Helping Protect The Things You Value Most

Group & Employee Benefits

  • FULLY INSURED-SELF INSURED-LEVEL FUNDED- CORE BENEFITS-WHAT IS THE BEST FOR YOUR COMPANY
  • EMPLOYER GROUP HEALTH- CORE BENEFITS- ACA COMPLIANT- CARE PLAN #HA8
  • EMPLOYER GROUP HEALTH- CORE BENEFITS- ACA COMPLIANT-THE METALLICS #HA9
  • GROUP INSURANCE- CORE BENEFITS- ACA COMPLIANT- MEDICAL ACCESS #HA10
  • GROUP LIMITED FIXED-BENEFIT INDEMNITY PLAN - EVOLUTION- #GI6
  • GROUP FIXED-BENEFIT INDEMNITY PACKAGE-HOSPITALIZATION-SURGERY-ACCIDENT- C.I.- PLUS –PERQ # GI8
  • GROUP GAP COVERAGE-FIXED INDEMNITY-LINK #GI7
  • PREMIER MEMBERSHIP BENEFITS PACKAGE FOR INDIVIDUALS-SMALL BUSINESSES-SELF EMPLOYED CONSUMERS #HI3
  • EMPLOYER GROUP MEDICARE ADVANTAGE, DENTAL & VISION-FROM ALL PRIVATE CARRIERS
  • VOLUNTARY BENEFITS- GROUP DISABILITY & INDIVIDUAL DISABILITY #GC1
  • VOLUNTARY BENEFITS - GROUP ACCIDENT & INDIVIDUAL ACCIDENT #GC2
  • VOLUNTARY BENEFITS - GROUP MEDICAL BRIDGE & INDIVIDUAL MEDICAL BRIDGE #GC3
  • VOLUNTARY BENEFITS - GROUP CANCER & INDIVIDUAL CANCER#GC4
  • VOLUNTARY BENEFITS - GROUP CRITICAL CARE & INDIVIDUAL CRITICAL ILLNESS #GC5
  • VOLUNTARY BENEFITS - GROUP DENTAL & VISION RIDER #GC6
  • VOLUNTARY BENEFITS - GROUP TERM LIFE & INDIVIDUAL TERM LIFE #GC7
  • VOLUNTARY BENEFITS - GROUP WHOLE LIFE & INDIVIDUAL WHOLE LIFE & LONG TERM CARE RIDER #GC8

How many employees do you have? How healthy is your employee pool? How much variation in your premiums can you accommodate, year to year? How much input into benefit design do you want to have if any? Call Maria Gutierrez representing top rated group insurance companies at 954-394-8672 or email MariaInsurance@gmail.com to discuss your specific employee’s situation to provide a feasible and cost effective solution.

Maria Gutierrez is “Certified Benefits Counselor”, “Benefits Communication and Education specialist”, helping employees understand and appreciate the benefits available to them through the workplace and select the benefits best suited for their needs in order to protect their families and lifestyle.

There are hundreds of plans available in the market today, please read below specific plan designs and some of the most popular options available. Allow us the opportunity to gather some basic company information and collect employee census to prepare a workplace solution package.

FULLY INSURED-SELF INSURED-LEVEL FUNDED- CORE BENEFITS- WHAT IS THE BEST FOR YOUR COMPANY

Small employers looking for ways to control their group health insurance costs are more closely examining what it means to be “fully insured.” These days, employers with as few as ten full-time employees are exploring other funding arrangements which can allow them more control—or at least more accountability—over their annual premium increases.

FULLY INSURED

“Fully insured” is what most people mean by “insurance.” The individual, or his employer, pays a premium to the insurance carrier; in return, the insurance carrier is responsible for paying future medical claims that are:

1) Covered in the insurance policy’s contract (thus usually excludes cosmetic or other elective procedures).

2) Beyond a certain annual “out-of-pocket maximum,” which is the total amount an individual or family will pay up front for medical services. For instance, an annual deductible amount or the individual’s share of a coinsurance percentage such as 80/20.

The financial risk for future medical claims, then, is almost entirely the insurance carriers. Beyond that out-of-pocket maximum—for instance, $5,000—it doesn’t matter whether an individual incurs a $13,000 appendectomy or $300,000 respiratory failure, or a combination of medical procedures in a given year; the insurance carrier has contracted to pay all claims, and not charge any more for monthly premiums during the term of the contract (typically at least one year).

Now, because an insurance carrier must obey simple math in order to function, it needs to bring in at least as much premium as it costs to pay the incurred medical claims (and the employees of the insurance carrier often want to take home paychecks, too). If, therefore, the cost of providing medical services increases—or, by actuarial calculation, is likely to increase—insurance carriers offer individuals or employers increased premium rates at the beginning of their next contract year, and those individuals or employers are free to accept those new premium rates or to shop around with other insurance carriers. Regardless of whether the individuals or companies stay with the same insurance carrier, the medical claims already incurred are the insurance carrier’s responsibility to pay.

The idea of “pooling” has always been a part of fully insured coverage as well. In simple terms, if ten people are insured, the insurance carrier’s goal is to make sure that the premium collected from all ten covers the claims incurred by all ten, not necessarily that the premium collected from each individual covers that individual’s claims. Up until the enactment of the Affordable Care Act, insurance carriers could put a higher price tag on the insurance offered to individuals and small employers with higher risk (existing sicknesses or other conditions) to cover the higher expected claims; now, the ACA mandates that, for individuals and small employers (under 50 full-time employees), insurance carriers use “community rating,” which equalizes the premiums charged to all in a certain geographic area for a certain level of service. Insurance carriers can still charge more by age—small-group coverage for a 21-year-old is usually much cheaper than that for a 61-year-old—but a sick 61-year-old and a healthy 61-year-old would pay the same amount for coverage with the same deductibles and out-of-pocket maximums.

The benefit of community rating is that individuals and companies with a large number of health conditions can find insurance coverage which is not priced completely out of their range. However, small employers with few health risks are finding that not only have their premiums increased by amounts greater than their own use of the insurance benefits would justify, but there is no benefit to them in prudently trying to control costs (via wellness plans or other initiatives), as their own efforts to reduce claims would only be drops in the huge bucket from which renewal increases are calculated.

SELF-FUNDING

Self-funded insurance is almost the complete opposite of full-insured coverage. A self-funded insurance plan is exactly what it says: A company provides all the funds to pay for expected claims (with an important caveat—see “Reinsurance/Stop-Loss” section). In essence, the employer has formed an “insurance pool” all of his own, with the participants in the pool consisting only of his employees.

REINSURANCE/STOP LOSS

Because even larger groups can incur greater than expected claims, most self-funded insurance plans still have a form of insurance in place, alternately called “reinsurance” or “stop-loss insurance.” These employers will pay a premium for protection in case their actual claims exceed, for example, 125% of actuarially predicted expenses, or in case a single large claimant incurs claims large enough to skew the entire “pool.” Typically, even employers with several thousand employees will have stop-loss to hedge their bets against the unexpected—which is really what insurance is for.

Self-funding is generally NOT an option for small employers, due to the nature of statistics. If you have 500 employees, you can estimate with fair accuracy the general level of claims you can expect to be incurred, and the probability of any specific large claims (systemic cancer, serious accidents, etc.). As the number of employees goes up, the accuracy of such statistical estimates goes up. As the number of employees goes DOWN, not only does the predictability of any individual large claim go down, but the ability of the “pool” to compensate for any one large claim goes down. If you have five employees and are funding their healthcare expenses to expected levels, it only takes one stroke or one high-risk pregnancy to incur expenses far beyond what you had planned for.

It is very much in the interests of a self-funded insurance plan to minimize claims, as all costs come out of the company’s pockets—and conversely, all savings benefit the company’s bottom line. Thus, wellness programs, biometric screenings, in-house exercise programs, and smoking cessation incentives can often be found at these companies, supplied and encouraged by well-motivated management.  Self-funded insurance plans are set up with the assistance of professional actuaries who can help determine reasonable levels of funding from year to year, and third-party administrators (TPAs) who provide the mechanics of claims payment to providers, and often contract with an existing insurance carrier for the use of their network.

LEVEL-FUNDING

Level-funding has recently attracted far more attention among larger small employers (those nearing 50 full-time employees) or smaller large employers. At its simplest, level-funding is simply self-funding done small, usually by an office or offshoot of a fully-funded insurance carrier. With some level-funding providers offering their services to companies down to 10 full-time employees, these plans obviously can’t operate under the kind of risk possible with a larger company; the stop-loss coverage comes into play at a much lower threshold, protecting the company from unforeseen huge claims. These plans are often thus referred to as “partially self-funded.”

Because self-funded and level-funded plans, even for small groups, don’t need to be community rated as fully insured plans do, a level-funded plan can cost less to provide health benefits to the employees, and save the company money… but only if the cost of its claims stays low so that the cost-per-employee doesn’t rise as high as, or higher than the community-rated premiums available to them. In other words, only a company of healthy individuals (who will need to attest to their health status by individual health questionnaires when applying) should consider level-funding.

WHAT IS THE “BEST” FOR YOUR COMPANY

As always, insurance is a balance between costs and risks. A fully insured plan removes most risk from the employer and employees, but the guaranteed cost of the plan is higher. A self-insured plan leaves most of the risk with the employer, but also has the greatest chance for savings. Level-funding attempts to combine the best of both worlds, but is really only viable for a narrow segment of employers. There is no one “right” answer to which funding arrangement is “best”—if there were, there would only be one way to fund an insurance plan, not three.

EMPLOYER GROUP HEALTH- CORE BENEFITS- ACA COMPLIANT- CARE PLAN #HA8

Health plans available to enroll all year round. Minimum Essential Coverage (MEC) solution offered alongside a Health Sharing Association model adding Hospitalization and Surgery coverage; these two-part offering with per Incident limit for coverage ranges from $150,000 to $500,000 and a Lifetime maximum of $1,000,000. Thus providing one of the most flexible and cost-effective programs in the market today! There are 3 levels of coverage with deductibles of $5K, $7.5K AND $10K to choose from. Access to PPO nationwide provider network of Doctors and hospitals.

Telemedicine: board-certified family practitioners, pediatricians, and internists diagnose, treat, and write prescriptions when necessary, and are available 24/7/365 from anywhere in the world. Providers can resolve most medical concerns over the phone or online through video consultation in the convenience of your home or on the go. Telemedicine consultations help make healthcare affordable for any employee.

Preventive & Primary Care: Preventive and Primary Care services are at the core of our goals and are considered key steps in becoming and staying healthy. Our model is based on an innovative approach to care that truly is patient-centered, combining excellent service with a modern approach. This includes medical care needs for employees such as office visits, a variety of screenings, wellness guidance, flu shots, etc.

Lab & Diagnostics: Most labs ordered by Primary Care Physicians (PCP) or Urgent Care facilities are included in your monthly membership, and include over 180 different tests to ensure the medical care you need is covered. The carrier maintains a national contract with Quest Diagnostics, the world’s leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions.

Urgent Care; Services within the scope of the nearest Urgent Care facility, including x-rays, are covered for treatment of an illness or injury. Urgent Care facilities are ideal for patients who need immediate, but not major trauma-level care. Providers administer treatment for minor injuries and illnesses, stitches for minor lacerations, and offer lab and x-ray services, as well as specialty care referrals, and flu shots.

Prescription Drug program: offering prescription savings program delivers significant discounts for a variety of drugs (depending on prescription), saving members an average of 55% on prescription drug purchases.

EMPLOYER GROUP HEALTH- CORE BENEFITS- ACA COMPLIANT-THE METALLICS #HA9

Health plans available to enroll all year round. Bronze, Silver, Gold & Platinum- PPO Network selection: Cigna or First Health or MultiPlan network of Doctors & hospitals. Plans designed based on deductibles and co-insurance., network and Non-network benefits including hospitalization and prescriptions copayments based on tiers. Available in 42 states. The Affordable Care Act (ACA) requires all individuals to have at least “minimum essential coverage”. If you do not have this minimum coverage, you may have to pay a penalty tax of 2.5% of your income. By purchasing a plan with “minimum essential coverage” through your employer, you can avoid being taxed the “Individual Mandate” penalty tax. The U.S. government has issued a list of Preventive and Wellness Benefits outlining MEC requirements which this plan will cover 100% of when obtained from a network provider and 50% of when obtained from a non-network provider. There are over 60 preventive services, including immunizations, blood pressure screenings, diabetes and cholesterol screenings, prenatal visits, and more.

The minimum enrollment in Level Funded is 25 employees and the minimum enrollment in the MEC is 3 employees. For pricing the “Employee Census” file and Individual Health Questionnaires and/or Disclosures must be completed and submitted for Medical Underwriting Dept. to determine the premium for the group. If the employer has 50+ persons enrolling in the plan and if claims experience is available and utilized to produce rates, final acceptance will be on the completion of the Employer Disclosure Form. In this case, Individual Health Questionnaires will not be required. All plans are set up on plan year basis.

GROUP INSURANCE- CORE BENEFITS ACA COMPLIANT- MEDICAL ACCESS #HA10

Health plans available to enroll all year round. Level –Funded & Self Funded Minimal Essential Coverage Plans. Very popular member based Minimum Essential Coverage (MEC) healthcare product that includes access to nationwide preventive, episodic primary & urgent care services, as well as to 24/7/365 access to U.S. board-certified providers and pediatricians via phone or online. No-co-pay, insurance or co-insurance required, includes x-rays, labs and testing. Members also enjoy prescription discounts, most x-rays, labs, and ancillary services, all of which is compliant under the new Affordable Care Act. Members will avoid the individual tax fine if an employer offers the program and contributes 50% towards the employee’s Plan fee. Convenient, medical care when you need it. No bills if services performed in clinics included. Pre-existing conditions are included. The Self Funded offer the option to add Hospital, Surgery & Ambulance with 0 deductible, different levels of coinsurance available.

Labs & Diagnostics Program: Most blood work discounts are included at participating network provider locations. Blood work covers tests such as Complete Metabolic Panel, Complete Blood Culture, Hemoglobin, Cholesterol and hundreds of others. You will have over 2000 locations to have your blood work drawn including participating Doctors offices.

Prescription Discount Program: Your PPO Select Plan includes a prescription discount program that can save you as much as 70% on certain prescription medications. Just present your card at the pharmacy and receive your discount.

MRI & CT Scan Discounts: With the PLUS Plan, most blood work and x-rays are included at a participating network provider location. Blood work covers tests such as Complete Metabolic Panel, Complete Blood Culture, Hemoglobin, Cholesterol and hundreds of others. X-rays include most common x-rays performed in the plan network urgent care facility.

Dental Discounts: Access services at urgent care facilities from hundreds of medical centers throughout the United States. HealthPass USA is raising the standard of healthcare by putting individuals first, treating them with clinical excellence, and focusing on their well-being. With your membership, there are no hidden fees to worry about.

GROUP LIMITED FIXED-BENEFIT INDEMNITY PLAN - EVOLUTION- #GI6

Evolution helps lessen the out-of pocket impact by providing hospital, accident and critical illness coverage in one simple package with benefits that may be used for medical and non-medical expenses in the case of a serious accident or illness. The plan offers 6 levels of coverage to meet your budget. Plan covers: Preventive Care, Accidental Death and Dismemberment (AD&D), Accident Expense, Critical Care Coverage, First-Day Hospital Admission, Sports, Pregnancy, PPO Network Access as Optional Benefit. Ideal plan to supplement a high deductible major medical. Plans are guaranteed issue. A business with at least two participating employees is eligible for Evolution. Must be directly employed full- or part-time. Must be 18-99 years of age. Must be a legal United States resident. 1099 employees may be considered eligible (a minimum of two W-2 employees must be participating). A spouse or domestic partner under the age of 99 allowed. Dependent children under age 26.

Enrollment: Initial enrollment is the period of time during which an employee or dependent is first eligible to enroll under the Policy. After initial enrollment, employees or dependents may enroll in coverage during the annual open enrollment period, unless a special enrollment period applies. Benefit options may only be changed during the annual open enrollment period.  For groups of 10 or more, employees may choose between two plan designs. The plan design chosen cannot be combined with any other benefits. Payment options include ACH, Direct Bill or payroll deductions. A Census file is required to quote the coverage.

GROUP FIXED-BENEFIT INDEMNITY PACKAGE-HOSPITALIZATION-SURGERY-ACCIDENT- C.I.- PLUS –PERQ  #GI8

Employer-sponsored fixed indemnity benefits for employees with or without major medical. Reduces employee out-of-pocket with first-dollar benefits. Employees not eligible for traditional group benefits may be looking for coverage options. Employers, who have chosen to offer Minimum Essential Coverage, or MEC plans, may want to enrich their benefit offerings. In some instances it may benefit employers and their employees to move from employer-sponsored benefits to individual medical plans.

The plan pays fixed benefit amounts for covered medical events such as hospitalization, surgery or outpatient services. All of the plans also include a critical care benefit paid in a lump sum upon the diagnosis of a covered illness such as life-threatening cancer, heart attack or stroke. Employers can choose among six unique plans to find one best suited to the needs of their employees. Critical care coverage offered in all 6 plans up to $25,000, accident medical expense, hospital admission, inpatient & outpatient surgery, emergency room and many outpatient services to choose from.

GROUP GAP COVERAGE-FIXED INDEMNITY-LINK #GI7

Link is designed to reduce the out-of-pocket expenses when used to supplement an ACA-compliant group major medical plan. Benefits are available for medical expenses applied to the major medical deductible and coinsurance, reducing the impact of employees’ out-of-pocket expenses. Select from numerous maximum-benefit options that will complement the group major medical deductible and coinsurance out-of-pocket.

Medical treatment, services or supplies must be covered by the group’s ACA-compliant major medical plan in order to be considered a covered expense by the Link Group Gap plan. Items specifically excluded by this Policy or the major medical plan will not be considered covered expenses. All benefits are subject to satisfaction of the deductible, if applicable, and limited to the coinsurance percentage and maximum benefit amount. The Link Group Gap plan is not designed to pay 100 percent of all out-of-pocket expenses.

Eligibility: A business with at least two full-time employees is eligible for a Link Group Gap plan. Groups with fewer than 10 eligible employees must have 100 percent participation. The group must have an ACA-compliant major medical plan. Employees not covered by the group ACA-compliant major medical plan are not eligible for the Link plan. The ACA compliant major medical plan (health benefit plan) may be any comprehensive plan, including self-funded plans. A Link Group Gap plan cannot be used to supplement a limited benefit program, Medicare, Medicaid, CHAMPUS or TRICARE.

PREMIER  MEMBERSHIP BENEFITS  PACKAGE FOR INDIVIDUALS-SMALL BUSINESSES-SELF EMPLOYED CONSUMERS #HI3

Association membership packages that bundles insurance and non-insurance products together, creating robust supplemental benefits that bridge the gap in coverage that can occur when an accident or illness strikes. With these additional benefits, members receive:

Critical illness insurance up to $10,000- Accident medical expense insurance up to $10,000- Accidental death insurance up to $10,000 and Term life insurance up to $10,000- Accident disability insurance up to $1,000/month for up to 12 months- No medical questions – guaranteed coverage- Four plan levels- Keep benefits if you change jobs- Cash benefits paid directly to you. Very low premium for you and your family with excellent benefits!

EMPLOYER GROUP MEDICARE ADVANTAGE, DENTAL & VISION-FROM ALL PRIVATE CARRIERS

PLANS OFFERED BY PRIVATE INSURANCE COMPANIES

For many employers, Medicare Advantage plans provide more efficient coverage for Medicare-eligible retirees, compared to Original Medicare and a secondary plan. Retirees and their spouses can enroll three months before or 3 months after their 65th birthday.

Group Medicare Advantage plans combine the benefits of Original Medicare and Medicare supplements in a single plan. For many employers, private carriers offer Medicare Advantage plans that provide more efficient coverage compared to Original Medicare and a secondary plan. Members remain in the Medicare program and continue to pay Medicare-applicable premiums; they just receive their Medicare benefits through a private insurance company. The plans may include Part D coverage, eliminating the need for freestanding pharmacy benefits.

Private insurance companies offer Medicare Advantage plans to private- and public-sector employers, as well as other collectively bargained groups. Carriers offers a broad range of funding options, so your company can choose to fund all, part, or none of retirees' Medicare premiums. And if your company is not sure which funding level to choose, ask Maria Gutierrez/Licensed Medicare Agent contracted with top carriers so she can help you “shop around” so you make an informed decision.

VOLUNTARY BENEFITS- GROUP DISABILITY & INDIVIDUAL DISABILITY #GC1

Voluntary short-term disability insurance policy is an individual plan that is sold via payroll deduction at the workplace. It insures your employee’s paycheck by replacing a portion of your employee’s income if he becomes disabled because of a covered accidental injury or covered sickness.

PRODUCT FEATURES: Guarantee Issue – Available for up to $4,000 in monthly benefits for up to 60% of income. Additional monthly benefits up to $6,500 are available.  Total Disability Benefits and disability benefits if working and unable to perform the material and substantial duties of your occupation.  Optional Employer-Selected Benefits are available. • Renewability:This policy is guaranteed renewable to age 75. • Premiums can be changed only if we change them on all policies of this kind in the state where the policy is issued.

No Integration - There is no coordination of benefits at claim with other coverages. Benefits are paid regardless of benefits received from other sources. For benefit amounts over $4,000 per month, offsetting occurs during the application process.  Level Premiums - Rates are based on issue age and are level, not step-rated. • Geographical Limitations (Worldwide Coverage) – Geographical Limitations provision allows coverage for disabilities that occur outside the regularly covered geographical areas for up to 60 days. • Waiver of Premium - available after 90 consecutive days of a covered disability. • Benefits are paid directly to the insured unless they specify otherwise.  Coverage is portable - An employee may continue this coverage if he changes jobs or leaves your company, with no evidence of insurability required.

AVAILABLE PLANS: This policy offers two base Individual Disability plan choices:  Off-Job Accident/Off-Job Sickness Disability benefits.  On/Off-Job Accident/ On/Off-Job Sickness Disability benefits The employer also has the option of including:  First Day Hospital Benefit (Waiver of Elimination Period for First Day of Hospital Confinement Benefit.)  Mental or Nervous Disorders Benefit (24 month lifetime maximum) several riders available upon request.

VOLUNTARY BENEFITS - GROUP ACCIDENT & INDIVIDUAL ACCIDENT #GC2

Voluntary accident insurance policy is a medical indemnity plan that provides employees and their families with hospital, doctor, accidental death and catastrophic accident benefits in the event of a covered accident. This policy offers six plan choices with varying benefit amounts and three optional riders: • Basic • Basic with Health Screening Benefit • Preferred • Preferred with Health Screening Benefit • Premier • Premier with Health Screening Benefit Each of the plans listed above may be offered as On/Off-Job or Off-Job Only. Optional Riders: • Off-Job Only or On/Off-Job Accident Disability Rider • Off-Job Only or On/Off-Job Accident/Sickness Disability Rider • Sickness Hospital Confinement Rider and Riders available upon request.

VOLUNTARY BENEFITS - GROUP MEDICAL BRIDGE & INDIVIDUAL MEDICAL BRIDGE #GC3

Plan 3: Hospital Confinement, Observation Room, Rehabilitation Unit Confinement, Waiver of Premium, Outpatient Surgical Procedure and Diagnostic Procedure.

PRODUCT FEATURES: Hospital Confinement*: Eight levels from $500-$5,000. The level(s) selected by you as the employer is paid once per covered person per calendar year. You can choose up to two levels of hospital confinement. The levels can’t be separated by more than $1,000. (For example, $1,000 and $2,000 are acceptable; $1,000 and $2,500 are not.) Observation Room • Payable for treatment in an observation room in a hospital for less than 20 hours. • Pays $100 per visit, up to a maximum of two visits per covered person per calendar year. Rehabilitation Unit Confinement * • Inpatient rehabilitation immediately following hospital confinement either in a unit that is part of a hospital or in a free-standing facility. • Pays $100 per day up to 15 days per period of confinement to a rehabilitation unit.• Calendar maximum of 30 days per covered person. Waiver of Premium • After 30 continuous days of a covered hospital confinement or rehabilitation unit confinement of the named insured. • Waives premium for the entire policy and any applicable riders.

VOLUNTARY BENEFITS - GROUP CANCER & INDIVIDUAL CANCER#GC4

Cancer insurance product helps to provide valuable financial protection for America’s workers and their families in times of need, when medical bills and other expenses related to cancer diagnosis and treatment may limit their ability to focus on what’s most important – getting well. Employees can choose from four Benefit Levels. Coverage types available: Insured Only; Insured and Spouse; One-Parent Family and Two Parent Family plans. Features • Guaranteed Renewability - Employees can keep the coverage for life as long as they pay premiums. • Portability - Employees can keep the same coverage at the same rates if they change jobs or retire. • Waiver of Premium - Premium payment is waived if the named insured is disabled due to cancer for longer than 90 consecutive days and the date of diagnosis is after the waiting period and while the policy is in force. • Composite Premiums - All eligible applicants in an account have the same premium, regardless of risk class or age • Direct Benefit Payment - Benefits are paid directly to the insured unless they specify otherwise.

No Coordination of Benefits - Benefits are paid in addition to other insurance your employees may have with other insurance companies. • Health Savings Account (HSA) Compatibility - This cancer insurance is HSA-compatible and allows employers to provide coverage that can be used alongside employees’ Health Savings Accounts. • Indemnity Benefits – Pays exactly what is listed for selected plan level. Plan Design There are a choice of levels (each level has the same benefits) allowing employees to select the benefit amounts that best suit them and their covered family members. The employer may allow his employees to choose from all four benefit levels or may limit the levels offered to his employees. • Level 1 • Level 2 • Level 3 • Level 4 In addition to the standard plan benefits, three optional riders are available: • Initial Diagnosis of Cancer Rider • Initial Diagnosis of Cancer Progressive Payment Rider • Specified Disease Hospital Confinement Rider Optional Cancer Wellness/Health Screening benefits are also available.

VOLUNTARY BENEFITS - GROUP CRITICAL CARE & INDIVIDUAL CRITICAL ILLNESS #GC5

Critical Illness 1.0 insurance helps your employees and their families maintain financial security during the lengthy, expensive recovery period of a critical illness. It provides a lump sum benefit to help with the out-of–pocket medical and non-medical expenses of employees who suffer a critical illness. Benefits are paid directly to the covered person unless they specify otherwise. As the employer, you may choose one of the following plan types to offer to your employees. • Critical Illness with Subsequent Diagnosis • Critical Illness with Subsequent Diagnosis and Health Screening An employee can choose to add cancer as a covered condition for additional premium. Coverage is available to: Employee; Spouse (as the named insured); Employee and Spouse; Employee and Dependent Children; Spouse and Dependent Children; and Employee, Spouse and Dependent Children. Face amounts for the employee range from $5,000 -$100,000 (amounts greater than $75,000 require underwriting approval), in $1,000 increments. Spouse coverage (as a named insured) is available in face amounts from $5,000 to $40,000. If a spouse is covered under the employee’s plan, their face amount is 50% of the employee’s coverage. If dependent children are covered, their face amount is 25% of the named insured’s coverage.

Benefits Critical Illness with Subsequent Diagnosis Benefits are paid as a lump-sum payment for the following specified critical illness when the covered person is diagnosed: 100% of face amount per covered person • Heart Attack (Myocardial Infarction) • Stroke • Major Organ Failure • End Stage Renal (Kidney) Failure • Cancer (if selected by Employee) • Permanent Paralysis due to a Covered Accident • Coma • Blindness • Occupational Infectious HIV or Occupational Infectious Hepatitis B, C or D 25% of face amount per covered person • Coronary Artery Bypass Graft Surgery • Carcinoma in Situ (if selected by Employee).

Subsequent Diagnosis – Employees can use this coverage more than once. If a covered person receives a benefit for a Specified Critical Illness and is later diagnosed with: a different condition, this product will pay the percentage of the face amount shown in the Benefits Section above up to the Maximum Benefit Amount payable. The same condition, this product will pay 25% of the face amount up to the Maximum. Wellness (Health Screening Benefit) – if selected by the Employer.

VOLUNTARY BENEFITS - GROUP DENTAL & VISION RIDER #GC6

Dental coverage is one of the most valued workplace benefits because of its importance to the overall well-being of employees.  Dental PPO covers a wide range of treatments, from routine cleanings to root canals and pays benefits based on a defined co-insurance percentage. With this coverage, employees have the freedom to choose any dentist, but when they see an in-network dentist they can receive discount on services which reduce their out-of-pocket costs.

Employer Optional Benefits: If selected, applies to all in an account Orthodontia Benefits (Class D). Rollover Benefit: Allows members to rollover unused portions of their annual maximum benefit to future years. Available Riders – Employee Choice Options Vision Rider: Fully-insured vision benefits with coverage for eye exams and materials • Maximum of one benefit for eye exam and one benefit for vision correction materials per covered person per benefit year • The materials co-pay will cover the purchase of lenses with generous allowances for frames or contact lenses • There are no brand restrictions for frames or contacts.

VOLUNTARY BENEFITS - GROUP TERM LIFE & INDIVIDUAL TERM LIFE #GC7

Term Life 1000 insurance plan offers life insurance protection that remains level for the period of time the employee selects―10, 20, or 30 years. At the end of the selected period, without evidence of insurability, the policy may be continued on a yearly renewable basis. The same benefit amounts are available for employees and their spouse. Spouse and children’s term riders are also available. Benefits Choice of three plan options depending on the employee or spouse’s age and the term period needed. The spouse term life insurance policy offers guaranteed premiums and level death benefits equivalent to those available to employees– whether or not the employee buys a policy.

Optional Riders: Choices of optional riders are available and can be purchased at an additional cost to provide extra coverage and benefits. Spouse Term Rider (on employee policy only) • 10 Year Spouse Term Rider is available on an employee policy with a 10, 20 or 30-year term period. • 20 Year Spouse Term Rider is available on an employee policy with a 20 or 30 year term period. • Face amounts range from $10,000 to $50,000. • Spouse signature is not required. • May convert to a cash value life policy if the base policy terminates, the rider terminates, or the insured and spouse divorce.

VOLUNTARY BENEFITS - GROUP WHOLE LIFE & INDIVIDUAL WHOLE LIFE & LONG TERM CARE RIDER #GC8

Whole Life 1000 is an individually owned, whole life insurance plan with guaranteed level premiums, guaranteed cash values and a guaranteed death benefit. Coverage is permanent and is guaranteed for the life of the policy (to age 100), provided premiums are paid when due.

Two Plan Options: Available for employee and spouse. Paid-Up at Age 65 Plan, the policy is paid-up at the original face amount when the insured reaches age 65, with no additional premiums due. Paid-Up at Age 95 Plan, the policy is paid-up at the original face amount when the insured reaches age 95, with no additional premiums due. Death Benefit: $5,000 to $300,000.Accelerated Death Benefit Provision: If the insured is diagnosed with a terminal illness and has a life expectancy of 12 months or less, the policy owner can request up to 75 percent of the death benefit, to a maximum of $150,000

Long-Term Care Insurance Benefit Rider: This rider is available and can be purchased at an additional cost to provide for flexible use of the Whole Life policy’s death benefit. The Long-Term Care Benefit Rider provides your employees with two kinds of insurance protection in one convenient Whole Life policy – life insurance benefits and long-term care benefits. The Long-Term Care Benefit Rider reduces the Whole Life policy death benefit to provide monthly indemnity benefit of 4% of the Death Benefit, to help pay for the insured’s long-term care services needed as a result of a chronic illness, serious accident, sudden illness, or cognitive impairment. The maximum benefit amount is equal to the policy death benefit, less any indebtedness. It also covers for Home Health Care by Licensed Home Health Care Agency or Licensed Home Health Care Professional and Adult Day Care Benefits.

ADDITIONAL PLAN AVAILABLE UPON REQUEST

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