VOLUNTARY BENEFITS. Plan Year January 1, December 31, 2016

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1 VOLUNTARY BENEFITS Plan Year January 1, December 31, 2016 View Benefits Online at: CNet Benefits page: Page 1

2 TABLE OF CONTENTS Aflac Accident Advantage Plus... Page 03 Aflac Critical Illness... Page 15 Lincoln Financial Long Term Disability... Page 23 Unum Whole Life... Page 24 Continuation of Benefits... Page 30 This booklet highlights the benefits offered through your employer for the current plan year. This is not an Insurance Contract and only the actual policy provisions will prevail. All information in this booklet including premiums are subject to change. All plan descriptions are for informational purposes only). Page 2

3 Aflac Accident Advantage Plus Aflac Group Accident Plan Features Benefits are payable regardless of any other insurance programs. Coverage is guaranteed-issue, provided the applicant is eligible for coverage. The plan features benefits for both inpatient and outpatient treatment of covered accidents. Benefits are available for spouse and/or dependent children. There s no limit on the number of claims an insured can file. Premiums are paid by convenient payroll deduction on a pre-tax basis. 24-Hour Coverage. Page 3

4 Eligibility This product is only available through payroll deduction. Issue Ages Employee at least age 18 Spouse at least age 18 Children under age 26 Class I All full-time benefit-eligible employees who are working at least 20 hours or more per week are eligible for Class I coverage. That eligibility extends to their spouses and children under age 26. Seasonal and temporary employees are not eligible. Class II A Class I primary insured is eligible for Class II coverage if he or she: Was previously insured under Class I; and Is no longer employed by the policyholder. The employee must elect Class II coverage under the Portability Privilege within 31 days after the date for which his/her Class I eligibility would otherwise terminate. Only dependents covered under Class I coverage are eligible for continued coverage under Class II. Class II insureds cannot continue coverage through the employer s payroll deduction process. They must remit premiums directly to the company. The employee may purchase Accident Plus coverage for their spouse and/or dependent children. The spouse and dependent children cannot participate if the employee is not eligible for coverage or elects not to participate. A spouse is the person married to the insured on the effective date of this coverage. A spouse means the legal spouse who is at least age 18. A spouse must not be hospitalized or unable to perform his or her normal duties or activities on the date of application and the effective date of coverage. Dependent child means natural children, step-children, legally adopted children, or children placed for adoption who are younger than age 26. Guaranteed-Issue During the initial enrollment, and for newly eligible employees, coverage is guaranteed-issue, provided the applicants are eligible for coverage. Enrollments take place once each 12-month period. Late enrollees cannot enroll outside of an annual enrollment period. Page 4

5 Portability When coverage is effective and would otherwise terminate because the employee ends employment with the employer, coverage may be continued. The employee may exercise the Portability Privilege when there is a change to their coverage class. The employee and any covered dependents will continue the coverage that is in-force on the date employment ends. The continued coverage will be provided under Class II. The premium rate for portability coverage may change for the class of covered persons on portability on any premium due date. Written notice will be given at least 31 days before any change is to take effect. The employee may continue the coverage until the earlier of: The date he or she fails to pay the required premium; or The date the class of coverage is terminated. Coverage may not be continued: If the employee fails to pay any required premium; or If the company receives notice of Class I plan termination. Accident Benefits Complete Fractures Employee Hip/Thigh $4,500 $4,000 Vertebrae $4,050 $3,600 Pelvis $3,600 $3,200 Skull (Depressed) $3,375 $3,000 Leg $2,700 $2,400 Forearm/Hand/Wrist $2,250 $2,000 Foot/Ankle/Knee Cap $2,250 $2,000 Shoulder Blade/Collar Bone $1,800 $1,600 Lower Jaw (Mandible) $1,800 $1,600 Skull (Simple) $1,575 $1,400 Upper Arm/Upper Jaw $1,575 $1,400 Facial Bones (Except teeth) $1,350 $1,200 Vertebral Processes $900 $800 Coccyx/Rib/Finger/Toe $360 $320 Page 5 Closed Reduction Benefits Spouse/Children If the fracture requires open reduction, we will pay 150% of the amount shown. A fracture is a break in a bone that can be seen by X-ray. If a bone is fractured in a covered accident, and it is diagnosed and treated by a doctor within 90 days after the accident, we will pay the appropriate amount shown. Multiple fractures refer to more than one fracture requiring either open or closed reduction. If multiple fractures occur in any one covered accident, we will pay the appropriate amounts shown for each fracture. However, we will pay no more than 150% of the benefit amount for the fractured bone which has the highest dollar amount.

6 Chip fracture refers to a piece of bone that is completely broken off near a joint. If a doctor diagnoses the fracture as a chip fracture, we will pay 25% of the amount shown for the affected bone. The maximum amount payable for the Fracture Benefit per covered accident is 150% the benefit amount for the fractured bone that has the higher dollar amount. Complete Dislocations Closed Reduction Benefits Employee Spouse/Children Hip $4,000 $3,000 Knee (not kneecap) $2,600 $1,950 Shoulder $2,000 $1,500 Foot/Ankle $1,600 $1,200 Hand $1,400 $1,050 Lower Jaw $1,200 $900 Wrist $1,000 $750 Elbow $800 $600 Finger/Toe $320 $240 If the dislocation requires open reduction, we will pay 150% of the amount shown. Dislocation refers to a completely separated joint. If a joint is dislocated in a covered accident, and it is diagnosed and treated by a doctor within 90 days after the accident, we will pay the amount shown. We will pay benefits only for the first dislocation of a joint. We will not pay for recurring dislocations of the same joint. If the insured dislocated a joint before the effective date of the certificate and then dislocates the same joint again, it will not be covered by this plan. Multiple dislocations refer to more than one dislocation requiring either open or closed reduction in any one covered accident. For each covered dislocation, we will pay the amounts shown. However, we will pay no more than 150% of the benefit amount for the dislocated joint that has the higher dollar amount. Partial dislocation is one in which the joint is not completely separated. If a doctor diagnoses and treats the accidental injury as a partial dislocation, we will pay 25% of the amount shown in the benefit schedule for the affected joint. The maximum amount payable for the Dislocation Benefit per covered accident is 150% of the benefit amount for the dislocated joint that has the higher dollar amount. If you have both fracture and dislocation in the same covered accident, we will pay for both. However, we will pay no more than 150% the benefit amount for the fractured bone or dislocated joint that has the higher dollar amount. Page 6

7 Paralysis Quadriplegia $10,000 Paraplegia $5,000 Paralysis means the permanent loss of movement of two or more limbs. We will pay the appropriate amount shown if, because of a covered accident: The insured is injured, The injury causes paralysis which lasts more than 90 days, and The paralysis is diagnosed by a doctor within 90 days after the accident. The amount paid will be based on the number of limbs paralyzed. If this benefit is paid and the insured later dies as a result of the same covered accident, we will pay the appropriate Death Benefit, less any amounts paid under the Paralysis Benefit. Lacerations Up to 2 long $ long $200 More than 6 long $400 Lacerations not requiring stitches $25 The laceration must be repaired with stitches by a doctor within 14 days of the accident. The amount paid will be based on the length of the laceration. If an insured suffers multiple lacerations in a covered accident, and the lacerations are repaired with stitches by a doctor within 14 days of the accident, we will pay this benefit based on the largest single laceration which requires stitches. Injuries Requiring Surgery Eye Injuries (treatment and surgery within 90 days) $250 Removal of foreign body from eye (requiring no surgery) $50 Tendons/Ligaments* (treatment within 60 days, surgical repair within 90 days) Single Multiple Ruptured Disc (treatment within 60 days, surgical repair within one year) Torn Knee Cartilage (treatment within 60 days, surgical repair within one year) $400 $600 $400 $400 Page 7

8 Burns (treatment within 14 days, first degree burns not covered) Second Degree Less than 10% of body surface covered At least 10%, but not more than 25% of body surface covered At least 25%, but not more than 35% of body surface covered More than 35% of body surface covered Third Degree Less than 10% of body surface covered At least 10%, but not more than 25% of body surface covered At least 25%, but not more than 35% of body surface covered More than 35% of body surface covered Benefit $100 $200 $500 $1,000 $1,000 $5,000 $10,000 $20,000 Concussion (A concussion or Mild Traumatic Brain Injury (MTBI) is defined as a disruption of brain function resulting from a traumatic blow to the head.(note: Concussion and MTBI are used interchangeably. The concussion must be diagnosed by a doctor.) Coma (state of profound unconsciousness lasting 30 days or more) $200 $10,000 Internal Injuries (resulting in open abdominal or thoracic surgery) $1,000 Exploratory Surgery (without repair, i.e., arthroscopy) $250 Emergency Dental Work (injury to sound, natural teeth) Repaired with crown Resulting in extraction $150 $50 Medical Fees (for each accident) Employee or Spouse $125 Child(ren) $75 We will pay the amount shown for X-rays or doctor services. For benefits to be payable, because of a covered accident, the insured must be injured and receive initial treatment from a doctor within 14 days of the accident. We will pay the Medical Fees Benefit: For treatment received due to injuries from a covered accident and For each covered accident up to one year after the accident date. Page 8

9 Emergency Room Treatment Employee or Spouse $125 Child(ren) $75 We will pay the amount shown for injuries received in a covered accident if the insured: Receives treatment in a hospital emergency room and Receives initial treatment within 14 days of the covered accident. This benefit is payable only once per 24-hour period and only once per covered accident. We will not pay the Accident Emergency Room Treatment Benefit and the Medical Fees Benefit for the same covered accident. We will pay the highest eligible benefit amount. Emergency Room Observation Benefit Employee or Spouse $75 Child(ren) $45 We will pay the amount shown for injuries received in a covered accident if the insured: Receives treatment in a hospital emergency room, and Is held in a hospital for observation for at least 24 hours, and Receives initial treatment within 14 days of the accident. This benefit is payable only once per 24-hour period and only once per covered accident. This benefit would be paid in addition to Accident Emergency Room Treatment Benefit. Accident Follow-Up Treatment $25 We will pay the amount shown for up to six treatments per covered accident, per covered person. The insured must have received initial treatment within 14 days of the accident, and the follow-up treatment must begin within 30 days of the covered accident or discharge from the hospital. Physical Therapy $25 We will pay the amount shown for up to six treatments (one per day) per covered accident, per covered person for treatment from a physical therapist. A physician must prescribe the physical therapy. The insured must have received initial treatment within 14 days of the accident, and physical therapy must begin within 30 days of the covered accident or discharge from the hospital. Treatment must take place within six months after the accident. This benefit is not payable for the same visit that the Accident Follow-up Treatment benefit is paid. Page 9

10 Air Ambulance $500 Ambulance $100 If an insured requires transportation to a hospital by a professional ambulance service within 90 days after a covered accident, we will pay the amount shown. Transportation (within 90 days) Train or Plane $300 Bus $150 If hospital treatment or diagnostic study is recommended by your physician and is not available in the insured s city of residence, we will pay the amount shown. The distance to the location of the hospital must be more than 50 miles from the insured s residence. Blood/Plasma $100 If the insured receives blood and plasma within 90 days following a covered accident, we will pay the amount shown. Prosthesis $500 If a covered accident requires the use of a prosthetic device, we will pay the amount shown. Hearing aids, wigs, or dental aids including false teeth are not covered. Appliance $100 We will pay the amount shown for use of a medical appliance due to injuries received in a covered accident. Benefits are payable for crutches, wheelchairs, leg braces, back braces, and walkers. Family Lodging Benefit (per night) $100 If an insured is required to travel more than 100 miles for inpatient treatment of injuries received in a covered accident, we will pay the amount shown for an immediate family member s lodging. Benefits are payable up to 30 days per accident and only while the insured is confined to the hospital. Wellness $60 This benefit is payable while coverage is in force. This benefit is only payable for Wellness Tests performed as the result of preventive care, including tests and diagnostic procedures ordered in connection with routine examinations. We will pay the amount shown once each calendar year for each covered person for the following: Page 10

11 Annual physical exams Blood screenings Mammograms Eye examinations Pap smears Immunizations PSA tests Flexible sigmoidoscopies Ultrasounds Hospital Admission $1,000 We will pay the amount shown, when because of a covered accident, the insured: Is injured, Requires hospital confinement, and Is confined to a hospital for at least 24 hours within 6 months after the accident date. We will pay this benefit once per calendar year. We will not pay this benefit for confinement to an observation unit. We will not pay this benefit for emergency room treatment or outpatient surgery or treatment. Hospital Confinement (per day) $200 We will pay the amount shown when, because of a covered accident, the insured: Is injured, and Those injuries cause confinement to a hospital for at least 24 hours within 90 days after the accident date. The maximum period for which you can collect the Hospital Confinement Benefit for the same injury is 365 days. This benefit is payable once per hospital confinement even if the confinement is caused by more than one accidental injury. We will not pay this benefit for confinement to an observation unit. We will not pay this benefit for emergency room treatment or outpatient surgery or treatment. Hospital Intensive Care (per day) $400 We will pay the amount shown when, because of a covered accident, the insured: Is injured, and Those injuries cause confinement to a hospital intensive care unit. The maximum period for which an insured can collect the Hospital Intensive Care Benefit for the same Injury is 30 days. This benefit is payable in addition to the Hospital Confinement Benefit. Page 11

12 Accidental Death & Dismemberment (within 90 days) Employee Spouse Children Accidental Death $50,000 $10,000 $5,000 Accidental Common Carrier Death $100,000 $50,000 $15,000 Single Dismemberment $12,500 $5,000 $2,500 Double Dismemberment $25,000 $10,000 $5,000 Loss of One or More Fingers or Toes $1,250 $500 $250 Partial Amputation of Finger(s) or Toe(s) (including at least one joint) $100 $100 $100 Dismemberment means: Loss of a hand The hand is cut off at or above the wrist joint; or Loss of a foot The foot is cut off at or above the ankle; or Loss of sight At least 80% of the vision in one eye is lost. Such loss of sight must be permanent and irrecoverable; or Loss of a finger/toe The finger or toe is cut off at or above the joint where it is attached to the hand or foot. If the employee does not qualify for the Dismemberment Benefit but loses at least one joint of a finger or toe, we will pay the Partial Dismemberment Benefit shown. If this benefit is paid and the employee later dies as a result of the same covered accident, we will pay the appropriate death benefit, less any amounts paid under this benefit. Accidental Death If the employee is injured in a covered accident and the injury causes him/her to die within 90 days after the accident, we will pay the Accidental Death Benefit shown. Accidental Common Carrier Death If the employee is injured in a covered accident and the injury causes him/her to die within 90 days after the accident, we will pay the Accidental Common Carrier Death Benefit in the amount shown if the injury is the result of traveling as a fare-paying passenger on a common carrier, as defined below. This benefit is paid in addition to the Accidental Death Benefit. Common carrier means: An airline carrier which is licensed by the United States Federal Aviation Administration and operated by a licensed pilot on a regular schedule between established airports; or A railroad train which is licensed and operated for passenger service only; or A boat or ship that is licensed for passenger service and operated on a regular schedule between established ports. Page 12

13 Limitations and Exclusions We will not pay benefits for injury, total disability, or death contributed to, caused by, or resulting from: War participating in war or any act of war, declared or not; participating in the armed forces of, or contracting with, any country or international authority. We will return the prorated premium for any period not covered by this certificate when you are in such service. This does not include terrorism. Suicide committing or attempting to commit suicide, while sane or insane. Sickness having any disease or bodily/mental illness or degenerative process. We also will not pay benefits for any related medical/surgical treatment or diagnostic procedures for such illness. This exclusion does not exclude an accidental death from a bacterial infection resulting from an accidental injury. Self-Inflicted Injuries injuring or attempting to injure yourself intentionally. Racing riding in or driving any motor-driven vehicle in a race, stunt show, or speed test. Intoxication being legally intoxicated, or being under the influence of any narcotic, unless taken under the direction of a Doctor. Legally intoxicated means that condition as defined by the law of the jurisdiction in which the accident occurred.) Illegal Acts participating or attempting to participate in an illegal activity, or working at an illegal job. Sports participating in any organized sport professional or semi-professional. Cosmetic Surgery having cosmetic surgery or other elective procedures that are not medically necessary or having dental Treatment except as a result of a covered accident. Terminations An employee s coverage will terminate on whichever occurs first: The date the master policy is terminated. The 31st day after the premium due date, if the premium has not been paid. The date an insured no longer meets the definition of an employee, unless the insured takes advantage of the portability privilege. The date an insured no longer belongs to an eligible class. If the master policy and/or certificate terminates, we will provide coverage for claims arising from covered accidents that occurred while the plan was in force. Page 13

14 Notices This is a brief description of coverage, not a contract. Read your certificate carefully for exact plan language, terms, and conditions. If this coverage will replace any existing individual policy, please be aware that it may be in your best interest to maintain your individual guaranteed-renewable policy. Continental American Insurance Company is not aware of whether you receive benefits from Medicare, Medicaid, or a state variation. If you or your dependents are subject to Medicare, Medicaid, or a state variation, any and all benefits under this plan could be assigned. This means that you may not receive any of the benefits in the plan. As a result, you should please check the coverage in all health insurance policies you already have or may have before you buy this insurance to verify the absence of any assignments or liens. Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. Continental American Insurance Company, 2801 Devine Street, Columbia, South Carolina Hour Plan / Weekly Rates Employee $3.74 Employee and Spouse $5.35 Employee and Dependent Child(ren) $7.13 Family $8.74 Wellness Benefit included in Rates. Page 14

15 Aflac Group Critical Illness Plan Aflac Group Critical Illness Plan Features Plan Features: Coverage Available For Spouse And Children $100 Health Screening Benefit Guaranteed Issue Coverage During Initial Enrollment Plan Is Portable Pays A Lump Sum Benefit In The Event Of A Covered Critical Illness, Including But Not Limited To Heart Attack, Stroke, End Stop Renal Failure, Internal Cancer And Major Organ Transplant Additional Occurrence Benefit - If Separated By 6 Months Reoccurrence Benefit - If Separated By 12 Months Premiums are paid pre-tax. ( Benefits may be subject to taxation). Page 15

16 Group Critical Illness Benefits The Aflac coverage described in this booklet is subject to plan limitations, exclusions, definitions, and provisions. For detailed information, please see the plan brochure, as this booklet is intended to provide a general summary of the coverage. This overview is subject to the terms, conditions, and limitations of policy form number CAI2800NC. First Occurrence Benefit After the Waiting Period, an insured may receive up to 100% of the benefit selected upon the first diagnosis of each covered critical illness. Covered Critical Illnesses* Illnesses Covered Under Plan Percentage of Face Amount Heart Attack 100% Stroke 100% Major Organ Transplant 100% Renal Failure (End Stage) 100% Cancer (internal/invasive) 100% Carcinoma in situ** 25% Coronary Artery Bypass Surgery** 25% Additional Occurrence Benefit If an insured collects full benefits for a Critical Illness under the plan and later has one of the remaining covered illnesses, then we will pay the full benefit amount for any additional illness. The two dates of diagnosis must be separated by at least 6 months and is not caused by or contributed by a Critical Illness for which benefits have been paid. Re-Occurrence Benefits If an insured receives full benefit for a covered condition and is later diagnosed with the same condition, we will pay the full benefit again. Occurrences must be separated by at least 12 months or 12 months treatment free for Cancer. Cancer that has spread (metastasized) even though there is a new tumor, will not be considered an additional occurrence unless you have been treatment free for 12 months. ** Payment of the partial benefit for Carcinoma in Situ will reduce by 25% the benefit for internal Cancer. Payment of the partial benefit for Coronary Artery Bypass Surgery will reduce by 25% the benefit for a Heart Attack. Carcinoma in situ means cancer that is in the natural or normal place, confined to the site of origin without having spread to surrounding tissue. Page 16

17 Health Screening Benefits After the Waiting Period, an insured may receive a maximum of $100 for any one covered screening test per calendar year. We will pay this benefit regardless of the results of the test. Payment of this benefit will not reduce the amount payable for the diagnosis of a critical illness. There is no limit to the number of years the insured can receive the health screening benefit; it will be paid as long as the policy remains inforce. This benefit is payable for the covered employee and spouse. This benefit is not paid for dependent children. The covered health screening tests include but are not limited to: Stress test on a bicycle or treadmill Fasting blood glucose test, blood test for triglycerides or serum cholesterol test to determine level of HDL and LDL Bone marrow testing Breast ultrasound CA 15-3 (blood test for breast cancer) CA 125 (blood test for ovarian cancer) CEA (blood test for colon cancer) Chest x-ray Colonoscopy Flexible sigmoidoscopy Hemocult stool analysis Mammography Pap smear PSA (blood test for prostate cancer) Serum protein electrophoresis (blood test for myeloma) Thermography Physical Exams Heart Benefit Covered Critical Illnesses* Illnesses Covered Under Plan Category 1 Percentage of Face Amount Coronary artery bypass surgery 100% Mitral valve replacement or repair 100% Aortic valve replacement or repair 100% Surgical Treatment of Abdominal aortic aneurysm Category 2** 100% AngioJet Clot Busting 10% Balloon Angioplasty (or Balloon valvuloplasty) 10% Laser Angioplasty 10% Atherectomy 10% Stent implantation 10% Page 17

18 Cardiac catheterization 10% Automatic Implantable (or Internal) Cardioverter Defibrillator (AICD) 10% Pacemakers 10% We will pay the indicated percentages of the applicable Initial Maximum Benefit amount shown in the Schedule that occurs while this Schedule is in force. Benefits are not payable under this Schedule for loss if these conditions result from another Specified Critical Illness. ***Benefits for Category II will reduce the benefit amounts payable for Category I benefits. Benefits will be paid only at the highest benefit level. If a Cat I and II are performed at the same time, benefits are only eligible at the 100% (higher) event and will not exceed the amount Initial Face Amount shown on the Schedule. You are only eligible to receive one payment for each benefit category listed on the schedule page. The Dates of Loss for Covered Procedures must be separated by at least 6 months for benefits to be payable for multiple Covered Procedures. Subject to the re-occurrence benefit in the base plan, only one Category II benefit is payable. Benefits will not be paid for multiple procedures listed under the Category II benefit. Additional Specified Critical Illnesses Rider Illness Covered Under Plan Percentage of Face Amount Coma 100% Paralysis 100% Burns 100% Loss of Sight 100% Loss of Hearing 100% Loss of Speech 100% We will pay the indicated percentages of the applicable Maximum Benefit Amount shown in the Certificate Schedule. Benefits are not payable for loss if these conditions result from another Specified Critical Illness. The Dates of Loss for Specified Critical Illnesses must be separated by at least 6 months for benefits to be payable for multiple Specified Critical Illnesses. Page 18

19 Individual Eligibility Issue Ages: Employee Spouse Children - under age 26 All full-time benefit-eligible employees who are working at least 20 hours or more per week are eligible for coverage. That eligibility extends to their spouses and children under age 26. Seasonal and temporary employees are not eligible. Spouse Coverage Available The employee may elect to purchase spouse coverage. In order to apply for spouse coverage, the employee must also apply. The employee may purchase $5,000 of spouse coverage when they purchase $5,000 or $10,000 on themselves, $10,000 when they purchase $20,000 on themselves, $15,000 when they purchase $30,000 on themselves and $20,000 when they purchase $40,000 on themselves. If the employee does not meet the underwriting requirements necessary to participate in the plan, the spouse can still obtain coverage. The spouse would then become the primary insured and is limited to face amounts between $5,000 and $40,000. Dependent Children Coverage at No Additional Charge Each eligible dependent child is covered at 50 percent of the primary insured. All regular employees working at least 20 hours or more weekly with at least 30 days of continuous employment. If an employee is eligible, their spouse is eligible for coverage and all natural children, step-children, foster children, legally adopted children or children placed for adoption who are under age 26. Seasonal and temporary workers are not eligible to participate. Employees must be actively at work to be eligible for coverage. Portability When coverage is effective and would otherwise terminate because employment ends with the employer, or the group master policy is cancelled by the employer, coverage may be continued. The employee may continue the coverage that is in force on the date employment ends, or the date the group policy is terminated. This includes dependent coverage that is in effect at that time. To keep his/her Certificate in force, the Employee must apply to the Company in writing within 31 days after the date his insurance would otherwise terminate and pay the required premium to the Company no later than 31 days after the date the Certificate would otherwise terminate and on each premium due date thereafter. Coverage will end 31 days after the date the Employee fails to pay any required premium. The portability premium rate is the rate in effect at the time of continuation. Page 19

20 Limitations and Exclusions This policy contains a 30-day waiting period. This means that no benefits are payable for any insured before coverage has been in force 30 days from their enrollment. If a covered person is first diagnosed during the waiting period, benefits for that Critical Illness will apply only to loss commencing after 12 months from the effective date of coverage, or the covered person may elect to void the certificate from the beginning and receive a full refund of premium. The date of diagnosis of a Critical Illness must be separated from the date of diagnosis of a subsequent different Critical Illness by at least 6 months. The date of diagnosis of the same Critical Illness must be separated from the date of diagnosis of the subsequent same Critical Illness by at least 12 months. The applicable benefit amount will be paid if: the date of diagnosis is after the waiting period; the date of diagnosis occurs while the policy and certificate are in force; and the cause of the illness is not excluded by name or specific description. Benefits will not be paid for loss due to: 1. Intentionally self-inflicted injury or action; 2. Suicide or attempted suicide while sane or insane; 3. Illegal activities or participation in an illegal occupation; 4. Participating in war or any act of war, declared or not, or participating in the armed forces of or contracting with any country or international authority. This exclusion does not include acts of terrorism. We will return the prorated premium for any period not covered by this certificate when you are in such service. 5. Substance abuse; or 6. Pre-existing conditions. 7. No benefits will be paid for diagnosis made or treatment received outside the United States. Pre-existing Conditions Limitation & Exceptions Pre-existing Condition means a sickness or physical condition which, within the 12-month period prior to an insured s effective date resulted in the insured receiving medical advice or treatment. We will not pay benefits for any condition or illness starting within 12 months of an insured s effective date which is caused by, contributed to, or resulting from a pre-existing condition. A claim for benefits for loss starting after 12 months from the effective date will not be reduced or denied on the grounds that it is caused by a pre-existing condition. A condition will no longer be considered pre-existing at the end of 12 consecutive months starting and ending after an insured s effective date. Page 20

21 Heart Benefit Exceptions: All limitations and exclusions that apply to the Critical Illness plan also apply to this Heart Benefit Schedule. The Waiting Period and Pre-existing condition limitation apply from the date this benefit is effective. Any Benefits for Coronary Artery Bypass Surgery denied under this benefit due to Pre-existing conditions may be paid at the reduced benefit amount under the certificate, subject to the terms of the certificate. No benefits will be paid for loss which occurred prior to the effective date of this benefit. Additional Specified Critical Illness Rider Exceptions and Reductions: No Benefits will be paid for loss which occurred prior to the effective date of the Rider. Benefits are not payable for Loss if these conditions result from another Specified Critical Illness. Note: If this coverage will replace any existing individual policy, please be aware that it may be in your best interest to maintain your individual guaranteed-renewable policy. Continental American Insurance Company (CAIC), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. Continental American Insurance Company 2801 Devine Street Columbia, South Carolina Continental American Insurance Company is not aware of whether you receive benefits from Medicare, Medicaid, or a state variation. If you or a dependent are subject to Medicare, Medicaid, or a state variation, any and all benefits under this plan could be assigned. This means that you may not receive any of the benefits in the plan. As a result, please check to the coverage in all health insurance policies you already have or may have before you buy this insurance to verify the absence of any assignments or liens. Notice to Consumer: The coverages provided by Continental American Insurance Company (CAIC) represent supplemental benefits only. They do not constitute comprehensive health insurance coverage and do not satisfy the requirement of minimum essential coverage under the Affordable Care Act. CAIC coverage is not intended to replace or be issued in lieu of major medical coverage. It is designed to supplement a major medical program. AGC09819 IV (8/15) aflacgroupinsurance.com Page 21

22 Aflac Group Critical Illness Plan - Employee and Spouse Weekly Rates 1 1 NONTOBACCO - Employee 1 AGES $ 5,000 $10,000 $20,000 $ 30,000 $ 40, $ 1.20 $ 1.83 $ 3.07 $ 4.32 $ $ 1.65 $ 2.73 $ 4.87 $ 7.02 $ $ 2.90 $ 5.22 $ 9.86 $ $ $ 4.72 $ 8.86 $ $ $ $ 8.25 $ $ $ $ NONTOBACCO - Spouse 1 AGES $ 5,000 $ 10,000 $15,000 $20, $ 1.20 $ 1.83 $ 2.45 $ $ 1.65 $ 2.73 $ 3.80 $ $ 2.90 $ 5.22 $ 7.54 $ $ 4.72 $ 8.86 $ $ $ 8.25 $ $ $ TOBACCO - Employee 1 AGES $5,000 $10,000 $20,000 $30,000 $40, $ 1.62 $ 2.66 $ 4.73 $ 6.81 $ $ 2.41 $ 4.25 $ 7.92 $ $ $ 5.45 $ $ $ $ $ 8.88 $ $ $ $ $ $ $ $ $ Rates include cancer benefit. 1 TOBACCO - Spouse 1 AGES $5,000 $10,000 $15,000 $20, $ 1.62 $ 2.66 $ 3.70 $ $ 2.41 $ 4.25 $ 6.08 $ $ 5.45 $ $ $ $ 8.88 $ $ $ $ $ $ $ Rates include: $100 Health Screening Benefit, Additional Benefits Rider, Heart Rider, and no additional riders. Benefits may be subject to taxation. No benefit reduction at age 70. Please Note: Premiums shown are accurate as of publication. They are subject to change. Published: Sep-14 CI CU-CI-52PP-CAN-100HSB-HRT-70BENERED-TNT Page 22

23 Lincoln Financial LTD Voluntary Long Term Disability (LTD) Plan The City of Charlotte is pleased to offer a Voluntary LTD program through Lincoln Financial. All active, regular employees who are scheduled to work at least thirty (30) hours per week are eligible to participate in this plan, regardless of whether or not you are vested in the North Carolina or Charlotte Firefighters Retirement System. The voluntary LTD program will pay 60% of your monthly salary to a $10,000 maximum. The voluntary LTD program will pay in addition to any disability retirement benefit you receive not to exceed 100% of your income. There is a 180-day waiting period before benefits begin. There are two maximum benefit duration periods from which to choose: o 5 years / or to age 70 but not less than one year o Social Security Normal Retirement Age (SSNRA) Premiums are payroll deducted on an after tax basis. Benefits are not taxable. During the open enrollment period you can enroll with NO HEALTH QUESTIONS. You must meet with a Mark III representative to enroll in the LTD plan or obtain your estimated cost. The effective date of the Voluntary LTD plan is January 1 following the open enrollment period. Page 23

24 Unum Whole Life Voluntary Whole Life Insurance Whole Life Insurance Features Whole life provides an additional source of financial protection for your working years and provides options for your retirement. Your policy builds cash value that you can borrow against or even cash out. Your policy is guaranteed to earn a 4.5% interest rate. Premiums do not increase as you get older. Premiums are payroll deducted for active employees on an after tax basis. Benefits are not taxable. You own the policy so you can keep it at the same rate even if you terminate employment or retire. The death benefit does not decrease as you get older. You don t have to purchase coverage on yourself to purchase coverage on spouses, dependent children or grandchildren. Benefit offering: - Employee Guarantee Issue amounts up to: (ages 15-50): $150,000; (ages 51-80):$75,000 - Spouse Conditional Guarantee Issue amounts up to: (ages 15-50): $30,000;(ages 51-80): $15,000 - Children/Grandchildren: Guarantee Issue of $1 $3 per week Benefit Highlights you ll appreciate Paid up at age 70 option Employee has the option for a fully paid up plan at age 70 (issue ages 15-50) Living Benefit Option if you become terminally ill, you may request part or all of your life benefit early, up to your plan s maximum (included on all policies) Accidental Death Benefit Rider Doubles the death benefit if you or your spouse die as a result of an accident prior to the age of 70 (optional rider to employee and spouse policies ages 15 to 65 with just a little extra cost to the policyholder) Long Term Care Rider Allows policyowner to use the death benefit for long term care. This rider is included on purchased benefit amounts of $10,000 or more. Whole Life Insurance provides important life benefits beyond your working years: 90% of Americans over age 70 have no life insurance 5 out of 6 men die after age 65 8 out of 9 women die after age 65 Note: If you do not enroll when first eligible, medical questions may be asked if you choose to enroll in the future This voluntary whole life insurance is being offered to regular benefit eligible employees working a minimum of 20 hours per week (including elected officials) and is in addition to any supplemental group term life insurance Page 24

25 Voluntary Whole Life Insurance $10,000 Coverage Amount Employee/Spouse Sample Rates* Non Tobacco Weekly Costs $25,000 Coverage Amount Employee/Spouse Sample Rates* Non Tobacco Weekly Costs Issue Age Base* Base with ADB* Issue Age Base* Base with ADB* $4.25 $ $6.56 $ $4.39 $ $10.97 $ $8.39 $ $20.96 $21.42 Employee/Spouse Sample Rates* Non Tobacco Weekly Costs $50,000 Coverage Issue Base with Amount Age Base* ADB* $75,000 Coverage Amount Employee/Spouse Sample Rates* Non Tobacco Weekly Costs Issue Age Base* Base with ADB* 25 $8.50 $ $12.74 $ $13.11 $ $19.67 $ $21.94 $ $32.90 $ $41.91 $ $62.86 $64.25 Child Weekly Sample Rates and Coverage Amounts* Issue Age $1 $2 $3 5 $7,084 $14,169 $21, $6,198 $12,396 $18, $5,274 $10,548 $15,822 *Policies of $10,000 or more include LTC rider. Policies accumulate cash value. Employee/Spouse rates are based on the paid up at age 120 option. See Mark III representative for details. ***To Learn More and Enroll*** You will have an opportunity to meet with a Mark III Representative during the enrollment period. In your Individual meeting you will be able to ask any questions you may have and enroll in these three valuable benefits. Four reasons to buy this coverage at work 1. You own the policy so you can keep it even if you leave or retire. Unum will bill you at home for the same premium. 2. Your buying decision is your choice you can cancel at any time throughout the year. 3. You lock in the rates. Rates don t increase as you age. 4. Premiums are conveniently deducted from your paycheck. This information is not intended to be a complete description of the insurance coverage available. The policy or its provisions may vary in some states. The policy has exclusions and limitations that may affect any benefits payable. For complete details of coverage, please refer to the full policy or see your enrollment representative for specific provisions and details. Page 25

26 Provident Life and Accident Insurance Company (Unum) Long Term Care Rider If you weather a serious disability, could your finances ride out the storm? Unum s Long Term Care (LTC) Rider can help you protect your savings. Protecting long-term plans Marcia s savings are modest, but she s worked hard for every penny. She wants to travel to Italy, pay for her daughter s wedding, and leave something behind for those she loves. But she s seen how quickly the cost of long term care can deplete a lifetime of savings. She wants to make sure a traumatic accident or illness won t scramble her nest egg. How long term care benefits work This is an example of how this LTC rider can help you finance a period of long term care. This illustration is based on an insured individual who has a $25,000 life insurance policy.* HIGHLIGHTS (HYPOTHETICAL EXAMPLE) RIDER Employer selected Benefits for the long haul We all wish for a long and prosperous life. However, a longer life can also mean long term treatment in a nursing home or assisted living facility. Most of us are not prepared for the costs associated with this kind of care. You may be surprised to learn that long term care isn t covered by health or other insurance policies. And waiting to buy long term care coverage may not be in your best interest. In fact, the younger you are, the less expensive it is. By adding a Long Term Care Rider to your life insurance policy, you can help protect your savings pool from the drain of this expensive care. Most importantly, this coverage allows you to use the benefit whether you receive care at home, in a long term care facility, an assisted living facility, an adult day care, or a nursing home. How to apply ) To learn more, watch for information from your employer. LTC pays 6% monthly benefit for either LTC facility benefit or assisted living facility benefit LTC pays 4% monthly benefit for home health care or adult day care $1,500 per month $1,000 per month Payments reduce the death benefit until exhausted (approximately 16 months) * Assumes there are no outstanding policy loans. EN-1696-NC (12-12) Page 26

27 Get the coverage you need. Here are the advantages of our Long Term Care Rider: Available at initial offering to employees and spouses ages 15 to 70. All newly eligible adult policies will automatically receive the Long Term Care Rider. Available with policy s specified amount (face amount) of at least $10,000. For long term care facility, nursing home care or assisted living facility, provides a maximum monthly benefit that is the lesser of: 6% of the death benefit less any policy debt at the end of the waiting period, or $3,000. For home health care or adult day care, provides a maximum monthly benefit that is the lesser of: 4% of the death benefit less any policy debt at the end of the waiting period; your actual monthly expenses; or $1,500. Benefits are payable once you have been receiving long term care for 90 days, subject to the conditions of the rider. If you are receiving benefits, you don t have to pay the policy s monthly premiums, even if your policy does not have the Waiver of Premium Rider. The benefit period maximum is 100% of the death benefit, less any policy debt at the end of the waiting period for each benefit period. The cost is based on your age at issue and whether you use tobacco. The rider is tax-qualified, which means that any benefits you receive will not be taxed.** Premiums are non-cancellable and cannot be increased. For whole life coverage, the following option may be available for employees and spouses age 15-50: You can pay an adjusted premium, so your policy will be paid-up by age 70. Your life coverage and long term care coverage will continue as long as you keep your life policy. Page 27

28 Whole life insurance for children Give your kids a strong financial start. Unum s whole life insurance for children can help. Teach your kids to start saving now. Katie and Derek work hard for what they have. But they re also smart financial planners who save their money and they re teaching their kids to do the same. By buying a life insurance policy that accumulates cash value, they can save for their children s future. Now that s a smart lesson. Features that add value 1. Cash value Accumulates at a rate of 4.5%*. You can borrow from the cash value if you choose, or use it to buy a reduced policy with no more premiums. 2. Policy amounts of $1 to $3 per week require no health questions if you apply when you are first eligible. If you wait, there will be a few medical questions. Coverage beyond $3 per week is available but requires health questions to determine eligibility. 3. At age 70, the policy is fully paid up. This means no more premiums must be paid. The benefit will be paid to the beneficiaries upon death. Financial protection for your family If an accident or illness were to claim the life of your child, this policy could provide the resources needed to deal with the financial strain of your loss so you can take care of your family during this difficult time. This coverage can be purchased without purchasing employee coverage. Each policy covers one child or grandchild; you can purchase coverage for each of your children and grandchildren. Child eligibility Coverage is available to your: Children (natural and legally adopted) Stepchildren Grandchildren Your child/grandchild is eligible from 14 days old until their 26th birthday. Children must reside in the U.S. to receive coverage. Three reasons to buy this coverage at work 1. You get affordable rates when you buy this policy through your employer, and the premiums are conveniently deducted from your paycheck. 2. You own the policy so you can keep it even if you leave the company or retire. Unum will bill you directly for the same premium amount. 3. Coverage becomes effective on the first day of the month in which payroll deductions begin. How to To learn more, watch for apply ) information from your employer. My child s whole life coverage Amount I applied for: $ Cost per pay period: $ Date deductions begin: / / (For your records complete during your enrollment) EN-1744 (11-13) Page 28

29 Get the coverage you need. Amounts and values Weekly premium $1 Weekly premium $2 Weekly premium $3 Issue age Coverage amount Cash value at age 65* Coverage amount Cash value at age 65* Coverage amount Cash value at age 65* 0 $7,461 $3,460 $14,921 $6,919 $22,382 $10,379 1 $7,450 $3,452 $14,900 $6,904 $22,350 $10,357 2 $7,429 $3,440 $14,857 $6,879 $22,286 $10,318 3 $7,345 $3,398 $14,689 $6,795 $22,034 $10,192 4 $7,232 $3,342 $14,465 $6,684 $21,697 $10,026 5 $7,084 $3,270 $14,169 $6,541 $21,253 $9,811 6 $6,924 $3,193 $13,848 $6,385 $20,772 $9,578 7 $6,753 $3,110 $13,506 $6,220 $20,260 $9,331 8 $6,574 $3,024 $13,148 $6,048 $19,722 $9,072 9 $6,380 $2,931 $12,761 $5,862 $19,141 $8, $6,198 $2,843 $12,396 $5,687 $18,594 $8, $5,998 $2,748 $11,995 $5,495 $17,993 $8, $5,810 $2,657 $11,620 $5,315 $17,430 $7, $5,622 $2,567 $11,243 $5,134 $16,865 $7, $5,445 $2,483 $10,890 $4,965 $16,335 $7, $5,274 $2,400 $10,548 $4,801 $15,822 $7, $5,118 $2,325 $10,236 $4,651 $15,354 $6, $4,967 $2,253 $9,933 $4,505 $14,900 $6, $4,828 $2,185 $9,656 $4,371 $14,485 $6, $4,693 $2,120 $9,386 $4,240 $14,079 $6, $4,565 $2,058 $9,131 $4,116 $13,696 $6, $4,441 $1,998 $8,881 $3,995 $13,322 $5, $4,323 $1,940 $8,645 $3,880 $12,968 $5, $4,207 $1,883 $8,414 $3,767 $12,621 $5, $4,098 $1,830 $8,195 $3,659 $12,293 $5, $3,994 $1,778 $7,988 $3,557 $11,982 $5,335 * The policy accumulates cash value based on a non-forfeiture interest rate of 4.5% and the 2001 CSO mortality shown in the policy. Cash value will be reduced by any outstanding loans against the policy. Page 29

30 Continuation of Benefits Aflac Group Accident and Critical Illness Plan When you leave employment, you may continue your Aflac Group Accident and Critical Illness plans by having the premiums that are currently deducted from your paycheck billed to your home address or drafted from your bank account. You may do so by contacting Aflac Group at: Phone: (800) Lincoln Financial LTD Plan Once an employee has been covered under the Long Term Disability plan for 12 months, you can port coverage at the group rate plus a direct billing fee without evidence of insurability. You may not port if you are disabled, retired or on a leave of absence. You have 30 days from the date of termination to contact Lincoln Financial to port your coverage by calling Please see your certificate for more detailed information regarding the guidelines for portability. Unum Whole Life When you leave your employment, you may continue your Unum Whole Life Insurance coverage by having the premiums that are currently deducted from your paycheck billed to your home address or drafted from your bank account. For billing options, please call Unum at Page 30

31 Plan arranged & enrolled by: 211 Greenwich Road Charlotte/NC Page 31