Market Review Example
DESIGNED FOR
Company Logo Here
123 Main Street
Chicago, Il 60604
PROPOSAL PREPARED BY: Aris Group
www.AG-Benefits.com
Aris Group - OH
7862 Kingland Dr. Suite 100
West Chester, OH 45069
(513) 373-4145
This statement serves as an acknowledgement that the client has been made aware of the following:
This benefit comparison is for illustration purposes only, is not complete, and is to be an initial step in the
client’s market review process. Please see product brochures and/or policies for a complete description of all
benefits, definitions, rates, and exclusions.
Table of Contents
Page Number
Carrier Recommendations
3
Carrier Examination
4
Service Model
5
Accident Plan
6 – 13
Short-Term Disability
14 - 15
Critical Illness Plan (Lump Sum)
16 – 21
Life Insurance – Term Coverage
22 - 24
Page 2
RECOMMENDATION S
PROPOSED
SOLUTIONS
sS
Our recommendations are based on our analysis of your current
benefits and the objective of potentially lowering rates of
voluntary coverage for employees while increasing overall
participation. We’ve identified the carrier(s) and specific
products below. We feel these new benefits will compliment
your existing medical plan design(s) based on the demographics
of your employees. You will find a detailed overview of each
product, located on the pages that follow.
Carrier Logo
Here
Carrier Logo
Here
Accident
Critical Illness (Lump Sum)
Short-Term Disability
Life Insurance
The Aris Group has designed the following policies
to give the employees best in class options.
With a high priority on increasing benefits we were
also mindful of containing premiums for employees.
RATE SUMMARY
See attached for Detailed Rate information
Page 3
HOW DO WE FIND THE CORRECT
-CARRIER -PRODUCT -PRICE -ENROLLMENT SOLUTION -SERVICE MODEL
EXPERIENCE
The Aris Group is a team of 10 to 25 yr. veteran field agents and managers
Market Review
Enrollment Solutions
Carrier’s are rated based on a specific list of criteria:
Veteran agents help you customize the most
-Strength of products (benefit/cost)
-Online Capabilities
-Underwriting
-Ease of Doing Business
Our carrier agnostic evaluation optimizes our ability
to deliver the best worksite benefits experience
suitable employee education solutions with:
-1 on 1 meetings
-Group Presentations
-Online enrollments
-Call Center
Traditional and ‘outside the box’ solutions!
DUE DILIGENCE COMPLETE
Post Enrollment Support
Claim Support
Aris Group’s top priority
CSR’s handle claims A-Z
Billing Support
Aris Group CSR’s ensure:
-Policy’s are issued correctly
-Bills are reconciled correctly
When It Comes To Service……..
Be Sure To ‘Look Under The Hood’
The Aris Group invests in the time and resources necessary to administer worksite benefits the right way.
Client Services:
Our mission is to provide our clients with the consultative delivery of the correct carrier, product, and enrollment
solutions. In addition, we place a strong emphasis on delivering the post enrollment support necessary for a successful
worksite benefits experience.
Consultation
The Aris Group specializes, only, in voluntary/worksite benefits.
- We examine as many carriers as possible to ensure we can provide solutions on a case by case basis.
- Minor & major differences, with each carrier & product, contribute to the success of the worksite benefits
experience
o Our focus on worksite benefits, along with our experience, makes us highly proficient in identifying the
correct carrier and product
Enrollment Communication
Each client is different & a successful enrollment requires careful consideration.
- Our team of worksite benefit veterans will identify the optimal enrollment solution, specific to each client
- We can also provide communication services for a client’s core health benefits
Administration
A limited number of firms in the country provide the level of post enrollment support provided by the Aris Group
- Aris Group Customer Service Representatives (CSR’s) help employees through the claim process
▪ Worksite products can sometimes be ‘maintenance heavy’ at the time of claim
▪ Each carrier & product’s specific claim processing protocol requires careful consideration:
✓
✓
✓
✓
Where do I get the claim form
Did I fill out the claim form correctly
Do I need to include medical records
Where/how do I obtain those medical records
✓
✓
✓
Where do I send the claim form & medical records
Were the medical records & claim forms received
Is there additional info. needed by the carrier
Aris Group CSR’s work with the policy holder, through this process, from start to finish
-
Aris Group can create a customized website designed for each client (includes: claim instruction & contact info)
Aris Group CSR’s also support pre-enrollment case setup and post enrollment billing oversight
o Our goal is to minimize the burden of the client’s HR team
Built from a team of worksite veterans
With a belief in the product and a genuine care and concern for the policy holder
Page 5
Accident Coverage Comparison*
24hr-Coverage
Emergency Room with X-ray
X-Ray Benefit
Physician Office
Follow-up Doctor visits
Physical, Occupational or Speech Therapy
Appliances (Crutches)
Organized Sporting Benefit
Gunshot Wound
Ambulance - Ground / Air
Lacerations (Stitches)
Diagnostic – MRI, CT Scan, EEG
Broken Tooth (Crown)
Eye Injury (Surgical Repair)
Current Carrier
Option 4
$170
$30
$120
$40
$40
$120
25%
N/A
$250/$1,875
$40-$600
$250
$500
$350
Proposed Carrier
$300
$300
$150
$100
$60
$250
10%
$2,000
$300/$900
$50-$200
$150
$400
$400
Hospitalization
Initial Hospital Admission
Daily Hospital Confinement
Daily Intensive Care Confinement
Blood, Plasma, Platelets
Transportation
Lodging Benefit
$1,500
$300
$500
$300
$700
$150
$1,000
$200
$400
$900
$200
$200
Fractures (Closed Reduction)
Hip
Leg
Upper Arm, Shoulder Blade
Ankle, Kneecap and Forearm
Foot, Hand or Wrist
Nose
Fingers
$2,000
$1,000
$450
$400
$400
$450
$150
$3,600
$2,200
$2,200
$1,600
$1,400
$600
$280
Dislocation (Closed Reduction)
Hip
Knee
Ankle / Foot
Lower Jaw
Wrist or Elbow
$1,125
$450
$360
$600
$450
$4,000
$1,600
$1,600
$1,000
$1,200
Accidental Death Only
Wellness Benefit
Rates – Weekly - OH
Employee
Employee + Spouse
Employee + Children
Family
$50k / $50k / $10k
$60
1 / Family / Year
$8.13
$10.89
$12.18
$15.51
$40k / $20k / $10k
$50
2-Person / 4-Family
$3.66
$6.40
$7.66
$11.33
*This benefit comparison is for illustration purposes only, is not complete, and
is to be an initial step in the client’s market review process. Please see product
brochures and/or policies for a complete description of all benefits, definitions,
rates, and exclusions.
Page 6
Group Accident Expense Insurance
for Aris Group
Even with a good health insurance plan, a trip to the doctor or hospital can be
expensive. Many people find themselves paying more out of their own pocket
each year. If you or someone in your family are hurt in an accident, the last
thing you want to think about is how you are going to pay for medical care.
Accident expense insurance provides peace of mind and gives you additional
cash to help pay your health insurance deductible and other expenses.
Group Accident Expense insurance pays a benefit directly to you when you
Know you
and your family
are protected.
It's easy —
sign up today
receive treatment from a physician for a covered accident.
Key Features
Helps with out-of-pocket expenses associated with covered
accidents
No deductibles, copays, coinsurance or networks - see any doctor
Guaranteed issue – no medical exams or tests
Portable – coverage continues if you retire or change jobs, as long
as you pay the premiums
Flexible - Proposal 113363
Page 7
Your Group Accident Expense Benefits (24-Hour) - Ohio
Form Nos. G H1708/G H1708C (HSA Compatible)
Plan includes the benefits listed in the schedule below for a covered accident. Coverage is 24-Hour. All treatment must be provided or
prescribed by a physician and is a payable only once per insured per accident unless otherwise noted. In most states, the term physician
does not include chiropractor or dentist. Each benefit is also subject to conditions for payments as detailed in the certificate.
Emergency Care
Payable within 60 days of accident unless otherwise noted
Initial Accident Treatment
One physician’s office, urgent care or emergency room visit per accident within 60 days of accident for doctor’s office and urgent
care; within 30 days of accident for: Physician's Office - $150; Urgent Care - $150; Emergency Room - $300
Telemedicine Treatment
$60
Ambulance
Transport to or from hospital; pays one of the of the following: Ground - $300; Air - $900
X-Rays
$300
Diagnostic Exams
CT, CAT, MRI or EEG - $150
Blood, Plasma or Platelets
Processing or transfusion - $900
Emergency Room Observation Unit
Held in hospital, without admission, after ER treatment: 4 to 20 hours - $75; 20 or more hours - $150
Supportive Care
Benefits in this category only payable if Initial Accident Treatment or Telemedicine Treatment benefit was paid for same injury.
Follow-Up Treatment
Pays $100 per visit, up to 2 visits per accident.
Physical, Occupational or Speech Therapy
Pays $60 per visit, up to 6 visits per accident.
Chiropractic/Acupuncture Treatment
Pays $60 per visit, up to 2 visits per accident.
Epidural Pain Management
Pays $100.
Prescription Medication
Other than while confined in hospital or nursing home; pays $10 up to two per accident; up to six per calendar year.
Medical Supplies
Over-the-counter; pays $10 once per accident; up to three per calendar year.
Appliances
Rented or purchased, such as crutches or wheelchair; pays $250.
Prosthetic Devices
Not including hearing or dental aids, eyeglassesor cosmetic devices; pays $1,000 for one device or $2,000 for mulitple devices.
Residence/Vehicle Modification
Pays $1,000.
Transportation
For physician treatment 50 or more miles from residence; up to three round trips per accident; pays $200 per trip for ground
transportation or $500 for air transportation.
Lodging
For companion accompanying an insured traveling more than 100 miles from residence for treatment; up to 30 days per
accident; pays $200 per day.
Proposal 113363
GROUP ACCIDENT EXPENSE INSURANCE PROVIDES LIMITED BENEFIT COVERAGE AND MAY CONTAIN REDUCTIONS OF BENEFITS, LIMITATIONS AND
EXCLUSIONS. The description of benefits is intended only to highlight the insured employee’s benefits and should not be relied upon to fully determine
coverage. If this description conflicts in any way with the terms of the policy/certificate, the terms of the policy/ certificate prevail. For complete benefits
descriptions and conditions, see the policy/certificate.
Page 8
Your Group Accident Expense Benefits (24-Hour) - Ohio
Form Nos. G H1708/G H1708C (HSA Compatible)
Plan includes the benefits listed in the schedule below for a covered accident. Coverage is 24-Hour. All treatment must be provided or
prescribed by a physician and is a payable only once per insured per accident unless otherwise noted. In most states, the term physician
does not include chiropractor or dentist. Each benefit is also subject to conditions for payments as detailed in the certificate.
Specific Injury Care
Burns
Pays a percentage of the $2,000 burn benefit, where the percentage payable is based on degree of burn and percentage of
body affected.
Burns — Skin Graft - Pays 50 percent of the burn benefit.
Child Organized Sport
Pays 10 percent of all other payable benefits resulting from injury of dependent child during amateur organized athletic
competition or supervised practice for such; up to $1,000 maximum.
Coma
Not medically induced or the result of drug or alcohol use - pays $40,000.
Concussion
Pays $100; not payable if traumatic brain injury benefit is paid.
Dental Emergency
Natural tooth treatment provided by a dentist - pays $400 for dental crown; pays $120 for dental extraction.
Dislocation
Pays a percentage of the $8,000 benefit for open reduction or the $4,000 benefit for closed reduction, where the percentage
payable is based on the joint or bone affected and degree of dislocation.
Ear Injury
Resulting in hearing loss greater than 60 percent; pays $400 once per lifetime.
Eye Injury
Requiring surgery or removal of foreign object; pays $400.
Fracture
Pays a percentage of the $8,000 benefit for open reduction or the $4,000 benefit for closed reduction, where the percentage
payable is based on the joint or bone affected.
Gunshot Wound
Requiring hospitalization and surgery; pays $2,000.
Lacerations
Pays a percentage of the $200 laceration benefit, where the percentage payable is based on the length of laceration.
Occupational HIV
Pays $1,200 on diagnosis.
Paralysis
Lasting 90 or more days and diagnosed to be permanent; one paralysis benefit payable per lifetime; pays $60,000 for
quadriplegia or $30,000 for paraplegia.
Poisoning
Pays $100.
Post-Traumatic Stress Disorder
Pays $800.
Traumatic Brain Injury
Diagnosed by CT, CAT, MRI, EEG, PET or X-Ray; pays $1,200.
Proposal 113363
GROUP ACCIDENT EXPENSE INSURANCE PROVIDES LIMITED BENEFIT COVERAGE AND MAY CONTAIN REDUCTIONS OF BENEFITS, LIMITATIONS AND
EXCLUSIONS. The description of benefits is intended only to highlight the insured employee’s benefits and should not be relied upon to fully determine
coverage. If this description conflicts in any way with the terms of the policy/certificate, the terms of the policy/ certificate prevail. For complete benefits
descriptions and conditions, see the policy/certificate.
Page 9
Your Group Accident Expense Benefits (24-Hour) - Ohio
Form Nos. G H1708/G H1708C (HSA Compatible)
Plan includes the benefits listed in the schedule below for a covered accident. Coverage is 24-Hour. All treatment must be provided or
prescribed by a physician and is a payable only once per insured per accident unless otherwise noted. In most states, the term physician
does not include chiropractor or dentist. Each benefit is also subject to conditions for payments as detailed in the certificate.
Hospital Care
Daily benefits paid within 180 days of accident
Hospital Admission
Pays $1,000 once per calendar year.
Hospital Confinement
Pays $200 per day, up to 365 days per accident.
Intensive Care
Pays $400 per day, up to 30 days per accident.
Sub-Acute Intensive Care
Pays $300 per day, up to 30 days per accident.
Rehabilitation Unit
Pays $200 per day, up to 30 days per accident; 60 days per calendar year.
Child Care during Hospital Confinement
Pays $40 per day for care of all dependent children by licensed provider while insured is confined to hospital; up to 30 days per
accident.
Surgical Care
Paid within 180 days of accident
Open Abdominal, Thoracic or Cranial Surgery
Not including hernia; pays $1,000.
Tendon, Ligament, Rotator Cuff or Knee Cartilage Surgery
Pays $500.
Ruptured Disc Surgery
Pays $500.
Hernia Surgery
Pays $250.
Exploratory Surgery
Diagnostic arthroscopic or laparoscopic; pays $250; not payable if any other surgery benefit is paid.
Miscellaneous Outpatient Surgery
Must require anesthesia; pays $100; not payable if any other surgery benefit is paid.
Anesthesia
Administered for a payable surgery benefit; pays $100.
Preventive Care Rider
(Form No. R G1723C)
Pays $50 once per day, up to two times per insured per calendar year, subject to a maximum of four times for all insured persons
per calendar year, for the following screenings or exams:
● Blood screening for triglycerides, cholesterol, HDL, LDL or fasting blood glucose
● Annual physical exam
● Routine eye exam
● Immunization
Proposal 113363
GROUP ACCIDENT EXPENSE INSURANCE PROVIDES LIMITED BENEFIT COVERAGE AND MAY CONTAIN REDUCTIONS OF BENEFITS, LIMITATIONS AND
EXCLUSIONS. The description of benefits is intended only to highlight the insured employee’s benefits and should not be relied upon to fully determine
coverage. If this description conflicts in any way with the terms of the policy/certificate, the terms of the policy/ certificate prevail. For complete benefits
descriptions and conditions, see the policy/certificate.
Page 10
Your Group Accident Expense Benefits (24-Hour) - Ohio
Form Nos. G H1708/G H1708C (HSA Compatible)
Plan includes the benefits listed in the schedule below for a covered accident. Coverage is 24-Hour. All treatment must be provided or
prescribed by a physician and is a payable only once per insured per accident unless otherwise noted. In most states, the term physician
does not include chiropractor or dentist. Each benefit is also subject to conditions for payments as detailed in the certificate.
Accidental Death and Dismemberment Rider
Form R G1712C
Accidental Death Benefit
Pays $40,000 for employee, $20,000 for insured spouse and $10,000 for insured child; not payable if Accidental Death-Common
Carrier benefit is paid.
Accidental Death Seatbelt Benefit
Additional death benefit if seatbelt in use; pays $10,000 for employee, $5,000 for insured spouse and $2,500 for insured child.
Accidental Death - Common Carrier Benefit
If fare-paying passenger on common carrier; $100,000 for employee, $50,000 for insured spouse and $25,000 for insured child.
Accidental Death - Children Education Benefit
Additional benefit for dependent children enrolled in post-secondary educational institution; pays $1,000 per accidental death, per
qualifying dependent child.
Accidental Dismemberment Benefit
Pays a percentage of $40,000 for employee, $20,000 for insured spouse and $10,000 for insured child, where the percentage
varies by body part.
Proposal 113363
GROUP ACCIDENT EXPENSE INSURANCE PROVIDES LIMITED BENEFIT COVERAGE AND MAY CONTAIN REDUCTIONS OF BENEFITS, LIMITATIONS AND
EXCLUSIONS. The description of benefits is intended only to highlight the insured employee’s benefits and should not be relied upon to fully determine
coverage. If this description conflicts in any way with the terms of the policy/certificate, the terms of the policy/ certificate prevail. For complete benefits
descriptions and conditions, see the policy/certificate.
Page 11
$3.66 Weekly Premiums
$6.40- Ohio
Group Accident Expense
$0.00
$0.00
All Ages
$0.00
$0.00Tier
Coverage
$7.66
$11.33
$0.00
$0.00
$0.00
$0.00
$0.00
Employee
$0.00
Employee
and Spouse
$0.00
Employee
and Children
$0.00
Family
$3.66
$6.40
$7.66
$11.33
Proposal 113363
*Premium rates shown are for the combined group Accident Expense policy and rider benefits as summarized in the proposal. For complete benefit
descriptions, limitations, conditions and exclusions, see the policy/certificate. Policy availability, features, provisions and rates may vary by state.
Page 12
Group Accident Expense - Ohio
Form G H1708/G H1708C
Limitations, Conditions and Exclusions
The following represents some policy limitations, conditions and exclusions. For complete details of the coverage, please contact
your agent, Assurity or ask to review the policy. Provisions may vary by state.
Limitations
GROUP ACCIDENT EXPENSE INSURANCE PROVIDES LIMITED BENEFIT COVERAGE.
This insurance does not provide major medical coverage and does not satisfy the requirement for minimum essential coverage
under the Affordable Care Act (ACA).
Availability of this product, and its benefits and premiums as presented, is subject to the approval of Assurity. Some applicants with
pre-existing conditions may not be eligible for coverage. Product availability, features and rates may vary by state. All benefits,
premiums, conditions, exclusions and limitations are governed by the actual contract as provided by Assurity, not this proposal.
Coverage Conditions
Actively Employed – The employee must be actively employed to be eligible for coverage.
Right to Cancel – The contract contains a 30-day free look period.
Termination – Coverage will terminate the earliest of the following: the date policy terminates for any reason; the date employee is
no longer an employee (portability available); when premiums are not paid by the end of the grace period; the date Assurity
receives written notice to terminate; when the employee establishes residence in a foreign country; or upon the employee's death.
Exclusions
Assurity will not pay benefits for losses caused by or the result of any Insured Person(s):
● operating, learning to operate, or serving as a crew member of any aircraft;
● engaging in hang-gliding, hot air ballooning, bungee jumping, parachuting, scuba diving, sail gliding, parasailing, parakiting,
mountain or rock climbing, B.A.S.E. jumping, sky diving or cave diving;
● riding in or driving any motor-driven vehicle in an organized race, stunt show or speed test;
● officiating, coaching, practicing for or participating in any semi-professional or professional competitive athletic contest for which
any type of compensation or remuneration is received;
● having a sickness independent of the Covered Accident, including physical or mental infirmity (sickness means any illness,
inflection, disease or any other abnormal physical condition which is not caused by an Injury);
● being exposed to war or any act of war, declared or undeclared;
● actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Army Reserve, except during
active duty training of less than 60 days;
● suffering from a Mental and Nervous Disorder (except for Post-Traumatic Stress Disorder as described in the policy/certificate);
● being addicted to drugs or suffering from alcoholism;
● being under the influence of an excitant, depressant, hallucinogen, narcotic, or any other drug or intoxicant, including those
prescribed by a Physician that are misused;
● being intoxicated (as determined by the laws governing the operation of motor vehicles in the jurisdiction where loss occurs) or
under the influence of an illegal substance or a narcotic (except for narcotics used as prescribed to the Insured Person by a
Physician);
● having cosmetic surgery or other elective procedures that are not medically necessary;
● having a hernia, except as paid under the Hernia Surgery Benefit, if applicable;
● committing or attempting to commit a felony;
● participating in a riot, insurrection or rebellion;
● driving any taxi for wage, compensation or profit;
● engaging in an illegal occupation;
● intentionally self-inflicting an injury; or
● committing or attempting to commit suicide, while sane or insane.
No benefits, except the Initial Accident Treatment benefit, will be payable for services provided outside of the United States.
Proposal 113363
Page 13
Short-Term Disability Comparisons*
With one of the most important products in our portfolio – it’s important that we offer the most competitive product
available. Employees truly see the value when we take over an existing disability product. Some employees see $300 +
savings on their disability product alone!
General Disability Comparison:
Annual Income:
Monthly Benefit:
$23,400
$1,300
0 – Day Accident Elimination
7 – Day Sickness Elimination
6 Month Benefit Period
Weekly Rates
Carrier A
Carrier B
Carrier C
Carrier D
Carrier E
Carrier F
Annual Income
$23,400
$23,400
$23,400
$23,400
$23,400
$23,400
Weekly Benefit
$300
$300
$300
$300
$300
$300
Monthly Benefit
$1,300
$1,300
$1,300
$1,300
$1,300
$1,300
<-30
$11.70
$11.10
$9.90
$14.44
$6.63
$4.59
30-44
$11.70
$11.10
$9.90
$14.44
$6.87
$4.76
45-49
$11.70
$11.10
$9.90
$14.44
$7.92
$5.50
50-54
$14.04
$14.40
$11.61
$18.95
$9.48
$6.57
55-59
$14.04
$14.40
$11.61
$18.95
$11.19
$7.76
60-64
$14.04
$14.40
$14.43
$22.21
$13.08
$9.06
65-69
$17.55
$14.40
$14.43
$23.12
N/A
$11.95
70-74
$17.55
N/A
$15.65
$26.31
N/A
$16.26
75 +
N/A
N/A
$15.65
$26.31
N/A
$20.28
*Rate Comparisons are a general example and specific industries may have a different classification rating
*This benefit comparison is for illustration purposes only, is not complete, and
is to be an initial step in the client’s market review process. Please see product
brochures and/or policies for a complete description of all benefits, definitions,
rates, and exclusions.
Page 14
Short-Term Disability
Voluntary Short-Term Disability Income coverage from Carrier Name gives your employees the peace
of mind that a protected paycheck brings. A program designed to help maintain a family's current
lifestyle and their plans for the future if the employee becomes disabled as a result of a nonoccupational accident or illness. A plan with the flexibility to meet an employee's individual needs.
Carrier Name
0 Day for Accident - 7 Days for Sickness
6 Month Benefit
Weekly Rates
Annual
Income
Weekly
Benefit
$19,500
$23,400
$27,300
$31,200
$35,000
$39,000
$42,900
$46,800
$50,700
$54,600
$250
$300
$350
$400
$450
$500
$550
$600
$650
$700
<-30
$3.83
$4.59
$5.36
$6.12
$6.89
$7.65
$8.42
$9.18
$9.95
$10.71
30-44
$3.97
$4.76
$5.56
$6.35
$7.14
$7.94
$8.73
$9.53
$10.32
$11.11
45-49
$4.58
$5.50
$6.41
$7.33
$8.25
$9.16
$10.08
$10.99
$11.91
$12.83
50-54
$5.48
$6.57
$7.67
$8.76
$9.86
$10.95
$12.05
$13.14
$14.24
$15.33
55-59
$6.47
$7.76
$9.06
$10.35
$11.64
$12.93
$14.23
$15.52
$16.82
$18.11
60-64
$7.55
$9.06
$10.57
$12.08
$13.59
$15.10
$16.62
$18.12
$19.64
$21.15
65-69
$9.96
$11.95
$13.94
$15.93
$17.92
$19.92
$21.91
$23.90
$25.89
$27.88
70-74
$13.55
$16.26
$18.96
$21.67
$24.38
$27.09
$29.80
$32.51
$35.22
$37.93
75 +
$16.90
$20.28
$23.66
$27.04
$30.42
$33.80
$37.18
$40.56
$43.94
$47.31
$58,500
$62,400
$66,300
$70,200
$74,100
$78,000
$81,900
$85,800
$89,700
$93,600
$750
$800
$850
$900
$950
$1,000
$1,050
$1,100
$1,150
$1,200
<-30
$11.48
$12.24
$13.01
$13.77
$14.54
$15.30
$16.07
$16.83
$17.60
$18.36
30-44
$11.91
$12.70
$13.50
$14.29
$15.08
$15.88
$16.67
$17.46
$18.26
$19.05
45-49
$13.74
$14.66
$15.57
$16.49
$17.41
$18.32
$19.24
$20.16
$21.07
$21.99
50-54
$16.43
$17.52
$18.62
$19.71
$20.81
$21.90
$23.00
$24.09
$25.19
$26.28
55-59
$19.40
$20.70
$21.99
$23.28
$24.58
$26.10
$27.16
$28.46
$29.75
$31.04
60-64
$22.66
$24.17
$25.68
$27.19
$28.70
$30.21
$31.72
$33.23
$34.74
$36.25
65-69
$29.87
$31.86
$33.86
$35.85
$37.84
$39.83
$41.82
$43.81
$45.81
$47.80
70-74
$40.64
$43.35
$46.06
$48.77
$51.48
$54.18
$56.89
$59.60
$62.31
$65.02
75 +
$50.70
$54.07
$57.45
$54.60
$64.21
$67.59
$70.97
$74.35
$77.73
$81.11
Weekly Rates
Annual
Income
Weekly
Benefit
Partial Disability Benefit - This benefit supports a recovering employee's return to full potential through part-time work.
Enrollment Age Freeze - As long as an employee remains enrolled, the premium payable for the selected insurance
coverage will always be based upon the employee's age at the time of original enrollment.
$10,000 of Accidental Death and Dismemberment (AD&D) coverage included.
Page
Page20
15
Critical Illness Coverage Summary*
A lot has changed since Critical Illness insurance was introduced to the market 30 years ago. Yet, CI polices have remained
conventional and typically only cover “Major Event” like the following:
Cancer
Heart Attack
Stroke
Major Organ Transplant
End Stage Renal Failure
With an increasing number of Insurance Carriers entering the voluntary market space there has been advancements to
policy offerings. Competition forces each carrier to update or revise their current coverage to remain competitive. We
have included the most updated Critical Illness policy on the market. This new version has illnesses that are not commonly
seen in a critical Illness policy and includes benefits for minor heart procedures. This Critical Illness policy includes a return
of premium for a non-CI death.
Invasive Cancer
Heart Attack
Stroke
Major Organ Transplant
End Stage Renal Failure
Coma
Paralysis (2 or more Limbs)
Advanced Alzheimer’s Disease
Advanced Parkinson’s Disease
100%
100%
100%
100%
100%
100%
100%
100%
100%
Benign Brain Tumor
Complete Loss of Sight
Complete Loss of Hearing
Complete Loss of Speech
Occupational HIV
Advanced ALS
Severe Burns
Bone Marrow Transplant
100%
100%
100%
100%
100%
100%
100%
100%
-------------------------------------------------------------------------------------------------------Multiple Sclerosis
Mitral Valve Replacement or Repair
50%
50%
Aortic Valve Replacement or Repair
Abdominal Aortic Aneurysm
50%
50%
-------------------------------------------------------------------------------------------------------Sudden Cardiac Arrest
Coronary Artery Bypass Surgery
Carcinoma In Situ
25%
25%
25%
Pulmonary Embolism
Idiopathic Pulmonary Fibrosis
Loss of Independent Living
25%
25%
25%
-------------------------------------------------------------------------------------------------------Angioplasty
Schizophrenia
Transient Ischemic Attack (TIA)
Angio Jet Clot Busting
Atherectomy
Stent Implementation
10%
10%
10%
10%
10%
10%
Cardiac Catheterization
Implantable Cardioverter Defibrillator
Pacemaker Placement
Valvuloplasty
Skin Cancer
10%
10%
10%
10%
$250
-------------------------------------------------------------------------------------------------------Wellness Screening:
Diagnosis after age 70
Guarantee Issue Amount
$50
100%
$30,000
Re-Occurrence Benefit
Spouse Coverage
100%
50%
Return of Premium for Non-CI Death
If the primary person dies from a cause other than a defined Critical Illness, Assurity will return 100% of all premiums paid for coverage
under the policy and any applicable riders, net of benefits paid for the policy and riders.
*This benefit comparison is for illustration purposes only, is not complete, and
is to be an initial step in the client’s market review process. Please see product
brochures and/or policies for a complete description of all benefits, definitions,
rates, and exclusions.
Page 12
Page 16
Group Critical Illness Insurance
for Sample
More people are surviving life threatening illnesses than ever before.
Unfortunately the cost of critical illness care is high and medical bills can
follow survivors long after they’ve proven victorious in their fight.
Critical illness insurance provides peace of mind and gives you additional cash
to help pay your health insurance deductible and other out-of-pocket
expenses.
Group Critical Illness insurance pays a lump-sum benefit directly to you if
you are diagnosed with stroke, heart attack or a number of other covered
Know you
and your family
are protected.
It's easy —
sign up today
conditions.
Key Features
Pays a lump sum directly to you
Includes a health screening benefit which pays $50 a year for any
number of common covered medical tests or procedures
The return of premium benefit pays you back 100% of the
premiums paid for the policy and riders if you die from a cause
other than a covered critical illness
Guaranteed issue – no medical exams or tests
Portable – coverage continues if you retire or change jobs, as long
as you pay the premiums
Tier 2 - Proposal 102383
Page1714
Page
Your Group Critical Illness Benefits - Ohio
Forms G H1715/G H1715C, R G1716C (HSA Compatible)
Group Critical Illness Policy and Additional Critical Illness Rider
Assurity’s Group Critical Illness insurance pays a lump sum benefit upon diagnosis of certain specified illnesses, conditions and
procedures. The amount payable is equal to the policy benefit amount times the applicable percentage or the specified dollar
amount as shown below for the specified covered condition..
Heart Attack
100%
Coronary Artery Bypass Surgery
25%
Sudden Cardiac Arrest
25%
Angioplasty
10%
Stroke
100%
Invasive Cancer
100%
Non-Invasive Cancer
25%
Skin Cancer
$250/calendar year
Kidney (Renal) Failure
100%
Major Organ Transplant
100%
Advanced Alzheimer's Disease
100%
Loss of Independent Living
25%
Coma
100%
Paralysis
100%
Loss of Sight
100%
Loss of Speech
100%
Loss of Hearing
100%
Advanced Parkinson's Disease
100%
Benign Brain Tumor
100%
Occupational HIV
100%
Advanced ALS
100%
Severe Burns
100%
Bone Marrow Transplant
100%
Multiple Sclerosis
50%
Schizophrenia
10%
Transient lschemic Attack (TIA)
10%
Other Features
Additional Diagnosis Benefit
Once benefits have been paid for a covered critical illness, benefits are payable for each additional critical illness when the date of
diagnosis is at least 30 days apart, and if the subsequent critical illness is not caused or contributed to by a critical illness for which
benefits were paid.
Reoccurrence Diagnosis Benefit
Once benefits have been paid for a coverd critical illness, benefits are payable for that same critical illness up to one time per
insured person per lifetime, if the insured person is symptom and treatment-free for a period of 12 consecutive months, and if the
subsequent critical illness is not caused or contributed to by a critical illness for which benefits were paid.
Waiver of Premium Benefit
Waives the premium for coverage after 90 consecutive days of total disability of the covered employee, for as long as total
disability continues, if the disability is due to a critical illness for which benefits were paid.
Return of Premium for Non-CI Death
Returns 100% of all premiums paid for the policy and riders minus any benefits paid under the policy and riders, if the covered
employee dies from a cause other than a covered critical illness.
Proposal 102383
GROUP CRITICAL ILLNESS INSURANCE PROVIDES LIMITED BENEFIT COVERAGE, IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE, AND MAY NOT BE
APPROPRIATE FOR MEDICAID RECIPIENTS. It may contain reductions of benefits, limitations and exclusions. The description of benefits is intended only to
highlight the insured employee’s benefits and should not be relied upon to fully determine coverage. If this description conflicts in any way with the
terms of the policy/certificate, the terms of the policy/certificate prevail. For complete benefits descriptions and conditions, see the policy/certificate.
15
Page 18
Your Group Critical Illness Riders:
Cardiopulmonary Rider
Pays a lump sum benefit upon diagnosis of the additional covered cardiopulmonary illnesses,
conditions or procedures listed below. The amount payable is equal to the policy benefit
amount times the applicable percentage shown below.
Open Heart Category (50% all procedures below)
Mitral Valve Replacement or Repair
Surgical Treatment of Abdominal Aortic Aneurysm
Aortic Valve Replacement or Repair
Pulmonary Category (25% all procedures below)
Pulmonary Embolism
Idiopathic Pulmonary Fibrosis
Invasive Procedure Category (10% all procedures below)
AngioJet Clot Busting
Automatic Implantable Cardioverter Defibrillator
Atherectomy
Pacemaker Placement
Stent Implementation
Valvuloplasty
Cardiac Catheterization
Health Screening Rider
Pays a $50 benefit per calendar year per insured
below.
Biopsy for skin cancer
Bone marrow biopsy and aspiration
Breast ultrasound
CA 15-3 (blood test for breast cancer)
CA 19-9 (blood test for pancreatic cancer)
CA 125 (blood test for ovarian cancer)
CEA (blood test for colon and cervical cancer)
Chest X-ray
Colonoscopy
(Form No. R G1717C)
(Form No. R G1720C)
person for specified screening services listed
Flexible sigmoidoscopy
Hemocult stool analysis
Mammography
Pap smear
PSA (blood test for prostate cancer)
Serum protein electrophoresis (blood test
for Myeloma)
Stress test (bicycle or treadmill)
Thermography
Proposal 102383
GROUP CRITICAL ILLNESS INSURANCE PROVIDES LIMITED BENEFIT COVERAGE, IS NOT A SUBSTITUTE FOR MAJOR MEDICAL INSURANCE, AND MAY NOT
BE APPROPRIATE FOR MEDICAID RECIPIENTS. It may contain reductions of benefits, limitations and exclusions. The description of benefits is intended
only to highlight the insured employee’s benefits and should not be relied upon to fully determine coverage. If this description conflicts in any way with
the terms of the policy/certificate, the terms of the policy/certificate prevail. For complete benefits descriptions and conditions, see the policy/certificate.
Page
Page16
19
Group Critical Illness Weekly Premiums - Ohio
Employee or Employee & Children (rates based on employee’s age; benefit amounts over $30,000 require underwriting of all covered persons)
Child benefit is equal to 25% of employee benefit.
Issue Age
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70+
$5,000
$0.73
$0.96
$1.21
$1.68
$2.22
$2.94
$4.04
$5.38
$6.83
$9.44
$17.85
Employee Benefit Amount
$10,000
$15,000 $20,000
$1.20
$1.66
$2.12
$1.57
$2.19
$2.83
$2.04
$2.89
$3.73
$2.88
$4.06
$5.25
$3.81
$5.39
$6.98
$5.16
$7.36
$9.58
$7.23
$10.42
$13.60
$9.88
$14.35
$18.84
$12.79
$18.78
$24.74
$18.04
$26.63
$35.25
$34.61
$51.41
$68.20
$25,000
$2.59
$3.46
$4.55
$6.43
$8.56
$11.79
$16.82
$23.35
$30.74
$43.84
$85.00
$30,000
$3.06
$4.07
$5.40
$7.61
$10.14
$13.99
$20.00
$27.84
$36.71
$52.45
$101.76
Employee & Spouse or Family (rates based on employee’s age; benefit amounts over $30,000 require underwriting of all covered persons)
Spouse benefit is equal to 50% of employee benefit.
Child benefit is equal to 25% of employee benefit.
Issue Age
18-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65-69
70+
$5,000
$1.18
$1.55
$1.94
$2.74
$3.62
$4.73
$6.43
$8.48
$10.64
$14.59
$27.31
Employee Benefit Amount
$10,000
$15,000 $20,000
$1.87
$2.47
$3.18
$4.51
$5.97
$8.03
$11.20
$15.22
$19.62
$27.49
$52.49
$2.56
$3.39
$4.43
$6.25
$8.32
$11.33
$15.97
$21.94
$28.58
$40.39
$77.67
$3.25
$4.29
$5.66
$8.02
$10.67
$14.63
$20.78
$28.67
$37.53
$53.30
$102.84
$25,000
$30,000
$3.94
$5.22
$6.89
$9.77
$13.03
$17.93
$25.55
$35.41
$46.50
$66.19
$128.02
$4.62
$6.13
$8.13
$11.54
$15.38
$21.24
$30.33
$42.13
$55.48
$79.11
$153.20
*Premium rates shown are for the combined group Critical Illness policy and rider benefits as summarized in the proposal. For
complete benefit descriptions, limitations, conditions and exclusions, see the policy/certificate. Policy availability, features,
provisions and rates may vary by state.
Proposal 102383
Page 17
Page 20
Group Critical Illness - Ohio
Form G H1715/G H1715C
Limitations, Conditions and Exclusions
The following represents some policy limitations, conditions and exclusions. For complete details of the coverage, please contact
your agent, Assurity or ask to review the policy. Provisions may vary by state.
Limitations
GROUP CRITICAL ILLNESS INSURANCE PROVIDES LIMITED BENEFIT COVERAGE.
This insurance does not provide major medical coverage and does not satisfy the requirement for minimum essential coverage
under the Affordable Care Act (ACA).
Availability of this product, and its benefits and premiums as presented, is subject to the approval of Assurity. Some applicants with
pre-existing conditions may not be eligible for coverage. Product availability, features and rates may vary by state. All benefits,
premiums, conditions, exclusions and limitations are governed by the actual contract as provided by Assurity, not this proposal.
Pre-existing conditions: Assurity will not pay benefits for a specified critical illness that is caused by a pre-existing condition unless
the specified critical illness starts after coverage has been in force for 12 months from the issue date. Pre-existing condition means a
sickness or physical condition for which, during the 12 months before the issue date, the insured person had symptoms which
would cause an ordinary prudent person to seek diagnosis, care or treatment, or received medical consultation, advice or treatment
from a physician or had taken prescribed medication.
Waiting period: The benefits payable for Loss of Independent Living, Invasive Cancer, Non-Invasive Cancer, and Skin Cancer have a
waiting period. There is no coverage for Loss of Independent Living, Invasive Cancer, Non-Invasive Cancer, or Skin Cancer, if an
insured person initially incurred or was diagnosed with any of these conditions before the end of the waiting period.
Elimination period: The benefit payable for Loss of Independent Living has an elimination period. Assurity will not pay benefits
during the elimination period.
Special Endorsement
The pre-existing condition clause will be waived during the initial enrollment for employees with the existing carrier’s coverage. Any
employee not covered by the prior policy, including new hires, will be subject to the normal pre-existing condition clause.
Coverage Conditions
Actively Employed – The employee must be actively employed to be eligible for coverage.
Right to Cancel – The contract contains a 30-day free look period.
Termination – Coverage will terminate the earliest of the following: the date policy terminates for any reason; the date employee is
no longer an employee (portability available); when premiums are not paid by the end of the grace period; the date Assurity
receives written notice to terminate; when the employee establishes residence in a foreign country; or upon the employee's death.
Exclusions
Assurity will not pay benefits for losses caused by or the result of any Insured Person(s):
● being exposed to war or any act of war, declared or undeclared;
● actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Army Reserve, except during
active duty training of less than 60 days;
● being addicted to drugs or suffering from alcoholism;
● being intoxicated (as determined by the laws governing the operation of motor vehicles in the jurisdiction where loss occurs) or
under the influence of an illegal substance or a narcotic (except for narcotics used as prescribed to the Insured Person by a
Physician);
● committing or attempting to commit a felony;
● engaging in an illegal occupation;
● intentionally self-inflicting an injury; or
● committing or attempting to commit suicide, while sane or insane.
Proposal 102383
Page
Page18
21
LIFE PRODUCTS
benefits for employees that benefit employers
Page
Page21
22
Life Products
VOLUNTARY
Life is priceless. Maybe that’s why life insurance can be a little expensive. But not with Companion Life.
Our Voluntary Group Term Life insurance plan is never out of reach for your employees and their
families — whether your business is small or large.
The Companion Choice Plus plan is for employee groups with a minimum of five enrollees. At least 10
employees or 25% of the group (whichever is greater) must enroll to include guaranteed issue of
coverage. Amounts depend on the level of employee participation and group size. But what if you’re not
sure how many employees will enroll for coverage? The program also offers up to $100,000 of
Group Life insurance at the same low rates to as few as five enrollees, subject to evidence
of insurability.
For added protection and value, you can include our Accidental Death and Dismemberment
(AD&D) option. The insurance amount is equal to the Voluntary Life benefits the employees
select for themselves and their covered spouses. AD&D benefit is selected at the group level.
This AD&D option includes these valuable benefits:
n Seat belt provision — increased benefit by 50%
n Common disaster provision — spouse benefit increased to equal employee coverage
n Spouse education benefit — additional $3,000 for a year’s study
n Paralysis benefit — up to AD&D amount
Yes, life is priceless. But we can price a life insurance plan to fit your employees’ budgets — and
with the benefits they want.
EMPLOYEE ELIGIBILITY Employees meeting all these requirements are eligible for coverage:
n
n
n
n
30 days of continuous service with the employer
Full-time employment (i.e., working 30 or more hours per week)
Work 15 of the 20 working days prior to the effective date of coverage
Actively at work on the effective date of coverage
Page 23
Page 22
COMPANION CHOICE PLUS AT A GLANCE
ABOUT COMPANION LIFE
Benefit Choice
$5,000 increments, minimum amount $10,000.
Companion Life Insurance
Maximum Benefit
$500,000 (up to 7x salary), subject to Guaranteed Issue schedule.
Company has specialized in
Spouse Benefit
$5,000 increments, not to exceed 50% of the employee amount.
$150,000 maximum benefit, subject to Guaranteed Issue schedule.
group benefits for more than
40 years. It has earned an A.M.
Dependent Child Benefit
Employee option of $2,500, $5,000, $7,500 or $10,000.
Note: Employee coverage required; $200 on children 14 days to
6 months. (Available for dependents age 14 days to 26 years old.)
Best rating of A+ (Superior)*.
Minimum Guaranteed Issue
investment practices and
10 employees enrolled or 25% of group, whichever is greater.
Requirement
We’ve earned these high marks
due to our fiscal strength,
sound management. Now, we
Guaranteed Issue
$25,000 minimum; amounts may vary; see schedule.
Larger amounts are subject to short-form medical.
want to earn your trust by
giving you the highest level
Accelerated Benefit ProvisionYes. Terminally ill employees may access up to 75% of their benefit.
Maximum benefit is $100,000.
of service and responsiveness
Yes, at same group rates. Continues until Master Policy cancels
Portability Provision
(applicable only to Employee and Spousal coverage; premium must be
paid directly to Companion Life).
Companion Life agent today.
Waiver of Premium Provision
Yes.
Group Term Life Plan is a
Conversion Privilege
Yes.
benefit plan that benefits you.
Age Reduction FormulaVoluntary Life benefit amounts will reduce to 65% of the original
amount at age 65, to 50% at age 70, to 35% at age 75, to 20% at age 80.
Benefits terminate at retirement. The spouse’s Voluntary Life benefit
amount will reduce in accordance with the spouse’s age and terminate
at the employee’s retirement.
GUARANTEED ISSUE SCHEDULE Guaranteed Issue is based on participation levels and the
number of employees eligible to participate at the time of enrollment. All coverage for children
is Guaranteed Issue. Guaranteed Issue is not available for individuals age 70 or older. Minimum
participation for Guaranteed Issue is 25%, but not fewer than 10 lives.
Eligible
Required
Minimum Number
Guaranteed
Guaranteed
Employees
Participation
of Enrollees
Issue Employee
Issue Spouse
10 - 49
25%
10
$100,000
$25,000
50 - 99
25%
15
$125,000
$50,000
100 - 199
25%
25
$175,000
$50,000
200 - 499
25%
50
$225,000
$50,000
500+
25%
125
$250,000
$50,000
possible. Talk with your
See for yourself how the
Companion Life Voluntary
FOR A PROPOSAL CONTACT
Group Marketing
Companion Life Insurance Co.
P.O. Box 100102
Columbia, SC 29202-3102
800-753-0404 phone
800-836-5433 fax
C.life@companiongroup.com
CompanionLife.com
Page 23
Page 24
*Rating as of Dec. 10, 2015. For the latest rating, access ambest.com. Opinion from the leading provider of insurer ratings of a company’s financial strength and ability to meet its obligations to policyholders.
Voluntary Group Plans from
Companion Life
Benefits for Employees that Benefit
Employers
Companion Life’s Voluntary products
enhance the total employee benefits package,
making it easier to attract and retain quality,
loyal employees.
Offer a complete Voluntary benefits portfolio
through Companion Life! We’ve listed a few
of our product highlights below for your
convenience.
Voluntary Dental
• $100 Lifetime Deductible Options
• Flexible Plan Design
•PPO Options with strong network
including 154,000 access points
• Value-added plans included
Vision by Design
• Flexible Plan Designs
•Access to more than 35,000 vision care
providers at 18,000 locations nationwide
•Value-added services including discount
laser vision correction
Voluntary Short Term Disability
Companion Life
5-Year Premium Rate Lock
Voluntary group term life
preferred Industries only — Monthly Premium Cost
The Companion Choice Plus Plan To determine your initial monthly premium within your current age category, simply find your age
bracket on the left side and follow that line to the right. The amount shown will be your monthly premium rate per $1,000 of coverage.
AD&D coverage is not included in the premiums shown. AD&D coverage is available at .03 per thousand dollars of insurance coverage per
month. The amount of AD&D coverage must be equal to the amount of Voluntary Life benefits the employees select for themselves and
their covered spouses. Our AD&D benefit is selected at the group level.
Monthly Premium
Rate per Thousand
Age
Dollars of Insurance
Category
Coverage
Rate Per $1,000
15 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69**
70 +**
Coverage Amount and Monthly Premium*
$10,000
$25,000
$50,000
$75,000
0.80
0.90
1.10
1.50
2.60
4.70
7.00
13.50
21.10
38.90
2.00
2.25
2.75
3.75
6.50
11.75
17.50
33.75
52.75
97.25
4.00
4.50
5.50
7.50
13.00
23.50
35.00
67.50
105.50
194.50
6.00
6.75
8.25
11.25
19.50
35.25
52.50
101.25
158.25
291.75
0.08
0.09
0.11
0.15
0.26
0.47
0.70
1.35
2.11
3.89
$100,000 $150,000
8.00
9.00
11.00
15.00
26.00
47.00
70.00
135.00
211.00
389.00
12.00
13.50
16.50
22.50
39.00
70.50
105.00
202.50
316.50
583.50
$200,000
16.00
18.00
22.00
30.00
52.00
94.00
140.00
270.00
422.00
778.00
*Employee coverage must be elected in $5,000 increments, minimum amount $10,000. The maximum amount per employee is $500,000,
subject to Guarantee Issue schedule.
**An individual’s life benefit reduces to 65% at age 65, to 50% at age 70, to 35% at age 75, to 20% at age 80. Monthly premium shown
assumes coverage amount shown is after benefit reductions. (Five-year premium rate lock does not affect age reduction schedule.)
• Entry Age Freeze
• $10K AD&D Included
•3 enrollees for groups of 2-9, 5 enrollees
for groups of 10 or more
Spouse coverage must be in $5,000 increments, not to exceed 50% of employee amount. The maximum spouse benefit is $150,000, subject
to Guarantee Issue schedule.
Voluntary Long Term Disability
This Premium Cost Chart is for illustrative purposes only; your monthly premium cost may be slightly higher or lower due to rounding.
The information provided is only a summary of the benefits available. Refer to your certificate for details and limitations of coverage.
•60% of pre-disability income up to a
$6,000 monthly benefit
• Social Security filing assistance
• Waiver of Premium
For more information or a proposal
please contact
P.O. Box 100102 · Columbia, SC 29202-3102
800-753-0404 phone · 800-836-5433 fax
C.life@companiongroup.com
CompanionLife.com
Child(ren) monthly rate is $0.25 per thousand dollars of coverage amount selected. (AD&D coverage is not available for children.)
Future premium age bracket increases for an insured may only occur on the group’s 5th renewal date, 10th renewal date, etc. In
addition, Companion Life reviews the plan annually and rates are subject to change.
Example
Monthly Premium
Employee, Age 41
$350,000 Selected (350 x .15 = 52.50)
$52.50
Spouse, Age 35
$25,000 Selected (25 x .11 = 2.75)
$ 2.75
$ 1.75
Two Children
$5,000 Selected (5 x .25 = 1.25)
$ 1.25
Total $56.50
The premiums shown above apply to the following preferred industries only:
SIC Code
6011-6029
6035-6036
6061-6062
6081-6099
6111-6163
6211-6289
6311-6399
6411
6512-6553
Industry
Banking
Savings & Loan Assoc.
Credit Unions
Misc. Banking Services
Credit Agencies/Mortgage Bankers
Security & Commodity Brokers
Insurance Carriers
Insurance Agents/Brokers
Real Estate
95971 Rates Effective 1/1/13
SIC Code
6712-6799
7311-7338
7371-7379
8010-8049
8062-8069
8071-8072
8082-8099
8111
8211
Industry
Holding/Investment Co.
Advertising/Other Services
Computer and D.P. Services
Physicians & Dentists
Hospitals
Medical & Dental Labs
Health & Allied Services
Legal Services
Elementary & Secondary Schools
SIC Code
8221-8222
8231
8243-8249
8299
8711-8713
8721
8731-8734
8741-8748
Industry
Colleges & Junior Colleges
Libraries
Vocational Schools
Other Educational Services
Engineering/Other Services
Accounting/Bookkeeping Services
R&D/Testing Services
Mgmt., Consulting & PR Services
Rev.
9/13
Page
24
Page
25