Disability Benefit Summary

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1 Taahassee Commuity Coege Disabiity Beefit Summary Group Number: About Your Beefits: You probaby have isurace for your car or home, but what about the source of icome that pays for it? You rey o your paycheck for so may thigs, but what if you were suddey uabe to work due to a accidet or iess? How wi you put food o the tabe, pay your mortgage or heat your home? Disabiity isurace ca hep repace ost icome ad make a difficut time a itte easier. Protect your most vauabe asset, your paycheck-ero today! What Your Beefits Cover:. Coverage amout Maximum paymet period: Maximum egth of time you ca receive disabiity beefits. Short-Term Disabiity 60% of saary to maximum $1000/week 12 weeks Log-Term Disabiity 60% of saary to maximum $10000/moth Socia Security Norma Retiremet Age Accidet beefits begi: Theegthoftimeyoumustbe disabed before beefits begi. Iess beefits begi: Theegthoftimeyoumustbedisabed before beefits begi. Day 8 Day 91 Day 8 Day 91 Evidece of Isurabiity: A heath statemet requirig you to aswer a few medica history questios. Guaratee Issue: The guaratee meas you are ot required to aswer heath questios to quaify for coverage up to ad icudig the specified amout, whe appicat sigs up for coverage durig the iitia eromet period. Miimum work hours/week: Miimum umber of hours you must reguary work each week to be eigibe for coverage. Heath Statemet may be required We Guaratee Issue $1000 i coverage Pahoder Determies Heath Statemet may be required We Guaratee Issue $10000 i coverage Pahoder Determies Pre-existig coditios: Apre-existigcoditioicudesay coditio/symptom for which you, i the specified time period prior to coverage i this pa, cosuted with a physicia, received treatmet, or took prescribed drugs. 3 moths ook back; 12 moths after 2 week imitatio 3 moths ook back; 12 moths after excusio Premium waived if disabed: Premium wi ot eed to be paid whe you are receivig beefits. Survivor beefit: Additioa beefit payabe to your famiy if you die whie disabed. Yes No Yes 3 moths UNDERSTANDING YOUR BENEFITS DISABILITY (Some iformatio may vary by state) Disabiity (og-term): For first two years of disabiity, you wi receive beefit paymets whie you are uabe to work i your ow occupatio. After two years, you wi cotiue to receive beefits if you caot work i ay occupatio based o traiig, experiece ad educatio. Beefit iformatio iustrated withi this materia refects the pa covered by Guardia as of 08/15/2018 Taahassee Commuity Coege A Others Beefit Summary The Guardia Life Isurace Compay of America, 7 Haover Square, New York, NY

2 Earigs defiitio: Your covered saary excudes bouses ad commissios. Specia imitatios: Provides a 24-moth beefit imit for meta heath ad substace abuse. Work icetive: Pa beefit wi ot be reduced for a specified amout of moths so that you have part-time earigs whie you remai disabed, uess the combied beefit ad earigs exceed 100% of your previous earigs. Taahassee Commuity Coege A Others Beefit Summary The Guardia Life Isurace Compay of America, 7 Haover Square, New York, NY

3 Disabiity Cost Iustratio: To determie the most appropriate eve of coverage, you shoud cosider your curret basic mothy expeses. To hep you assess your eeds, you ca aso go to Guardia Aytime ad view a video: Short-Term Disabiity Pa Mothy Cost Iustratio: Poicy amouts show based o sampe saary amouts oy. Your premium rate $0.590 $20,000 Aua Saary $231 Weeky Beefit $13.63 Deductio $30,000 Aua Saary $346 Weeky Beefit $20.41 Deductio $40,000 Aua Saary $462 Weeky Beefit $27.26 Deductio $50,000 Aua Saary $577 Weeky Beefit $34.04 Deductio $60,000 Aua Saary $692 Weeky Beefit $40.83 Deductio $70,000 Aua Saary $808 Weeky Beefit $47.67 Deductio $80,000 Aua Saary $923 Weeky Beefit $54.46 Deductio $90,000 Aua Saary $1,000 Weeky Beefit $59.00 Deductio $100,000 Aua Saary $1,000 Weeky Beefit $59.00 Deductio $110,000 Aua Saary $1,000 Weeky Beefit $59.00 Deductio $120,000 Aua Saary $1,000 Weeky Beefit $59.00 Deductio Log-Term Disabiity Pa Mothy Cost Iustratio: Poicy amouts show based o sampe saary amouts oy. Your premium rate $0.710 $20,000 Aua Saary $1,000 Mothy Beefit $11.84 Deductio $30,000 Aua Saary $1,500 Mothy Beefit $17.75 Deductio $40,000 Aua Saary $2,000 Mothy Beefit $23.66 Deductio $50,000 Aua Saary $2,500 Mothy Beefit $29.59 Deductio Taahassee Commuity Coege A Others Beefit Summary The Guardia Life Isurace Compay of America, 7 Haover Square, New York, NY

4 $60,000 Aua Saary $3,000 Mothy Beefit $35.50 Deductio $70,000 Aua Saary $3,500 Mothy Beefit $41.41 Deductio $80,000 Aua Saary $4,000 Mothy Beefit $47.34 Deductio $90,000 Aua Saary $4,500 Mothy Beefit $53.25 Deductio $100,000 Aua Saary $5,000 Mothy Beefit $59.16 Deductio $110,000 Aua Saary $5,500 Mothy Beefit $65.09 Deductio $120,000 Aua Saary $6,000 Mothy Beefit $71.00 Deductio Maage Your Beefits: Go to to access secure iformatio about your Guardia beefits. Your o-ie accout wi be set up withi 30 days after your pa effective date. Need Assistace? Ca the Guardia Hepie (888) , weekdays, 8:00 AM to 8:30 PM, EST. Refer to your member ID (socia security umber) ad your pa umber: A SUMMARY OF DISABILITY PLAN LIMITATIONS AND EXCLUSIONS Evidece of Isurabiity is required o a ate eroees. This coverage wi ot be effective uti approved by a Guardia uderwriter. This proposa is hedged subject to satisfactory fiacia evauatio. Pease refer to certificate of coverage for fu pa descriptio. Youmustbeworkigfu-timeotheeffectivedateofyourcoverage; otherwise, your coverage becomes effective after you have competed a specific waitig period. Empoyees must be egay workig i the Uited States i order to be eigibe for coverage. Uderwritig must approve coverage for empoyees o temporary assigmet: (a) exceedig oe year; or (b) i a area uder trave warig by the US Departmet of State. Subject to state specific variatios. For Log-Term Disabiity coverage, we pay o beefits for a disabiity caused or cotributed to by a pre-existig coditio uess the disabiity starts after you have bee isured uder this pa for a specified period of time. We imit the duratio of paymets for og term disabiities caused by meta or emotioa coditios, or acoho or drug abuse. For Short-Term Disabiity coverage, beefits for a disabiity caused or cotributed to by a pre-existig coditio are imited, uess the disabiity starts after you have bee isured uder this pa for a specified period of time. We do ot pay short term disabiity beefits for ay job-reated or o-the-job ijury, or coditios for which Workers' Compesatio beefits are payabe. We do ot pay beefits for charges reatig to a covered perso: takig part i ay war or act of war (icudig service i the armed forces) committig a feoy or takig part i ay riot or other civi disorder or itetioay ijurig themseves or attemptig suicide whie sae or isae. We do ot pay beefits for charges reatig to ega itoxicatio, icudig but ot imited to the operatio of a motor vehice, ad for the voutary use of ay poiso, chemica, prescriptio or o-prescriptio drug or cotroed substace uess it has bee prescribed by a doctor ad is used as prescribed. We imit the duratio of paymets for og term disabiities caused by meta or emotioa coditios, or acoho or drug abuse. We do ot pay beefits durig ay period i which a covered perso is cofied to a correctioa faciity, a empoyee is ot uder the care of a doctor, a empoyee is receivig treatmet outside of the US or Caada, ad the empoyee s oss of earigs is ot soey due to disabiity. This poicy provides disabiity icome isurace oy. It does ot provide "basic hospita", "basic medica", or "medica" isurace as defied by the New York State Isurace Departmet. If this pa is trasferred from aother isurace carrier, the time a isured is covered uder that pa wi cout toward satisfyig Guardia's pre-existig coditio imitatio period. State variatios may appy. Whe appicabe, this coverage wi itegrate with NJ TDB, NY DBL, CA SDI, RI TDI, Hawaii TDI ad Puerto Rico DBA. Cotract #.s GP-1-STD et a; GP-1-STD2K-1.0 et a; GP-1-STD et a; GP-1-STD et a. Cotract #.s GP-1-LTD94-A,B,C-1.0 et a.; GP-1-LTD2K-1.0 et a; GP-1-LTD et a; GP-1-LTD et a. This documet is a summary of the major features of the refereced isurace coverage. It is iteded for iustrative purposes oy ad does ot costitute a cotract. The isurace pa documets, icudig the poicy ad certificate, comprise the cotract for coverage. The fu pa descriptio, icudig the beefits ad a terms, imitatios ad excusios that appy wi be cotaied i your isurace certificate. The pa documets are the fia arbiter of coverage. Coverage terms may vary by state ad actua sod pa. The premium amouts refected i this summary are a approximatio; if there is a discrepacy betwee this amout ad the premium actuay bied, the atter prevais. Taahassee Commuity Coege A Others Beefit Summary The Guardia Life Isurace Compay of America, 7 Haover Square, New York, NY

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