions and limitationsWe will not pay benefits for a claim that is caused by, contributed to by, or resulting from any of the following:• committing or attempting to commit a felony;• being engaged in an illegal occupation or activity;• injuring oneself intentionally or attempting or committing suicide, whether sane or not;• active participation in a riot, insurrection, or terrorist activity. This does not include civil commotion or disorder, Injury as an innocent bystander, or Injury for self-defense;• participating in war or any act of war, whether declared or undeclared;• Combat or training for combat while serving in the armed forces of any nation or authority, including the National Guard, or similar government organizations;• being intoxicated;• a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution;• elective procedures, cosmetic surgery, or reconstructive surgery unless it is a result of organ donation, trauma, infection, or other diseases;• treatment for dental care or dental procedures, unless treatment is the result of a Covered Accident; • any Admission or Daily Stay of a newborn Child immediately following Childbirth unless the newborn is Injured or Sick;• voluntary use of or treatment for voluntary use of any prescription or non-prescription drug, alcohol, poison, fume, or other chemical substance unless taken as prescribed or directed by the Insured’s Physician; and • Mental or Nervous Disorders. This exclusion does not include dementia if it is a result of:• stroke, Alzheimer’s disease, trauma, viral infection; or• other conditions which are not usually treated by a mental health provider or other qualified provider using psychotherapy, psychotropic drugs, or other similar methods of treatment.Additionally, no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date.End of employee coverageIf you choose to cancel your coverage under this certificate, your coverage will end on the first of the month following the date you provide notification to your Employer.Otherwise, your coverage under this certificate ends on the earliest of:• the date the Policy is cancelled by us or your Employer;• the date you are no longer in an Eligible Group;• the date your Eligible Group is no longer covered;• the date of your death;• the last day of the period any required premium contributions are made; or• the last day you are in Active Employment.However, as long as premium is paid as required, coverage will continue in accordance with the Continuation of your Coverage During Absences provision or if you elect to continue coverage for you under Portability of Hospital Indemnity Insurance.We will provide coverage for a Payable Claim that occurs while you are covered under this certificate.THIS INSURANCE PROVIDES LIMITED BENEFITSThis 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 hospital insurance.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 benefits payable. For complete details of coverage and availability, please refer to Policy Form GHIP16-1 and Certificate Form GHIC16-1 or contact your Unum representative.Unum complies with applicable civil union and domestic partner laws.Underwritten by: Unum Insurance Company, Portland, Maine© 2023 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 33
Unum | Long Term Disability Insurance EN-1978 FOR EMPLOYEES (3-22) Ron Hoover Companies IncorporatedHow does it work?This coverage provides a monthly benefit if you have a covered illness or injury and you can’t work for a few months — or even longer.You’re generally considered disabled if you’re unable to do important parts of your job — and your income suffers as a result. Why is this coverage so valuable?You can use the money however you choose. It can help you pay for your rent or mortgage, groceries, out-of-pocket medical expenses and more.Long Term Disability InsuranceConsider your expensesUtilities $Housing $Groceries $Transportation $Child care/Elder care $Medical/Personal care $Education $Insurance $Long Term Disability Insurance can replace part of your income if a disability keeps you out of work for a long period of timeWhat else is included?Survivor Benefit If you die while you’ve been disabled and receiving benefits for at least 180 days, your family could get a benefit equal to 3 months of your gross disability payment.Waiver of premiumIf you’re disabled and receiving benefit payments, Unum waives your cost until you return to work.Page 34
Unum | Long Term Disability Insurance EN-1978 FOR EMPLOYEES (3-22) Billed amount may vary slightly. Your rate is based on your age and will increase as you move to the next age band. If you don’t sign up now but decide to apply later, you may have to answer health questions.Elimination period (EP)Your elimination period is 90 days. This is the number of days that must pass after a covered accident or illness before you can begin to receive benefits.Benefit duration (BD)This is the maximum length of time you can receive benefits while you’re disabled. You can receive benefits to age 65.How much coverage can I get?You*You are eligible for coverage if you are an active employee in the United States working a minimum of 30 hours per week. Cover 60% of your monthly income, up to a maximum payment of $7,000. The monthly benefit may be reduced or offset by other sources of income. *See the Legal Disclosures for more information.This plan does not cover pre-existing conditions. See the disclosure section to learn more.Calculate your cost • Use $140,000 if your annual earnings exceed this amount. This is the maximum coverage amount offered in this plan. • Multiply by your rate.Use the rate table to find the rate based on your age.(Choose the age you will be when your coverage becomes effective on 01/01/2025.)Age Rates15-24$0.14025-29$0.18030-34$0.32035-39$0.50040-44$0.83045-49$1.12050-54$1.42055-59$1.62060-64$1.58065-69$1.45070+$1.480Disability worksheet1Enter your annual earnings and calculate your maximum monthly benefit available.$________ ÷ 12 = $_______ x 60% = $__________Your annual earningsYour monthly earnings(Max % of income covered) Max monthly benefit available 2Calculate your cost per paycheck $_______ ÷ 100 = $_______ x $_____ = $__________Your annual earningsRate Total cost per paycheck$_______ ÷ _________ =Number of paychecksper yearPage 35
Unum | Long Term Disability Insurance EN-1978 FOR EMPLOYEES (3-22) Exclusions and limitationsActive employeeYou are considered in active employment, if on the day you apply for coverage, you are being paid regularly by your employer for the required minimum hours each week and you are performing the material and substantial duties of your regular occupation.Delayed effective date of coverageInsurance coverage will be delayed if you are not an active employee because of an injury, sickness, temporary layoff, or leave of absence on the date that insurance would otherwise become effective.Benefit duration (BD)The duration of your benefit payments is based on your age when your disability occurs. Your Long Term Disability benefits are payable while you continue to meet the definition of disability. Please refer to your plan document for the duration of benefits under this policy.Definition of disabilityYou are considered disabled when Unum determines that:• You are limited from performing the material and substantial duties of your regular occupation due to sickness or injury; and• You have a 20% or more loss of indexed monthly earnings due to the same sickness or injuryAfter 24 months, you are considered disabled when Unum determines that due to the same sickness or injury, you are unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience.You must be under the regular care of a physician in order to be considered disabled.The loss of a professional or occupational license or certification does not, in itself, constitute disability.“Substantial and material acts” means the important tasks, functions and operations that are generally required by employers from those engaged in your usual occupation and that cannot be reasonably omitted or modified.Unless the policy specifies otherwise, as part of the disability claims evaluation process, Unum will evaluate your occupation based on how it is normally performed in the national economy, not how work is performed for a specific employer, at a specific location or in a specific region.Pre-existing conditionsYou have a pre-existing condition if:• You received medical treatment, consultation, care or services including diagnostic measures for the condition, or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage; and• The disability begins in the first 12 months after your effective date of coverage.Deductible sources of incomeYour disability benefit may be reduced by deductible sources of income and any earnings you have while you are disabled, including such items as group disability benefits or other amounts you receive or are entitled to receive:• Workers’ compensation or similar occupational benefit laws, including a temporary disability benefit under a workers’ compensation law• State compulsory benefit laws• Automobile liability insurance policy• No fault motor vehicle plan• Third-party settlements• Other group insurance plans• A group plan sponsored by your employer• Governmental retirement system• Salary continuation or sick leave plans, if applicable• Retirement payments• Social Security or similar governmental programsExclusions and limitationsBenefits will not be paid for disabilities caused by, contributed to by, or resulting from:• Intentionally self-inflicted injuries;• Active participation in a riot;• War, declared or undeclared or any act of war;• Commission of a crime for which you have been convicted;• Loss of professional license, occupational license or certification; or• Pre-existing conditions (See the disclosure section to learn more).The loss of a professional or occupational license does not, in itself, constitute disability.Unum will not pay a benefit for any period of disability during which you are incarcerated.The lifetime cumulative maximum benefit for all disabilities due to mental illness is 24 months. Disabilities based primarily on self-reported symptoms are limited to 24 months. Only 24 months of benefits will be paid for any combination of such disabilities even if the disabilities are not continuous and/or are not related. Payments can continue beyond 24 months only if you are confined to a hospital or institution as a result of the disability.Termination of coverageYour coverage under the policy ends on the earliest of the following:• The date the policy or plan is cancelled• The date you no longer are in an eligible group• The date your eligible group is no longer covered• The last day of the period for which you made any required contributions• The last day you are in active employment except as provided under the covered layoff or leave of absence provision.Unum will provide coverage for a payable claim that occurs while you are covered under the policy or plan.Unum’s LTD contracts standardly include a provision called the Social Security Claimant Advocacy Program. With this feature, claimants can receive expert advice and assistance from us regarding their Social Security Disability claim during the application and appeal process. Social Security advocacy services are provided by GENEX Services, LLC or Brown & Brown Absence Services Group. Referral to one of our advocacy partners is determined by Unum.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 benefits payable. For complete details of coverage and availability, please refer to Policy Form C.FP-1 et al. or contact your Unum representative.Underwritten by:Unum Life Insurance Company of America, Portland, Maine© 2022 Unum Group. All rights reserved. Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries.Page 36
DID YOU KNOW?are sent to the emergency room through ground or air ambulance every year.Insurance companies may not cover all air and ground ambulance expenses which can result in excessive bills.$5,000$60,000MEMBERSHIP BENEFITS COMPARISONYou can decide which MASA MTS plan will provide you with the ultimate peace of mind at an aordable rate when it comes to protecting your family from massive out-of-pocket ambulance charges.MILLIONPEOPLE25Page 37
MEMBERSHIP BENEFITS COMPARISONThe information provided in this product sheet is for informational purposes only. The benets listed, and the descriptions thereof, do not represent the full terms and conditions applicable for usage and may only be oered in some memberships. Premiums vary depending on the benets selected. Commercial Air and Worldwide coverage are not available in all territories. For a complete list of benets, premiums, and full terms and conditions please refer to the applicable member service agreement for your territory. MASA MTS products and services are not available where prohibited. For Florida residents, Medical Air Services Association of Florida, Inc. is doing business as MASA MTS and is a prepaid limited health service organization licensed under Chapter 636, Florida Statutes, license number: 65-0265219 operating in Florida at 1250 S. Pine Island Road, Suite 500, Plantation, FL 33324. MASA Global, MASA MTS and MASA TRS are registered trade names of Medical Air Services Association, Inc., an Oklahoma corporation.SOURCE: Welch, Shari. “Emergency Department Usage Trend Data Can Help Physicians Prepare for Patients.” ACEP Now http://bit.ly/3qBvNrcA MASA MTS Membership provides the ultimate peace of mind at an aordable rate for emergency ground and air transportation service within the United States and Canada, regardless of whether the provider is in or out of a given group healthcare benets network. After the group health plan pays its portion, MASA MTS works with providers to deliver our members’ $0 in out-of-pocket costs for emergency transport.VER: MCPSLAVS1.050521Page 38
Disability InsuranceHelp protect your income from the unexpectedIt’s important to be nancially prepared for the future. That’s why you have insurance for your house, your car and your health. But do you have insurance for the thing you use to pay for these expenses — your income?If an accident or illness prevented you from earning an income, how would you pay for your everyday expenses? Colonial Life disability insurance helps protect your way of life by providing a benet for a covered disability. It’s a smart way to prepare for the unexpected.More than one in four 20-year-olds will become disabled before reaching retirement age.The Faces and Facts of Disability. https://www.ssa.gov/disabilityfacts/facts.html. Accessed April 2023DISABILITY INSURANCE Page 39
How disability insurance helps peopleMany people make plans for their income and savings. Yet when they least expect it, some of them will have an accident or illness that can change their plans dramatically. Here are a few stories:BENEFITS STORIESARIAAria is a recent college grad in her rst full-time job. She injured her leg jogging after work one evening. Her doctor advised her to stay off her leg for three weeks. After using paid time off for a week, Aria stopped receiving a paycheck. How her disability policy helped: Aria used her disability benets to help with her rent and monthly student loan payment.MIA AND ALEXAfter having a baby, Mia took maternity leave. The couple was worried about how they’d pay for everyday expenses without her income. Fortunately, Mia purchased a disability policy through work two years ago. How her disability policy helped: Mia’s benets helped the couple pay for their growing family’s ongoing expenses, and they didn’t have to use any of the money they’d been saving for a bigger house.WILLIAMA 50-year-old father of the bride, William suffered an unexpected heart attack and had to have surgery. He needed unpaid leave from work to recover, but his usual monthly bills didn’t stop. How his disability policy helped: William’s disability benets gave him some comfort in knowing that his bills wouldn’t get in the way of giving his daughter the wedding they planned.KIMKim fell in her home and couldn’t work for three months. Watch a video for Kim’s story and learn how Colonial Life disability insurance helps families with unexpected moments. Scan the code or go to ColonialLife.com/ee-disability.All benets stories are for illustrative purposes only. They are not intended to depict real people.Page 40
How Colonial Life Disability Insurance worksIf you can’t work because of an illness or injury, you might use savings to help cover ongoing monthly expenses. But would you have enough? And what would that do to your savings goals? Disability insurance can help replace missing income so you can focus on what’s most important — recovery. Here’s how it works:• At enrollment, you can choose the disability benet amount to best meet your needs (subject to income).• If you can’t work because of a covered illness or injury, a benet is payable in regular payments after a pre-determined waiting period called an elimination period.• Benets are payable directly to you unless otherwise specied, and you can use them however you’d like.• Benet payments do not coordinate at the time of claim with other insurance or state paid medical leave benets.1• Disability benets may also be available if you return to work part-time.TOP CAUSES OF DISABILITIES IN WORKING-AGE ADULTS IN THE U.S.:Injuries:2• Exposure to harmful substances or environments at work• Overexertion• Falls, slips, trips• Contact with objects or equipment• Transportation incidentsIllnesses:3• Musculoskeletal pain• Heart disease• Cancer• Stroke• Kidney diseasePage 41
To learn more, talk with your Colonial Life benets counselor. Meet with a benets counselor By attending a 1-to-1 counseling session with a Colonial Life benets counselor, you can learn more about disability insurance and how it can help protect your income and your family’s way of life. Your benets counselor can also review the rest of your insurance coverage and help you determine where you may need additional nancial protection.1. 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.2. National Safety Council, Top Work-related Injury Causes, https://injuryfacts.nsc.org/work/work-overview/top-work-related-injury-causes/. Accessed 5/25/2023.3. MedicineNet, What Are the Leading Causes of Disability?, https://www.medicinenet.com/what_are_the_leading_causes_of_disability/article.htm. Accessed 5/25/2023.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 form 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), policy form ICC21-DIP3000 and rider form ICC21-DIP3000-R-DIS (including state abbreviations where used), policy form ED DIS 1.0 (including state abbreviations where used), 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). 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 | 101623-6ColonialLife.comPage 42
Life insurance: Term or Whole?Life insurance for all phases of your employees’ livesIf you’re wondering which life insurance to offer your employees — term or whole life? The answer is: They need both options.Term and Whole Life work hand in hand Term and Whole Life insurance work together to provide nancial protection for your employees and their loved ones at all phases of life — whether they’re just starting out, raising a family or planning for retirement. Term Life offers nancial protection for employees and their families during their working years.Whole Life provides coverage employees can keep into retirement — at competitive rates when they buy it early. Whole life Term life Childhood Young professional Mid-career RetirementWhen employees purchase both types of life insurance, they have valuable nancial protection that can last a lifetime.By offering these benets at work with premiums paid by payroll deduction, you provide valuable coverage options for employees without added costs to your bottom line.Coverage for spouse and children also provides valuable protection for your employees’ family.LIFE INSURANCEPage 43
Term LifeWHAT IS TERM LIFE?• Offers nancial protection for loved ones during an employee’s working years • Offers highest amount of life insurance coverage for the lowest premiums KEY BENEFITS• Income replacement if the insured passes away• Can help pay ongoing expenses for the family, such as: ‐ Mortgage or rent ‐ Education ‐ Saving for retirementHOW IT WORKS Group Term Life • Employer-owned • Portability options• Flexible coverage that normally ends at retirement• Benet typically decreases after age 70• Guaranteed issue no medical underwriting to qualify for coverage up to certain amountsIndividual Term Life • Employee can continue their coverage if they change jobs or retire• The insured chooses a term period of 10, 15, 20, or 30 years• Guaranteed level premiums that do not increase during the selected term period • After the term period, the insured can end or renew coverage, or convert to a whole life policyWhole Life WHAT IS WHOLE LIFE? • Provides nancial protection for loved ones through their retirementKEY BENEFITS • Can help with nal expenses• Can provide a living benet to help pay for expenses associated with a terminal illness, critical illness, chronic illness or long term care services1• Accumulates cash value at a guaranteed interest rate; employees can borrow against this value during times of need2HOW IT WORKS • Guaranteed issue no medical underwriting to qualify for coverage up to certain amounts• Coverage for life with level premiums that can be paid up at age 70 or 100• Death benet is designed to stay the same, as long as the premiums are paid on time How they work togetherTerm Life and Whole Life can provide comprehensive life insurance with nancial protection during working years and benets that carry into retirement. Together, Term Life and Whole Life can help your employees and their loved ones prepare for the unexpected. To learn more, talk with your Colonial Life benets representative.1. Accelerated death benet payments will reduce the amount the policy pays upon the covered person’s death. Benets may be taxable as income. Individuals should consult with their legal or tax counsel when deciding to apply for accelerated benets.2. Accessing the accumulated cash value reduces the death benet by the amount accessed. Cash value will be reduced by any outstanding loans against the policy.This life insurance does not specically cover funeral goods or services and may not cover the entire cost of your funeral at the time of your death. The beneciary of this life insurance may use the proceeds for any purpose, unless otherwise directed. This information is not intended to be a complete description of the insurance coverage available. The policies or their provisions may vary or be unavailable in some states. The policies have exclusions and limitations which may affect any benets payable. Applicable to policy forms ICC18-ITL5000/ITL5000, ICC19-IWL5000-70/IWL5000-70, ICC19-IWL5000-100/IWL5000-100, and ICC19-IWL5000J/IWL5000J, GTL1.0-P and certicate number GTL1.0-C and applicable state variations. For cost and complete details of the coverage, call or write your Colonial Life benets counselor or the company.ColonialLife.comUnderwritten 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 BROKERS AND EMPLOYERS 8-23 | 691150-1Page 44