PRODUCT INFORMATION APPROVED FOR POLICY TYPE

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1 MARKETPLACE BULLETIN INTENSIVE CARE PROTECTOR PRODUCT INFORMATION APPROVED FOR POLICY TYPE Plan Code Policy Form Issue Ages PRODUCT OVERVIEW 5JP, 5JQ, 5JR Same As Plan Codes 0-60; for Family or Single Parent Individual (Bank Draft) Worksite Advantage (Payroll Deduction) Worksite Advantage Section 125 (Pretax Savings) Accident and Health Term Life Whole Life Annuity Medicare Supplement y Benefits for Hospital Intensive Care Unit confinement due to sickness or injury. y Benefit amounts increase if confinement is a result of automobile or travel accident. y Additional benefits for regular hospital room, blood and ambulance service. See policy for full details and descriptions. y Intensive Care Unit, ICU, as defined in the policy: Special intensive care areas of the hospital, which at the time of admission to the hospital are also separate and apart from the surgical recovery room and from the rooms, beds, and wards customarily used for patient confinement. The term Intensive Care Unit does not include lesser treatment units such as progressive or intermediate care units, private monitored rooms, isolation units, observation, or telemetry units. In addition, intensive care units must have 24-hour nursing attendance by nurses assigned on a full-time basis exclusively to such unit, and such unit must contain a special apparatus used in the treatment of the critically ill. Further, such intensive care facilities or units must be under direct professional supervision and/or direction of a full-time physician director or a standing intensive care committee of the medical staff of the hospital. Intensive care unit also includes special care units where such units meet the standards set forth above. The following types of accommodations are special care units: Surgical Intensive Care Unit; Coronary Intensive Care Unit, Burn Unit; Pediatric Intensive Care Unit; Neonatal Care Unit; Trauma Unit; or Medical Intensive Care Unit. y Monthly pay mode must be on Bank Draft/Bank Budget; Monthly direct bill (premium notice) pay mode is not allowed. ELIGIBILITY y An individual cannot be covered by more than one Liberty National Hospital Intensive Care policy. y Worksite eligibility requirements apply to worksite sales. Refer to the Worksite Advantage Agent Reference Guide R y On family policies, older spouse is the proposed insured. y For family coverage, a child under 21 years of age, unmarried, and lives with or is primarily dependent upon primary insured for support. Legally adopted children and step children are eligible for family coverage. y marriage, age 21, or when they are no longer dependent on primary insured if not living with the primary insured. y Coverage on mentally or physically incapacitated children may continue even longer. Coverage on full-time students may continue to age 25. y Guaranteed renewable until insured is 65 or eligible for Medicare due to age, as long as premiums are paid on time. 1 ICP MPB Liberty National Life Insurance Company. All rights reserved. LNL

2 BENEFIT OVERVIEW There is no maximum limit for total benefits paid on this policy. Coverage can be purchased in one or two units. Benefits : 1 Unit 2 Units Daily Intensive Care $ 500 $ 1,000 y Per day up to 30 days for each ICU confinement (other than automobile and travel accidents) beginning the first day for accidental bodily injury and the second day for sickness. y Benefits are limited to payment for a total of 30 days for each period of hospital confinement in an intensive care unit. y If less than 30 days separates two periods of hospital confinement for which benefits are payable under this policy, then for the purpose of calculating daily benefits, the second period of hospital confinement is considered a continuation of the prior period. y Periods of hospital confinement in an ICU resulting from different and unrelated causes are considered separate periods of hospital confinement. Automobile and Travel Accident $ 500 $1,000 y Policy pays an additional daily benefit of $500 per unit of coverage if: Benefits are payable under the Daily ICU Benefit; and If a covered person s initial ICU confinement is for treatment of an accidental bodily injury resulting from an automobile or travel accident. y Benefit pays only if initial ICU confinement begins within 48 hours of the automobile or travel accident. y Benefit is payable for the same number of days as the initial ICU confinement. y Subsequent confinements for the same automobile or travel accident are paid only under the Daily ICU Benefit. For example, (based on 1 unit) if a person is confined to the ICU as a result of an automobile or travel accident, and the confinement is within 48 hours of the automobile or travel accident, they receive a $500 daily benefit per unit of coverage under the Automobile and Travel Accident Benefit in addition to the benefit amount to which they are entitled under the Daily ICU Benefit. Regular Hospital Room $ 100 $ 200 Per day for confinement in a regular hospital room up to the same number of covered days of ICU confinement. For example, (based on 2 units) if a person is in ICU for two covered days, they receive $200 per day for up to two days of regular room confinement occurring during the same hospitalization. Blood $ 100 $ 200 For whole blood or blood components administered during a hospital stay involving an ICU confinement. Ambulance $ 100 $ 200 For a professional ambulance or air ambulance when a covered insured is transported to the hospital for an ICU confinement. Hospital admission involving the ICU confinement must begin within 12 hours of transport. LIMITATIONS, EXCLUSIONS, AND EXCEPTIONS No benefit is paid for medical treatment: y Caused by mental or emotional disorders. y Resulting from war or act of war. y Involving preexisting conditions for two years after the effective date of the policy. y For which no charge is normally made in the absence of insurance, except for U.S. government hospitals, Medicare, Medicaid, and Champus. y For the first day of confinement in an ICU due to sickness. y Occurring or beginning within the first 30 days of life for children born within ten months of the effective date of the policy. 2 ICP MPB LNL

3 REPLACEMENTS A replacement occurs when new accident or health insurance is purchased and existing accident or health insurance is terminated (lapsed, surrendered, etc); or amended to reduce benefits or shorten the term of coverage. When a replacement occurs, the replacement question on the application must be answered Yes. The number of the policy you are replacing must be written next to the replacement question. If accident or health replacement forms are required in your state, the appropriate form should be completed and attached to the application. Replacement of existing Torchmark Corporation subsidiary policies is not allowed. Torchmark subsidiaries include: American Income Life Insurance Company, Family Heritage Life Insurance Company, First United American Life Insurance Company, Globe Life And Accident Insurance Company, Liberty National Life Insurance Company, National Income Life Insurance Company, and United American Insurance Company. MAILING ADDRESS Paper Application and Home Office Verification Sheet Liberty National Life Insurance Company Attn: New Business 100 Concourse Pkwy., Ste. 350 Hoover, AL SUPPLIES AND TOOLS MUST BE RETURNED TO THE HOME OFFICE Application A-272 Replacement Notice Arbitration Agreement ^ (AL & MS) R-3423 Bank Draft Authorization R-3616 or Payroll Deduction Form (for worksite sales) R-3231 R-3637 Home Office Verification Sheet Agent Certification (FL Only) H-100-Z ^ Spanish Version Available AVAILABLE FOR THE CONSUMER Laptop Sales Presentation eapp (availability varies by state) Product Brochure Outline of Coverage (requirement varies by state) (must be left with applicant) AVAILABLE FOR AGENT TRAINING Agent s Instruction Guide Marketplace Bulletin Agent Training PowerPoint (available on Laptop on Demand) Worksite Advantage Agent Reference Guide R-3631 Sample Policy State Guide to Brochures Rate Cards R-3714 (individual) R-3715 (worksite) 3 ICP MPB LNL

4 STATE APPROVAL & REQUIRED FORMS CHART Application Brochure INTENSIVE CARE PROTECTOR Outline of Coverage Replacement Notice State Specific Policy Exceptions Alabama A272AL (0313) R-3713-K H173 Alaska Arizona A272 (0813) R-3713-F Arkansas California Colorado Connecticut Delaware District of Columbia Florida A272IC (1211) R-3713-G H173FL R Children covered to age 25 instead of 21. Agent Certification H-100-Z must be signed by applicant and returned with application. Georgia Hawaii Idaho A272 (0813) R-3713-A H173ID R-3650-B marriage, age 25, or when they are no longer dependent on the insured. Newborns covered from birth. Illinois A272 (0813) R-3713 H173IL R-3650 Indiana A272 (0813) R-3713-H R-3650 Children covered to age 24 instead of 21. Iowa A272 (0813) R-3713 R-3650 Kansas A272KS (1109) R-3713-F H173KS Kentucky Louisiana Maine Maryland Massachusetts Michigan A272 (0813) R-3713-E Newborns covered from birth. Minnesota Mississippi A272 (0813) R-3713-K H173MS Missouri Montana Montana has a state special Marketplace Bulletin Nebraska A272 (0813) R-3713 Nevada Neveda has a state special Marketplace Bulletin New Hampshire New Jersey New Mexico A272 (0813) R-3713-B marriage, age 25, or when they are no longer dependent on the insured if not living with the insured. New York North Carolina A272NC (0714) R-3713 H173NC Children covered at birth. North Dakota Ohio A272OH (0313) R-3713 H173OH Oklahoma A272OK (0313) R-3713 H173OK R-3650 Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas A272 (0813) R-3713 H173TX R-3650 Payments may be made to Texas Department of Human Services if policyholder has Medicare Expenses. Grandchildren coverage included. Children of the insured s children are covered if those children are insured s dependents for tax purposes. Not Required CONTINUED 4 ICP MPB LNL

5 Application Brochure INTENSIVE CARE PROTECTOR Outline of Coverage Replacement Notice Utah A272UT (0813) R-3713-C H173UT R-3650 Vermont Virginia Washington West Virginia A272 (0813) R-3713 H173WV R-3650 Wisconsin Wyoming A272 (0813) R-3713-D Not Required State Specific Policy Exceptions marriage, age 26, or when they are no longer dependent on the insured. 5 ICP MPB LNL