Corsicana ISD Benefit Summary 2016.pub

Transcription

CORSICANA ISD
BENEFIT GUIDE
Plan Year: September 1, 2016 – August 31, 2017
Information Provided By:
First Financial Group of America
1200 W. Walnut Hill Ln, Suite 3400
Irving, TX 77060
800-883-0007
Attention Corsicana ISD: It’s time to enroll!
It’s that time again. FFGA reps will be in the district May 9th - 16th to help you with all of your
supplemental benefit needs. FFGA and Corsicana ISD are always working hard to bring you
competitive and cost effective benefits. There are several changes this year to your benefit offering so
please take a few minutes to review the information attached prior to enrollment.
What’s New this Year???
As you know, out of pocket Medical costs continue to rise putting more and more liability on you to
cover the costs when you need your insurance the most. The two new benefits listed below are a
great way to help you supplement your medical insurance and cover those high deductibles, out of
pocket maximums and costs not covered by medical insurance.
2 New Benefits from AFLAC
1) AFLAC –Critical Illness (will replace Humana CI)
2) AFLAC – Hospital Indemnity
Video Links: Critical Illness
http://www.aflac.com/videos/ciM/
Hospital Indemnity http://www.aflac.com/videos/hiC1/
For all benefit information, please visit http://benefits.ffga.com/corsicanaisd
***All employees need to meet with an FFGA representative or enroll online.
Online enrollment instructions are on the benefits website.
***Medical Insurance will be enrolled online July 18th – August 19th
Ryan Hancock, Account Manager
First Financial Group of America
[email protected]
1
TABLE OF CONTENTS
PAGE
WHAT’S NEW
1
TABLE OF CONTENTS
2
BENEFIT OVERVIEW
3
HOW TO ENROLL
4
SECTION 125 INFORMATIOM
5
FLEXIBLE SPENDING ACCOUNT DETAILS
6
CRITICAL ILLNESS INSURANCE
8
HOSPITAL INDEMNITY INSURANCE
15
DISABILITY INSURANCE
22
ACCIDENT INSURANCE
31
VISION INSURANCE
40
DENTAL INSURANCE
42
CANCER INSURANCE
45
LEGAL SHIELD
48
ASSURANT TERM LIFE INSURANCE
50
TEXAS LIFE PERMANENT LIFE INSURANCE
55
2
Overview
Corsicana Independent School District and First Financial Group of America would like to take this opportunity to
present to you the information for the upcoming plan year. This information has been created to bring forth a
brief overview of your choices as well as offer you a reference guide when questions may arise regarding your
insurance plans.
Please take the time to look over the
information contained in this booklet to
familiarize yourself with the benefits that are
provided to you as an employee.
Open Enrollment will be May 9 –May 16. All
employees must review plan options and make
any necessary changes to your supplementary
elections under the Cafeteria Plan. This is the
only time you can make changes to your
supplemental insurance, unless there is a
qualified family status change during the year.
Your plan year is September 1 through August 31.
Payroll deductions for your benefits will begin in
September.
This guide contains a summary of the benefits offered by your employer. If there is a conflict between the terms of this
outline of benefits and the actual contracts, the terms of the contracts will prevail. For a more detailed explanation of
benefits you may contact First Financial Administrators at 1-800-523-8422 or visit the website listed below.
For detailed information your benefits website is:
http://benefits.ffga.com/corsicanaisd
3
Online Enrollment Instructions
How do I enroll my benefits prior to open enrollment?
Conveniently, you can view your benefits, enroll or make any necessary changes for the upcoming plan year at
work or at home using our secure, online website.
Where do I go to enroll in my benefits?
Go to https://ffga.benselect.com/enroll.
What is my login and PIN?
Your login is your social security number (123456789). Your pin is the last four digits of your social security
number and the last two numbers of your birth year (678977).
Once you login you will see a Welcome presentation. Once finished Click “Next,” then:
 Verify your personal information
 Verify all dependent information (ssn/date of birth) **Very Important**
 View employment information
You will then see a brief presentation on
each benefit available. Notify the Business
Office/Payroll Department of any
discrepancies.
Useful Information to know


Contact First Financial at
855-523-8422 with any technical
questions.
No changes will be allowed until the
annual open enrollment period
(unless you have an IRS S125
approved event).
4
Section 125 Cafeteria Plan
First Financial Administrators, Inc.
As a district employee, you are eligible to participate in a Section 125 Flexible Plan. Enrollment opportunities are
limited to the plan year dates for your district.
A Section 125 Flexible Plan allows you, the employee, to select from a list of available benefits that will meet your
family’s healthcare needs. Certain premiums are deducted from your gross earnings before federal withholding
taxes are figured. The amount you elect to have deducted “pre-tax” actually lowers your taxable income. By
implementing this plan, your employer is helping you reduce your taxes and increase your take home pay.
You cannot change your elections during the plan year except for certain specified changes in family status. Those
changes include:
 Marriage
 Divorce
 Death of a spouse/child
 Birth or adoption of a child
 Termination of spouse’s employment
You must notify your employer within 31 days of the qualifying event to make changes.
Section 125 Plan Sample Paycheck
The example below shows how a married employee claiming 1 exemption can reduce their taxable income
5
Flexible Spending Accounts (FSAs)
Flexible Spending Accounts (FSAs) are tax-favored accounts that allow participants to set aside money pretax
for eligible Medical and Dependent Care costs. FSAs allow an employee the opportunity to put some of
his/her salary aside before taxes to pay for many common out-of-pocket expenses.
Use-it-or-lose-it-Rule: Money remaining in your FSA account(s) will not be returned to you at the end of the
plan year. Any amount remaining after the end of the runoff will be forfeited. Because of the use-it-or-lose-it
rule, it is important for you to carefully estimate your out-of-pocket health and dependent care expenses for
the upcoming plan year.
Your employer has chosen the $500 Roll-Over Option for your plan. This option allows you the opportunity to
roll over $500 of unclaimed Medical FSA funds into the following plan year. Any amount in excess of $500 will
be forfeited under the use-it-or-lose-it rule.
Medical FSA
Your Medical FSA may be used to reimburse you for expenses that you incur for treatment of yourself,
spouse and dependent children during your plan year. Eligible medical expenses include deductibles and
coinsurance amounts under a group health plan, charges that are in excess of the amount reimbursed under
a group health plan, and charges that are not covered under a group health plan such as certain corrective
surgeries, vision care, dental care and hearing aids.
Effective January 1, 2011, all over -the counter medications eligible for reimbursement must be accompanied
by a doctor’s prescription.
Maximum contribution amount for 2016/2017 plan year is 2,550 ($212.50 per month).
Reminder – If you or your spouse participate in a Qualified High Deductible Health Plan and contribute to a
Health Savings Account, you are not eligible to enroll in Medical Reimbursement.
Dependent Care Reimbursement
A Dependent Care FSA allows you to pay for daycare expenses for your qualified dependent/child with pretax dollars while you (and your spouse) are working, seeking employment, or attending school as a full- time
student for at least 4 months during the year.
Eligible dependents must be claimed as an exemption on your tax return. These dependents can include
step-children, grandchildren, adopted children or foster children. Under IRS regulations, eligible dependents
are further defined as: under age 13 and/or physically or mentally unable to care for themselves, such as a
disabled spouse, disabled child, or elderly parents that live with you.
The IRS allows employees to contribute up to $5,000 annually to a Dependent Care FSA.
6
Flex Benefits Card
The Flex Benefits Card is available to all employees that participate in Medical Reimbursement FSA. The
Benefits Flex Card gives you immediate access to your money at the point of purchase. Cards are available for
participating employees, their spouse and eligible dependents that are at least 18 years old.
The IRS requires validation of most transactions. You must submit receipts for validation of expenses when
requested. If you fail to substantiate by providing a receipt to First Financial within 60 days of the purchase or
date of service your card will be suspended until the necessary receipt or explanation of benefits from your
insurance provider is received.
FF Flex Mobile App
The FF Flex Mobile App is available for Apple® or AndroidTM devices on the App StoreSM or the Google Play
StoreTM.
With the FF Flex Mobile App you can:
 Submit Claims
FFA818 is the mobile app number
 View Account Balance & History
 See Claim Status
for Corsicana ISD
 View Alerts
 Upload Receipts and Documentation
Download & register your app today!
FSA Store
First Financial has partnered with the FSA Store to bring you an easy to use online store to better understand
and manage your Flexible Spending Account (FSA). Shop at FSA Store for eligible items from bandages to
vitamins and thousands of products in between, browse or search for eligible products and services using the
FSA Eligibility List, and visit the FSA Learning Center to help find answers to questions you may have about
your FSA.
www.ffga.com/fsaextras
7
AFLAC
Critical Illness
8
Aflac
Group Critical
Illness Advantage
INSURANCE – PLAN INCLUDES BENEFITS
FOR CANCER AND HEALTH SCREENING
We help take care of your
expenses while you take
care of yourself.
THIS IS NOT A MEDICARE SUPPLEMENT PLAN.
If you are eligible for Medicare, review the Guide to Health
Insurance for People with Medicare, which is available from
the company.
AGC150049
9
IV (9/15)
AFLAC GROUP CRITICAL ILLNESS ADVANTAGE
CI
G
Aflac can help ease the financial stress
of surviving a critical illness.
Chances are you may know someone who’s been diagnosed with a critical
illness. You can’t help notice the difference in the person’s life—both physically
and emotionally. What’s not so obvious is the impact a critical illness may have on
someone’s personal finances.
That’s because while a major medical plan may pay for a good portion of the
costs associated with a critical illness, there are a lot of expenses that may not be
covered. And, during recovery, having to worry about out-of-pocket expenses is the
last thing anyone needs.
That’s the benefit of an Aflac Group Critical Illness plan.
It can help with the treatment costs of covered critical illnesses, such as a heart
attack or stroke.
More importantly, the plan helps you focus on recuperation instead of the
distraction of out-of-pocket costs. With the Critical Illness plan, you receive cash
benefits directly (unless otherwise assigned)—giving you the flexibility to help pay
bills related to treatment or to help with everyday living expenses.
Understanding the facts can help you decide if the
Aflac group Critical Illness plan makes sense for you.
FACT NO. 1
AN ESTIMATED
FACT NO. 2
83.6
MILLION
AMERICAN ADULTS–GREATER THAN 1 IN 3–HAVE ONE
OR MORE TYPES OF CARDIOVASCULAR DISEASE (CVD).1
1
2
108.9
$
BILLION
THE AMOUNT OF MONEY CORONARY HEART DISEASE COST THE
UNITED STATES. THIS TOTAL INCLUDES THE COST OF HEALTH
CARE SERVICES, MEDICATIONS AND LOST PRODUCTIVITY.2
American Heart Association/American Stroke Association 2013 Statistical Fact Sheet
Centers for Disease Control and Prevention Heart Disease Fact Sheet 2015
Coverage underwritten by Continental American Insurance Company (CAIC)
A proud member of the Aflac family of insurers
10
Here’s why the Aflac
Group Critical Illness
plan may be right
for you.
For over 60 years, Aflac has been dedicated to helping provide individuals and
families peace of mind and financial security when they’ve needed it most. The
Aflac Group Critical Illness plan is just another innovative way to help make sure
you’re well protected under our wing.
But it doesn’t stop there. Having group critical illness insurance from Aflac means
that you may have added financial resources to help with medical costs or ongoing
living expenses.
The Aflac Group Critical Illness plan benefits include:
•• Critical Illness Benefit payable for:
–– Cancer
–– Heart Attack (Myocardial Infarction)
–– Stroke
–– Kidney Failure (End-Stage Renal Failure)
–– Major Organ Transplant
–– Bone Marrow Transplant (Stem Cell Transplant)
–– Sudden Cardiac Arrest
–– Coronary Artery Bypass Surgery
–– Non-Invasive Cancer
–– Skin Cancer
•• Health Screening Benefit
Features:
•• Benefits are paid directly to you, unless you choose otherwise.
•• Coverage is available for you, your spouse, and dependent children.
•• Coverage may be continued (with certain stipulations). That means you can take it with you if you change jobs
or retire.
•• Fast claims payment. Most claims are processed in about four days.
How it works
Aflac Group
Critical Illness
Advantage
coverage is
selected.
You experience
chest pains
and numbness
in the left arm.
You visit the
emergency
room.
A physician
determines
that you have
had suffered a
heart attack.
Aflac Group Critical Illness Advantage pays
a First Occurrence Benefit of
$30,000
Amount payable based on $30,000 First Occurrence Benefit.
For more information, ask your insurance agent/producer,
11 call 1.800.433.3036, or visit aflacgroupinsurance.com.
Benefits Overview
COVERED CRITICAL ILLNESSES:
CANCER (Internal or Invasive)
100%
HEART ATTACK (Myocardial Infarction)
100%
STROKE (Ischemic or Hemorrhagic)
100%
MAJOR ORGAN TRANSPLANT
100%
KIDNEY FAILURE (End-Stage Renal Failure)
100%
BONE MARROW TRANSPLANT (Stem Cell Transplant)
100%
SUDDEN CARDIAC ARREST
100%
BURNS*
100%
COMA**
100%
PARALYSIS**
100%
LOSS OF SIGHT / HEARING / SPEECH**
100%
NON-INVASIVE CANCER
25%
CORONARY ARTERY BYPASS SURGERY
25%
INITIAL DIAGNOSIS
We will pay a lump sum benefit upon initial diagnosis of a covered critical illness when such diagnoses is caused by or solely
attributed to an underlying disease. Employee benefit amount available is $30,000. Spouse coverage is also available in a
benefit amount of $15,000. Cancer diagnoses are subject to the cancer diagnosis limitation. Benefits will be based on the face
amount in effect on the critical illness date of diagnosis.
ADDITIONAL DIAGNOSIS
We will pay benefits for each different critical illness after the first when the two dates of diagnoses are separated by at least 6
consecutive months, and the new critical illness is not contributed to or caused by a critical illness for which benefits have been
paid. Cancer diagnoses are subject to the cancer diagnosis limitation.
REOCCURRENCE
We will pay benefits for the same critical illness after the first when the two dates of diagnoses are separated by at least 6
consecutive months, and the new critical illness is not contributed to or caused by a critical illness for which benefits have
been paid. Cancer diagnoses are subject to the cancer diagnosis limitation.
CHILD COVERAGE AT NO ADDITIONAL COST
Each dependent child is covered at 50 percent of the primary insured’s benefit amount at no additional charge. Children-only
coverage is not available.
SKIN CANCER BENEFIT
We will pay $250 for the diagnosis of skin cancer. We will pay this benefit once per calendar year.
*This benefit is only payable for burns due to, caused by, and attributed to, a covered accident.
**These benefits are payable for loss due to a covered underlying disease or a covered
12 accident.
WAIVER OF PREMIUM
If you become totally disabled due to a covered critical illness prior to age 65, after 90 continuous days of total disability, we
will waive premiums for you and any of your covered dependents. As long as you remain totally disabled, premiums will be
waived up to 24 months, subject to the terms of the plan.
SUCCESSOR INSURED BENEFIT
If spouse coverage is in force at the time of the primary insured’s death, the surviving spouse may elect to continue coverage.
Coverage would continue at the existing spouse face amount and would also include any dependent child coverage in force at
the time.
HEALTH SCREENING BENEFIT (Employee and Spouse only)
We will pay $100 for health screening tests performed while an insured’s coverage is in force. We will pay this benefit once per
calendar year.
This benefit is only payable for health screening tests performed as the result of preventive care, including tests and diagnostic
procedures ordered in connection with routine examinations. This benefit is payable for the covered employee and spouse.
This benefit is not paid for dependent children.
COVERED HEALTH SCREENING TESTS INCLUDE:
••
••
••
••
••
••
••
••
••
••
••
Blood test for triglycerides
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
DNA stool analysis
Fasting blood glucose test
Flexible sigmoidoscopy
••
••
••
••
••
••
••
••
••
Hemocult stool analysis
Mammography
Pap smear
PSA (blood test for prostate cancer)
Serum cholesterol test to determine level of of HDL
and LDL
Serum protein electrophoresis (blood test for
myeloma)
Spiral CT screening for lung cancer
Stress test on a bicycle or treadmill
Thermography
PROGRESSIVE DISEASES RIDER
AMYOTROPHIC LATERAL SCLEROSIS (ALS or Lou Gehrig’s Disease)
100%
SUSTAINED MULTIPLE SCLEROSIS
100%
This benefit is paid based on your selected Progressive Disease Benefit amount. We will pay the benefit shown upon
diagnosis of one of the covered diseases if the date of diagnosis is while the rider is in force.
OPTIONAL BENEFITS RIDER
BENIGN BRAIN TUMOR
100%
ADVANCED ALZHEIMER’S DISEASE
25%
ADVANCED PARKINSON’S DISEASE
25%
These benefits will be paid based on the face amount in effect on the critical illness date of diagnosis. We will pay the optional
benefit if the insured is diagnosed with one of the conditions listed in the rider schedule if the date of diagnosis is while the
rider is in force.
The plan has limitations and exclusions that may affect benefits payable.
This brochure is for illustrative purposes only. Refer to your certificate
13 for complete details, definitions, limitations, and exclusions.
Group Critical Illness Advantage
Corsicana ISD - Monthly (12pp/yr) Rates
0
1
1
Issue Age
18-29
30-39
40-49
50-59
60-69
1
$5,000
$
$
$
$
$
1
Issue Age
18-29
30-39
40-49
50-59
60-69
$
$
$
$
$
5.56
7.16
11.10
17.93
27.71
1
$5,000
$
$
$
$
$
1
Issue Age
18-29
30-39
40-49
50-59
60-69
$
$
$
$
$
1
$5,000
1
Issue Age
18-29
30-39
40-49
50-59
60-69
5.56
7.16
11.10
17.93
27.71
2
1
$10,000
6.59
9.49
15.74
27.09
41.55
1
$7,500
$
$
$
$
$
6.59
9.49
15.74
27.09
41.55
Base Plan:
-With Cancer Benefit
-$100 Health Screening Benefit
-$250 Skin Cancer Benefit
-With Additional Benefits
(Loss of Sight, Speech, Hearing)
(Coma, Burns, Paralysis)
6.83
9.23
15.15
25.38
40.05
1
$10,000
$
$
$
$
$
1
$5,000
$
$
$
$
$
8.09
11.30
19.19
32.84
52.39
10.16
15.95
28.46
51.17
80.07
1
$7,500
$
$
$
$
$
8.38
12.72
22.10
39.13
60.81
3
1
$15,000
$
$
$
$
$
10.63
15.44
27.27
47.74
77.08
1
$10,000
$
$
$
$
$
8.09
11.30
19.19
32.84
52.39
1
$15,000
$ 13.73
$ 22.42
$ 41.18
$ 75.24
$ 118.60
1
$10,000
$
$
$
$
$
10.16
15.95
28.46
51.17
80.07
4
5
NONTOBACCO - Employee
$20,000
$25,000
$ 13.17
$ 19.58
$ 35.36
$ 62.65
$ 101.76
$ 15.70
$ 23.72
$ 43.44
$ 77.56
$ 126.45
NONTOBACCO - Spouse
$12,500
$15,000
$
$
$
$
$
9.36
13.37
23.23
40.29
64.74
$
$
$
$
$
10.63
15.44
27.27
47.74
77.08
TOBACCO - Employee
$20,000
$25,000
$ 17.30
$ 28.88
$ 53.90
$ 99.31
$ 157.13
$ 20.88
$ 35.35
$ 66.62
$ 123.39
$ 195.65
TOBACCO - Spouse
$12,500
$15,000
$
$
$
$
$
11.95
19.18
34.82
63.20
99.34
$ 13.73
$ 22.42
$ 41.18
$ 75.24
$ 118.60
Riders:
-Optional Benefits Rider (BTAP)
-Progressive Diseases Rider
6
7
8
14
10
1
$35,000
1
$40,000
1
$45,000
1
$50,000
$ 18.24
$ 27.86
$ 51.52
$ 92.47
$ 151.14
$ 20.78
$ 32.00
$ 59.61
$ 107.38
$ 175.82
$ 23.31
$ 36.14
$ 67.69
$ 122.29
$ 200.51
$ 25.85
$ 40.28
$ 75.78
$ 137.19
$ 225.20
$ 28.39
$ 44.42
$ 83.86
$ 152.10
$ 249.88
1
$17,500
1
$20,000
1
$22,500
1
$25,000
$ 13.17
$ 19.58
$ 35.36
$ 62.65
$ 101.76
$ 14.44
$ 21.65
$ 39.40
$ 70.11
$ 114.11
$ 15.70
$ 23.72
$ 43.44
$ 77.56
$ 126.45
1
$30,000
1
$35,000
1
$40,000
1
$45,000
1
$50,000
$ 24.45
$ 41.81
$ 79.34
$ 147.46
$ 234.18
$ 28.02
$ 48.28
$ 92.05
$ 171.53
$ 272.71
$ 31.59
$ 54.74
$ 104.77
$ 195.61
$ 311.24
$ 35.16
$ 61.21
$ 117.49
$ 219.68
$ 349.76
$ 38.73
$ 67.67
$ 130.21
$ 243.75
$ 388.29
1
$17,500
1
$20,000
1
$22,500
1
$25,000
$ 15.52
$ 25.65
$ 47.54
$ 87.28
$ 137.86
$ 17.30
$ 28.88
$ 53.90
$ 99.31
$ 157.13
$ 19.09
$ 32.11
$ 60.26
$ 111.35
$ 176.39
$ 20.88
$ 35.35
$ 66.62
$ 123.39
$ 195.65
$
$
$
$
$
11.90
17.51
31.31
55.20
89.42
Provisions:
-No Pre-Existing Condition Limitation
-Add'l Separation Waiting Period: 6 Months
-Re-Separation Waiting Period: 6 Months
-Benefit Reduction at Age 70
-Standard Portability
-Rate Guarantee: 2 Years
Please Note: Premiums shown are accurate as of publication. They are subject to change.
Published:
Mar-16
Series C21000
9
1
$30,000
Group Attributes:
-Situs State: TX
-Eligible Lives: 850
CI21000-160303-134457-F3zii3Fw-037Yj4H-02202
AFLAC
Hospital Indemnity
15
Aflac
Group Hospital
Indemnity
INSURANCE
Even a small trip to the hospital can
have a major impact on your finances.
Here’s a way to help make your visit a
little more affordable.
16
AG80075M R1
IV (2/16)
AFLAC GROUP HOSPITAL INDEMNITY
Policy Series C80000
HI
G
The plan that can help with
expenses and protect your savings.
Does your major medical insurance cover all of your bills?
Even a minor trip to the hospital can present you with unexpected expenses and medical bills. And even
with major medical insurance, your plan may only pay a portion of your entire stay.
That’s how the Aflac Group Hospital Indemnity plan can help.
It provides financial assistance to enhance your current coverage. So you may be able to avoid dipping
into savings or having to borrow to address out-of-pocket-expenses major medical insurance was never
intended to cover. Like transportation and meals for family members, help with child care,
or time away from work, for instance.
The Aflac Group Hospital Indemnity plan benefits include
the following:
• Hospital Confinement Benefit
• Hospital Admission Benefit
• Hospital Intensive Care Benefit
• Intermediate Intensive Care Step-Down Unit
How it works
The
Aflac Group
Hospital Indemnity
plan is selected.
The insured
has a high
fever and
goes to the
emergency
room.
The
physician
admits the
insured into
the hospital.
The insured
is released
after two
days.
The Aflac Group Hospital Indemnity
plan pays
$1,300
Amount payable was generated based on benefit amounts for: Hospital Admission ($1,000), and Hospital Confinement ($150 per day).
The plan has limitations and exclusions that may affect benefits payable. This brochure is for illustrative purposes only. Refer to your
17
certificate for complete details, definitions, limitations, and exclusions.
Benefits Overview
BENEFIT AMOUNT
HOSPITAL ADMIS SION BENEFIT per confinement (once per covered sickness or accident per calendar year for
each insured)
Payable when an insured is admitted to a hospital and confined as an in-patient because of a covered
accidental injury or covered sickness. We will not pay benefits for confinement to an observation unit, or
for emergency room treatment or outpatient treatment.
$1,000
HOSPITAL CONFINEMENT per day (maximum of 31 days per confinement for each covered sickness or accident for
each insured)
Payable for each day that an insured is confined to a hospital as an in-patient as the result of a covered
accidental injury or covered sickness. If we pay benefits for confinement and the insured becomes
confined again within six months because of the same or related condition, we will treat this confinement
as the same period of confinement. This benefit is payable for only one hospital confinement at a time
even if caused by more than one covered accidental injury, more than one covered sickness, or a
covered accidental injury and a covered sickness.
$150
HOSPITAL INTENSIVE CARE BENEFIT per day (maximum of 10 days per confinement for each covered sickness
or accident for each insured)
Payable for each day when an insured is confined in a Hospital Intensive Care Unit because of a covered
accidental injury or covered sickness. We will pay benefits for only one confinement in a Hospital's
Intensive Care Unit at a time. Once benefits are paid, if an insured becomes confined to a Hospital's
Intensive Care Unit again within six months because of the same or related condition, we will treat this
confinement as the same period of confinement.
$150
This benefit is payable in addition to the Hospital Confinement Benefit.
INTERMEDIATE INTENSIVE CARE STEP-DOWN UNIT per day (maximum of 10 days per confinement for each
covered sickness or accident for each insured)
Payable for each day when an insured is confined in an Intermediate Intensive Care Step-Down
Unit because of a covered accidental injury or covered sickness. We will pay benefits for only one
confinement in an Intermediate Intensive Care Step-Down Unit at a time.
$75
Once benefits are paid, if an insured becomes confined to a Hospital's Intermediate Intensive Care
Step-Down Unit again within six months because of the same or related condition, we will treat this
confinement as the same period of confinement.
This benefit is payable in addition to the Hospital Confinement Benefit.
In order to receive benefits for accidental injuries due to a covered accident, an insured must be admitted within six months of the date of
the covered accident.
LIMITATIONS AND EXCLUSIONS
EXCLUSIONS
We will not pay for loss due to:
•• War – voluntarily participating in war, any act of war, or military conflicts, declared
or undeclared, or voluntarily participating or serving in the military, armed forces, or
an auxiliary unit thereto, or contracting with any country or international authority.
(We will return the prorated premium for any period not covered by the certificate
when the insured is in such service.) War also includes voluntary participation in an
insurrection, riot, civil commotion or civil state of belligerence. War does not include
acts of terrorism.
•• Suicide – committing or attempting to commit suicide, while sane or insane.
•• Self-Inflicted Injuries – injuring or attempting to injure oneself intentionally.
•• Racing – riding in or driving any motor-driven vehicle in a race, stunt show or speed
test in a professional or semi-professional capacity.
•• Illegal Occupation – voluntarily participating in, committing, or attempting to commit
a felony or illegal act or activity, or voluntarily working at, or being engaged in, an
illegal occupation or job.
•• Sports – participating in any organized sport in a professional or semi-professional
capacity.
•• Custodial Care – this is non-medical care that helps individuals with the basic tasks
of everyday life, the preparation of special diets, and the self-administration of
medication which does not require the constant attention of medical personnel.
•• Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any
related procedures, including any resulting complications.
•• Services performed by a family member.
•• Services related to sex or gender change, sterilization, in vitro fertilization, vasectomy
or reversal of a vasectomy, or tubal ligation.
•• Elective Abortion – an abortion for any reason other than to preserve the life of the
person upon whom the abortion is performed.
•• Dental Services or Treatment.
•• Cosmetic Surgery, except when due to:
−− Reconstructive surgery, when the service is related to or follows surgery
resulting from a Covered Accidental Injury or a Covered Sickness, or is related to
or
results from a congenital disease or anomaly of a covered dependent child.
18
−− Congenital defects in newborns.
TERMS YOU NEED TO KNOW
A Covered Accident is an accident that occurs on or after an insured’s effective date
while coverage is in force, and that is not specifically excluded by the plan.
Dependent means your spouse or dependent children, as defined in the applicable rider,
who have been accepted for coverage. Spouse is your legal wife, husband, or partner in
a legally recognized union. Refer to your certificate for details.
Dependent Children are your or your spouse’s natural children, step-children,
grandchildren who are in your legal custody and residing with you, foster children,
children subject to legal guardianship, legally adopted children, or children placed for
adoption. Newborn children are automatically covered from the moment of birth for 60
days. Newly adopted children are automatically covered for 60 days also. See certificate
for details. Dependent children must be younger than age 26, however this limit will not
apply to any insured dependent child who is incapable of self-sustaining employment
due to mental or physical handicap and is chiefly dependent on a parent for support and
maintenance.
Doctor is a person who is duly qualified as a practitioner of the healing arts acting within
the scope of his license, and: is licensed to practice medicine; prescribe and administer
drugs; or to perform surgery, or is a duly qualified medical practitioner according to the
laws and regulations in the state in which treatment is made.
A Doctor does not include you or any of your Family Members. For the purposes of this
definition, Family Member includes your spouse as well as the following members of
your immediate family: son, daughter, mother, father, sister, or brother.
A Hospital is not a nursing home; an extended care facility; a skilled nursing facility; a
rest home or home for the aged; a rehabilitation facility; a facility for the treatment of
alcoholism or drug addiction; an assisted living facility; or any facility not meeting the
definition of a Hospital as defined in the certificate.
A Hospital Intensive Care Unit is not any of the following step-down units: a progressive
care unit; a sub-acute intensive care unit; an intermediate care unit; a private monitored
room; a surgical recovery room; an observation unit; or any facility not meeting the
definition of a Hospital Intensive Care Unit as defined in the certificate
Sickness means an illness, infection, disease, or any other abnormal physical condition
or pregnancy that is not caused solely by, or the result of, any injury. A Covered Sickness
is one that is not excluded by name, specific description, or any other provision in this
plan. For a benefit to be payable, loss arising from the covered sickness must occur
while the applicable insured’s coverage is in force.
Treatment is the consultation, care, or services provided by a doctor. This includes
receiving any diagnostic measures and taking prescribed drugs and medicines.
Treatment does not include telemedicine services.
You May Continue Your Coverage
Your coverage may be continued with certain stipulations. See certificate for details.
Termination of Coverage
Your insurance may terminate when the plan is terminated; the 31st day after the
premium due date if the premium has not been paid; or the date you no longer belong
to an eligible class. If your coverage terminates, we will provide benefits for valid claims
that arose while your coverage was in force.
NOTICES
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 • Columbia, South Carolina
The certificate to which this sales material pertains is written only in English; the certificate prevails if interpretation of this material
varies. This brochure is a brief description of coverage and is not a contract. Benefits, terms, and conditions may vary by state.
This brochure is subject to the terms, conditions, and limitations of19
Policy Series C80000.
AFLAC GROUP HOSPITAL INDEMNITY INSURANCE
Policy Series C80000
HI
G
HEALTH SCREENING BENEFIT / $50 PER CALENDAR YEAR
The Health Screening Benefit is payable once per calendar year for health screening tests performed as the result of
preventive care, including tests and diagnostic procedures ordered in connection with routine examinations.
This benefit is payable for each insured.
COVERED HEALTH SCREENING TESTS INCLUDE, BUT ARE NOT LIMITED TO:
••
••
••
••
••
••
••
••
••
••
••
••
••
Blood test for triglycerides
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
DNA stool analysis
Fasting blood glucose test
Flexible sigmoidoscopy
Non-diagnostic vascular screening
Immunization
••
••
••
••
••
••
••
••
••
••
••
Hemoccult stool analysis
Mammography
Pap smear
PSA (blood test for prostate cancer)
Serum cholesterol test to determine level of
of HDL and LDL
Serum protein electrophoresis (blood test
for myeloma)
Spiral CT screening for lung cancer
Stress test on a bicycle or treadmill
Thermography
Urinalysis
Vision screening
Residents of Massachusetts are not eligible for the Health Screening Benefit.
For a complete list of limitations and exclusions please refer to the brochure.
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.
20
A G 80075 H S B R 1 I V ( 2/16)
Group Hospital Indemnity
Corsicana - Monthly (12pp/yr)
Coverage
Employee
Employee & Dependent Spouse
Employee & Dependent Child(ren)
Family
Rates
$24.50
$44.90
$36.60
$57.00
Hospitalization Category:
Hospital Admission
Hospital Confinement
Hospital Intensive Care Unit
Intermediate I.C. Step-Down Unit
Health Screening Benefit
$1,000
$150
$150
$75
$50
Provisions:
Group Attributes:
Waiver of Pre-existing Conditions Exclusion
Waiver of Pregnancy Exclusion
Waiver of Mental and Emotional Disorders Exclusion
No Issue Age or Termination Age Limitations
Rate Guarantee: 2 years
Portability: Standard
Situs State: TX
Group Size: 850
Please note: Premiums shown are accurate as of publication. They are subject to change.
Published:
Apr-16
Series C80000 - TX
HI80000-160419-170123-028T2AhY-5Pxv75fB-16772
21
Product Code: HI160419-170123
AFA
Disability
22
LONG-TERM DISABILITY
Income Insurance
Underwritten by: American Fidelity Assurance Company
Enhanced Disability Income Plan
Coverage Options · Benefits Paid Directly to You · Excellent Customer Service · Learn More » »
Marketed by:
23
First Financial Capital Corporation
P.O. Box 670329 • Houston, TX 77267-0329
Local (281) 847-8422 | Toll Free (800) 523-8422
www.ffga.com
Disabilities Happen.
Are You Prepared?
What would you do if you experienced a disability today and your paycheck suddenly stopped? Nearly
70% of American employees live paycheck to paycheck1, staying current on bill payments, but not
preparing for the loss of that valuable income.
Think It Couldn’t
Happen to You?
68%
Know The Facts:
“I’ll use my sick leave
or savings.”
68% of American employees live
from paycheck to paycheck.1
“I don’t have a significant
risk of being disabled.”
1/3 of Americans entering
the work force today will
become disabled before
they retire.2
Reuters. “More than two-thirds in
U.S. live paycheck to paycheck:
survey,” September 19, 2012.
2
”Chances of Disability: Overview.”
Council for Disability Awareness. 2010.
Web. 24 Mar. 2011
1
Ready To Learn More?
Contact your First Financial Account Representative for more details or to schedule a one-on-one appointment.
24
Find the plan that’s best for you!
1. Locate your current salary and review the monthly benefit offered based on your income.
2. Review Elimination Period and Premium columns to choose the one that best fits your needs.
3. See your First Financial Representative to enroll in your plan!
SALARY
BENEFIT
Annual Salary
Monthly Salary*
Monthly
Disability
Benefit**
Accidental
Death
Benefit
ELIMINATION PERIOD/MONTHLY PREMIUM
14 day
30 day
60 day
90 day
150 day
Elimination Elimination Elimination Elimination Elimination
Period
Period
Period
Period
Period
$3,432.00 - $5,147.99
$286.00 - $428.99
$200.00
$20,000.00
$7.28
$5.80
$4.92
$4.16
$3.12
$5,148.00 - $6,863.99
$429.00 - $571.99
$300.00
$20,000.00
$10.92
$8.70
$7.38
$6.24
$4.68
$6,864.00 - $8,579.99
$572.00 - $714.99
$400.00
$20,000.00
$14.56
$11.60
$9.84
$8.32
$6.24
$8,580.00 - $10,295.99
$715.00 - $857.99
$500.00
$20,000.00
$18.20
$14.50
$12.30
$10.40
$7.80
$10,296.00 - $11,999.99
$858.00 - $999.99
$600.00
$20,000.00
$21.84
$17.40
$14.76
$12.48
$9.36
$12,000.00 - $13,715.99
$1,000.00 - $1,142.99
$700.00
$20,000.00
$25.48
$20.30
$17.22
$14.56
$10.92
$13,716.00 - $15,431.99
$1,143.00 - $1,285.99
$800.00
$20,000.00
$29.12
$23.20
$19.68
$16.64
$12.48
$15,432.00 - $17,147.99
$1,286.00 - $1,428.99
$900.00
$20,000.00
$32.76
$26.10
$22.14
$18.72
$14.04
$17,148.00 - $18,863.99
$1,429.00 - $1,571.99
$1,000.00
$20,000.00
$36.40
$29.00
$24.60
$20.80
$15.60
$18,864.00 - $20,579.99
$1,572.00 - $1,714.99
$1,100.00
$20,000.00
$40.04
$31.90
$27.06
$22.88
$17.16
$20,580.00 - $22,295.99
$1,715.00 - $1,857.99
$1,200.00
$20,000.00
$43.68
$34.80
$29.52
$24.96
$18.72
$22,296.00 - $23,999.99
$1,858.00 - $1,999.99
$1,300.00
$20,000.00
$47.32
$37.70
$31.98
$27.04
$20.28
$24,000.00 - $25,715.99
$2,000.00 - $2,142.99
$1,400.00
$20,000.00
$50.96
$40.60
$34.44
$29.12
$21.84
$25,716.00 - $27,431.99
$2,143.00 - $2,285.99
$1,500.00
$20,000.00
$54.60
$43.50
$36.90
$31.20
$23.40
$27,432.00 - $29,147.99
$2,286.00 - $2,428.99
$1,600.00
$20,000.00
$58.24
$46.40
$39.36
$33.28
$24.96
$29,148.00 - $30,863.99
$2,429.00 - $2,571.99
$1,700.00
$20,000.00
$61.88
$49.30
$41.82
$35.36
$26.52
$30,864.00 - $32,579.99
$2,572.00 - $2,714.99
$1,800.00
$20,000.00
$65.52
$52.20
$44.28
$37.44
$28.08
$32,580.00 - $34,295.99
$2,715.00 - $2,857.99
$1,900.00
$20,000.00
$69.16
$55.10
$46.74
$39.52
$29.64
$34,296.00 - $35,999.99
$2,858.00 - $2,999.99
$2,000.00
$20,000.00
$72.80
$58.00
$49.20
$41.60
$31.20
$36,000.00 - $37,715.99
$3,000.00 - $3,142.99
$2,100.00
$20,000.00
$76.44
$60.90
$51.66
$43.68
$32.76
$37,716.00 - $39,431.99
$3,143.00 - $3,285.99
$2,200.00
$20,000.00
$80.08
$63.80
$54.12
$45.76
$34.32
$39,432.00 - $41,147.99
$3,286.00 - $3,428.99
$2,300.00
$20,000.00
$83.72
$66.70
$56.58
$47.84
$35.88
$41,148.00 - $42,863.99
$3,429.00 - $3,571.99
$2,400.00
$20,000.00
$87.36
$69.60
$59.04
$49.92
$37.44
$42,864.00 - $44,579.99
$3,572.00 - $3,714.99
$2,500.00
$20,000.00
$91.00
$72.50
$61.50
$52.00
$39.00
$44,580.00 - $46,295.99
$3,715.00 - $3,857.99
$2,600.00
$20,000.00
$94.64
$75.40
$63.96
$54.08
$40.56
$46,296.00 - $47,999.99
$3,858.00 - $3,999.99
$2,700.00
$20,000.00
$98.28
$78.30
$66.42
$56.16
$42.12
$48,000.00 - $49,715.99
$4,000.00 - $4,142.99
$2,800.00
$20,000.00
$101.92
$81.20
$68.88
$58.24
$43.68
$49,716.00 - $51,431.99
$4,143.00 - $4,285.99
$2,900.00
$20,000.00
$105.56
$84.10
$71.34
$60.32
$45.24
$51,432.00 - $53,147.99
$4,286.00 - $4,428.99
$3,000.00
$20,000.00
$109.20
$87.00
$73.80
$62.40
$46.80
$53,148.00 - $54,863.99
$4,429.00 - $4,571.99
$3,100.00
$20,000.00
$112.84
$89.90
$76.26
$64.48
$48.36
$54,864.00 - $56,579.99
$4,572.00 - $4,714.99
$3,200.00
$20,000.00
$116.48
$92.80
$78.72
$66.56
$49.92
$56,580.00 - $58,295.99
$4,715.00 - $4,857.99
$3,300.00
$20,000.00
$120.12
$95.70
$81.18
$68.64
$51.48
$58,296.00 - $59,999.99
$4,858.00 - $4,999.99
$3,400.00
$20,000.00
$123.76
$98.60
$83.64
$70.72
$53.04
$60,000.00 - $61,715.99
$5,000.00 - $5,142.99
$3,500.00
$20,000.00
$127.40
$101.50
$86.10
$72.80
$54.60
$61,716.00 - $63,431.99
$5,143.00 - $5,285.99
$3,600.00
$20,000.00
$131.04
$104.40
$88.56
$74.88
$56.16
$20,000.00
$134.68
$107.30
$91.02
$76.96
$57.72
$20,000.00
$138.32
$110.20
$93.48
$79.04
$59.28
$63,432.00 - $65,147.99
$5,286.00 - $5,428.99
$3,700.00
$65,148.00 - $66,863.99
$5,429.00 - $5,571.99
$3,800.00
$66,864.00 - $68,579.99
$5,572.00 - $5,714.99
$3,900.00
$20,000.00
$141.96
$113.10
$95.94
$81.12
$60.84
$68,580.00 - $70,295.99
$5,715.00 - $5,857.99
$4,000.00
$20,000.00
$145.60
$116.00
$98.40
$83.20
$62.40
25your First Financial Representative for details.
* Higher benefit amounts available up to a maximum Monthly Disability Benefit of $7,500. Ask
** Not to exceed 70% of your covered monthly compensation.
Plan Features
ACCIDENTAL DEATH BENEFIT
A lump sum of $20,000.00 will be paid if you die as the direct result of an
Injury and death occurs within 90 days after the Injury.
The benefit will be increased 1% for each full month that your Certificate
was continuously in force just prior to death. The total increase shall not
be more than 60% of the benefit amount.
DIRECT DEPOSIT DISABILITY BENEFITS
In the event you choose the direct deposit option on an approved
claim, we will deposit your benefits directly into your bank account at
no additional cost. This can accelerate access to your benefits by several
days. We also have a toll-free fax that allows you instant transmission of
your claim forms to our Benefits Department.
DONOR BENEFIT
If you are Disabled as a result of being an organ or tissue donor, we will
pay your benefit as any other Sickness under the terms of the plan.
FAMILY CARE BENEFIT
If you are Disabled and Working, qualify to receive a Disability Payment
from us, and have one or more eligible family members, you may be
eligible to receive a Family Care Benefit. This may include payment for
the care of an eligible family member by a licensed childcare provider or
licensed caregiver who is not related to you by blood or marriage. We
will provide a Family Care Benefit for expenses incurred of up to 25%
of your monthly Disability Benefit provided the total of your Disability
Earnings, the gross Disability Benefit, and the Family Care Benefit do not
exceed 100% of your Monthly Compensation. Payment of the Family
Care Benefit will end on the earlier of the following: the date you no
longer incur Family Member expenses; or the date you no longer qualify
as Disabled and Working; or the date Disabled and Working benefits
have been paid for a total of 24 months.
HOSPITAL CONFINEMENT BENEFIT
The Hospital Confinement Benefit will not begin until the elimination
period has been satisfied and will pay up to 60 days. The Hospital
Confinement Benefit will be paid each day the insured is confined as a
patient in a Hospital due to an Injury or Sickness. The amount payable
is one times the Disability Benefit which will be pro-rated on a daily
basis. This benefit is not reduced by Deductible Sources of Income. The
Hospital Confinement must be at least 18 hours of continuous duration.
PHYSICIAN EXPENSE BENEFIT
»» Injury - $150.00 per Injury
»» Sickness - $50.00
If you need personal treatment by a Physician due to an Injury or Sickness,
we will pay the amount shown above provided no other claim has been
paid under the Policy. This benefit will be paid for Sickness only if the
treatment is received during one full day of Disability during which you
missed one full day of work. To be eligible for more than one payment for
the same or related condition due to Sickness, you must have returned
to Active Employment for at least 14 consecutive scheduled workdays.
You are not required to miss one full day of work in order to receive the
Injury benefit.
PORTABILITY CONVERSION
The Conversion Plan will be a separate group plan with a 30 day
elimination period and 2 year benefit period. Certain other qualifications
may apply. A brochure is available for this plan upon request after
termination.
RETURN TO WORK INCENTIVE BENEFIT: DISABLED
WHILE WORKING
We will provide a Disability Payment if you are Disabled and your
monthly Disability Earnings, if any, are less than 20% of your Monthly
Compensation due to the same Disability.
If you are Disabled and your Disability Earnings are greater than 20% of
your Monthly Compensation due to the same Disability, we will figure
your payment as follows:
During the first 24 months of payments while Disabled and Working:
»» Your Disability Payment will not be reduced as long as the Disability
Earnings plus the gross Disability Benefit does not exceed 80% of
your Monthly Compensation.
»» If the Disability Earnings plus the gross Disability Benefit exceeds
80% of your Monthly Compensation, the Disability Payment
will be reduced by the amount exceeding 80% of your Monthly
Compensation.
After 24 months of payments, while Disabled and Working, you will
receive payments based on the percentage of Monthly Compensation
you are losing due to Lost Earnings based on your Disability.
We will stop payments and your claim will end, if at any time you are no
longer Disabled or if your Disability Earnings exceed 80% of your Monthly
Compensation. The Elimination Period cannot be satisfied with days you
are Disabled and Working.
SOCIAL SECURITY FILING ASSISTANCE
If we determine you are a likely candidate for Social Security Disability
benefits, we can assist you with the application and appeal process.
SPECIAL CONDITIONS LIMITED BENEFIT
The Special Conditions Limited Benefit provides a benefit up to 2 years,
due to Special Conditions if you are disabled and under the regular and
appropriate care of your physician. Special Conditions means: Chronic
Fatigue Syndrome; Fibromyalgia; Any disease, disorder, accident or
injury of the neck or back not resulting in hemiplegia, paraplegia or
quadriplegia; Environmental allergic illness including, but not limited
to sick building syndrome and multiple chemical sensitivity; and Selfreported symptoms. Self-reported symptoms are symptoms that the
insured tells their physician that are not verifiable using tests, procedures
or clinical examinations. Examples include: headaches, pain, fatigue,
26 stiffness, soreness, ringing in ears, dizziness, numbness, or loss of energy.
SUCCESSIVE DISABILITIES
»» Sick leave or other salary or wage continuance plans provided by
the Employer which extend beyond 60 (14, 30, 60 day Elimination
Periods), 90 (on 90 day Elimination Period) and 150 (on 150 day
Elimination Period) calendar days from the Date of Disability.
Disabilities which result from the same or related causes will be
considered one period of Disability unless the Disabilities are separated
by your return to Active Employment or any other gainful occupation for
at least 3 consecutive months.
We reserve the right to estimate these Deductible Sources of Income that
you may receive as defined in your Certificate.
WAIVER OF PREMIUM
MINIMUM DISABILITY BENEFIT
No premium payments are required while you are receiving payments
under the plan after Disability Payments have been received under the
plan for 180 consecutive days. We will require proof on an annual basis
that you remain Disabled during this time.
The minimum Monthly Disability Benefit is 10% of the Monthly Disability
Benefit or $100.00, whichever is greater.
INCREASE OF INCOME DUE TO COST OF LIVING
ADJUSTMENTS
WORKSITE ACCOMMODATION
The Disability Payment will not be reduced due to a cost of living increase
if the increase from a Deductible Source of Income takes effect after the
onset of Disability and while benefits are payable under the Policy.
As part of our claims evaluation process, if worksite modifications may
assist your return to work, we will evaluate your claim for appropriate
action.
MENTAL ILLNESS LIMITED BENEFIT
Important Policy Provisions
If you are Disabled due to a mental illness, regardless of the cause,
Disability Payments will be provided for up to 2 years, not to exceed the
Maximum Disability Period.
ELIGIBILITY
All permanent employees in subscribing group working 20 hours or
more per week. Proof of good health may be required by us in order
to be eligible for disability coverage. We will rely on answers given on
your application to determine if coverage can be issued. Regardless of
your health at the time of application, if coverage is approved and issued,
claims incurred while coverage is in force will be subject to all terms of the
Policy including any Pre-Existing Condition limitation.
ALCOHOLISM AND DRUG ADDICTION LIMITED BENEFIT
If you are disabled due to alcoholism or drug addiction, a limited benefit
of up to 15 days for each Disability will be paid. Benefits will not be paid
beyond the Maximum Benefit Period. If drug addiction is sustained at the
hands of, or while under the regular and appropriate care of a physician in
the course of treatment for Injury or Sickness, it will be covered the same
as any other Sickness.
WHEN COVERAGE BEGINS
Certificates will become effective on the requested effective date
following the date we approve the application, providing you are on
Active Employment and premium has been paid.
PRE-EXISTING CONDITION LIMITATION
A limited benefit up to 1 month’s Disability Benefit will be payable for
Disability caused by or resulting from a Pre-Existing Condition. This
provision will not apply if you have:
IF YOU ARE DISABLED DUE TO A COVERED DISABILITY AND
NOT WORKING
»» gone treatment-free;
Your Disability Payment will be the Disability Benefit described in the
Benefit Schedule less any Deductible Sources of Income you receive or
are entitled to receive. No Disability Payment will be provided for any
period in which you are not under the regular and appropriate care of a
physician.
»» incurred no expense;
»» taken no medication; and
»» received no diagnosis or advice from a Physician,
for 12 consecutive months for such condition(s).
This limitation will not apply to a Disability resulting from a Pre-Existing
Condition that begins after you have been continuously covered under
the Policy for 24 months.
OFFSETS WITH OTHER SOURCES OF INCOME
Deductible Sources of Income include:
»» Other group disability income.
Any increase in benefits will be subject to this Pre-Existing Condition
limitation. A new Pre-Existing Condition period must be satisfied with
respect to any increase applied for and approved by us.
»» Governmental or other retirement system, whether due to Disability,
normal retirement or voluntary election of retirement benefits.
»» United States Social Security Act or similar plan or act, including any
amounts due your dependent(s) on account of your Disability.
EXCLUSIONS
»» State Disability.
The Policy does not cover any loss, fatal or non-fatal, resulting from:
»» Unemployment compensation.
»» Intentionally self-inflicted injury while sane or insane.
»» An act of war, declared or undeclared.
27
»» Injury sustained or Sickness contracted while in the service of the
armed forces of any country.
»» Committing a felony.
DISABILITY: Disability or Disabled for the first 12 months of Disability
means that you are unable to perform the material and substantial duties
of your Regular Occupation. After that, Disability means you are unable
to perform the material and substantial duties of any Gainful Occupation
for wage or profit for which you are reasonably qualified by training,
education, or experience.
»» Penal incarceration. We will not pay benefits for Disability or any
other loss during any period for which you are incarcerated in a
penal or correctional institution for a period of 30 consecutive days
or longer.
»» Injury or Sickness arising out of and in the course of any occupation
for wage or profit or for which you are entitled to Workers’
Compensation*.
DISABILITY EARNINGS: Means the gross monthly earnings you receive
while Disabled and Working.
*The term “entitled to Workers’ Compensation” shall also include Workers’
Compensation claim settlements that occur via compromise and release. Further,
no benefits will be paid under this Policy for any period during which you are
entitled to Workers’ Compensation benefits.
DISABILITY PAYMENT: Means your Disability Benefit minus Deductible
Sources of Income.
ELIGIBLE FAMILY MEMBERS: With regards to the Family Care Benefit,
this means your child (natural, step, or adopted) living in your household
and under age 13; or your family member who is:
LEAVE OF ABSENCE
Your coverage may be continued for up to 1 year during a Leave of
Absence approved in writing by your Employer.
»» living in your household;
TERMINATION OF INSURANCE
»» dependent upon you for support; and
Your insurance coverage will end on the earliest of these dates:
»» in need of supervision or assistance due to physical or mental
incapacity.
»» the date you do not meet the Eligibility requirements as defined in
the Eligibility paragraph in this brochure;
HOSPITAL: The term “Hospital” shall not include an institution used by
you as:
»» the date you retire;
»» the date you cease to be on Active Employment, except as provided
for under the Leave of Absence provision;
»» a place for rehabilitation;
»» a place for rest or for the aged;
»» the end of the last period for which premium has been paid;
»» a nursing or convalescent home;
»» the date the Policy is discontinued; or
»» a long-term nursing unit or geriatrics ward; or
»» the date your employment terminates.
»» as an extended care facility for the care of convalescent, rehabilitative,
or ambulatory patients.
If:
»» your coverage ends as a result of your termination of Active
Employment;
LOST EARNINGS: Means the percentage of Monthly Compensation
you are losing due to your Disability while Disabled and Working. This is
computed as follows:
»» such termination is caused by an Injury or Sickness for which
Disability Benefits would be payable; and
»» Disability is established prior to the termination of Active
Employment,
then:
»» subtract your Disability Earnings from your Monthly Compensation;
»» divide this answer by your Monthly Compensation.
This will be your percentage of lost earnings.
Multiply your Disability payment by your percentage of lost earnings.
Disability Benefits will be paid as if such termination had not occurred.
Termination of the Policy will have no affect on Disability Payments which
began before termination. We may end your coverage if you submit a
fraudulent claim. Your coverage can be terminated or premiums may be
increased on any premium due date with 31 days advance notice.
MONTHLY COMPENSATION: Means for contracted employees, onetwelfth (1/12) of your contract salary through your Employer; or for noncontracted employees, one-twelfth (1/12) of your annual salary through
your Employer, in effect on the date Disability began. It excludes any
additional compensation including but not limited to, overtime pay,
weekend or summer work compensation, bus or other allowances,
bonuses or district-funded fringe benefits. If you become Disabled
while on an approved leave of absence, we will use your gross Monthly
Compensation from your Employer in effect just prior to the date your
absence began.
DEFINITIONS
ACTIVE EMPLOYMENT: Means you are doing in the usual manner all of
the regular duties of your employment on a full-time basis on a scheduled
work day and these duties are being done at one of the places of business
where you normally do such duties or at some location to which your
employment sends you. You will be said to be on Active Employment on
a day which is not a scheduled work day only if you are not Disabled and
would be able to perform in the usual manner all the regular duties of your
employment if it were a scheduled work day.
28
Marketed
by: First Financial Group of America
BENEFITS BEGIN
PRE-EXISTING CONDITION: The term “Pre-Existing Condition” means
a disease, Injury, Sickness, physical condition or mental illness for which
you:
»» had treatment;
»» incurred expense;
»» took medication;
»» received care or services including diagnostic testing or related
measures; or
»» received a diagnosis or advice from a Physician,
during the 12-month period immediately before your Effective Date of
coverage. The term Pre-Existing Condition will also include conditions
which are related to such disease, Injury, Sickness, physical condition, or
mental illness.
Benefits begin on the following days, upon satisfying any required
elimination period.
14 Day Elimination Period: Benefits begin on the 15th day of
Disability due to a covered Injury or Sickness.
30 Day Elimination Period: Benefits begin on the 31st day of
ELIMINATION PERIOD
BENEFITS ARE PAYABLE
Period of time you must be disabled before benefit payments begin.
Up to the period of time shown in the table below, based on your age as
of the date Disability due to a covered Injury or Sickness begins.
Age
Maximum Benefit Period
Less than age 60
To Social Security Normal Retirement Age (SSNRA)*
60
60 months, or to SSNRA*, whichever is greater
61
62
63
64
65
66
67
68
Age 69 or older
*Age at which you are entitled to unreduced Social Security benefits based
on current Social Security Amendments.
Disability Income Insurance Can Help!
Ask Your First Financial Account
Representative For More Details.
If you reside in a state other than your employer’s state of domicile,
29where required by law, policy provisions and benefits may vary.
PLAN HIGHLIGHTS
»» Effective Date
Your Effective Date is different than the date you sign your application. Your Effective Date of coverage is the date shown on your certificate. Please be sure to view your group certificate to understand when your coverage begins upon
approval of application it can either be mailed to you or you can receive an email with a link to view securely online.
»» Hospital Confinement Benefit
Pays an immediate benefit each day you are confined to a hospital for an injury or sickness, and will not begin until the elimination period has been satisfied. Benefit will pay up to 60 days.
»» Limitations and Exclusions
This policy has limitations and/or exclusions to select benefits during certain situations, including self inflicted injury, an act of war, injuries contracted not to cover any loss, fatal or non-fatal, resulting from while serving in the armed forces, while committing a felony or during penal incarceration, or an injury or sickness in which you are entitled to Workers’ Compensation.
»» Physicians Expense Benefit
Receive a benefit if you receive treatment by a Physician due to a covered Injury.
»» Pre-Existing
Means a disease, Injury, Sickness, physical condition or mental illness that received medical advice or treatment prior to enrollment in a new disability insurance plan.
»» Offsets
If applicable, your disability benefit will be reduced by deductible sources of Income that include, but are not limited
»» Sick leave or other salary or wage continuance plans
to: • other group disability income benefits;
provided by the Employer which extend beyond 60 (14,
• government or retirement system benefits;
30, 60 day Elimination Periods), 90 (on 90 day Elimination
• Social Security benefits (if applicable in your
Period) and 150 (on 150 day Elimination Period) calendar
state), including any amounts due to your
days from the Date of Disability.
dependent(s) on account of your disability;
»» Salary Increases
Your Monthly Disability Benefit does not automatically increase if you have an increase in pay! It is important to notify
your Account Manager when applying for a new, higher benefit that is aligned with your current income.
»» Waiver of Premium
Premiums may be waived while you are disabled based on the length of your disability and the plan selected.
Please review the full benefit definition of each section above under “Plan Features” inside this brochure for plan details, limitations and exclusions.
Sign up for online secured access to view and print your
policies at americanfidelity.com.
American Fidelity’s Online Service Center provides you convenient,
secure 24/7 access to your detailed certificate. We understand
your privacy is important so we will not use your e-mail address for
solicitation purposes.
SB-29298(FF)(ENHANCED)-0316
Underwritten and administered by:
9000 Cameron Parkway
Oklahoma City, Oklahoma 73114
800-654-8489
www.americanfidelity.com
30 MCH#1309; 014405-8, 014406-9, 014407-10, 014408-11, 014410-12
G-120-TX-100-060;
AFA
Accident
31
32
33
»
»
»
»
»
»
34
35
36
37
38
2000 N. Classen Boulevard • Oklahoma City, Oklahoma 73106 • 800-654-8489 • www.americanfidelity.com
39
Superior
Vision
40
Vision Plan Benefits for Corsicana ISD
Co-Pays
Exam
Materials
Services/Frequency
Monthly Premiums
$10
$25
Emp. only
Emp. + spouse
Emp. + child(ren)
Emp. + family
$7.43
$12.65
$13.35
$20.07
Exam
Frame
Lenses
Contact Lenses
12 months
24 months
12 months
12 months
(Based on date of service)
Benefits
Exam
Frames
Lenses (standard) per pair
Single Vision
Bifocal
Trifocal
Progressive
Lenticular
2
Contact Lenses
Medically Necessary Contact Lenses
Lasik Vision Correction
In-Network
Out-of-Network
Covered in full
$125 retail allowance
Up to $35 retail
Up to $70 retail
Covered in full
Up to $25 retail
Covered in full
Up to $40 retail
Covered in full
Up to $45 retail
1
See description
Up to $45 retail
Covered in full
Up to $80 retail
$150 retail allowance
Up to $80 retail
Covered in full
Up to $150 retail
3
$200 allowance
Co-pays apply to in-network benefits; co-pays for out-of-network visits are deducted from reimbursements
1
Covered to provider’s in-office standard retail lined trifocal amount; member pays difference between progressive and standard retail lined trifocal,
plus applicable co-pay
2
Contact lenses and related professional services (fitting, evaluation and follow-up) are covered in lieu of eyeglass lenses and frames benefit
3
Lasik Vision Correction is in lieu of eyewear benefit, subject to routine regulatory filings and certain exclusions and limitations
Discount Features
Non-Covered Eyewear Discount: Members may also receive a discount of 20% from a participating provider’s usual and
customary fees for eyewear purchases which exceed the benefit coverage (except disposable contact lenses, for which no
discount applies). This includes eyeglass frames which exceed the selected benefit coverage, specialty lenses (i.e.
progressives) and lens “extras” such as tints and coatings. Eyewear purchased from a Walmart Vision Center does not
qualify for this additional discount because of Walmart’s “Always Low Prices” policy.
.
SuperiorVision.com
Customer Service
800.507.3800
The Plan discount features are not insurance.
All allowances are retail; the member is responsible for paying the provider directly for all non-covered items and/or any amount over the allowances,
minus available discounts. These are not covered by the plan.
Discounts are subject to change without notice.
Disclaimer: All final determinations of benefits, administrative duties, and definitions are governed by the Certificate of Insurance for your vision plan.
Please check with your Human Resources department if you have any questions
41
Ameritas
Dental
42
FFGA TEXAS STATE SCHOOL PLAN
CORSICANA ISD
Dental Highlight Sheet
Plan 1: Dental Plan Summary
Plan Benefit
Policy # 36814 Effective Date: 9/1/2016
100%
80%
50%
$5/visit Type 1
$50 Calendar Year Type 2,3
No Family Maximum
$1,000 per calendar year
Ameritas U&C
Included
Type 3 – 6 months
Type 1
Type 2
Type 3
Deductible
Maximum (per person)
Allowance
Dental Rewards®
Waiting Period
Orthodontia Summary - Child Only Coverage
Allowance
Plan Benefit
Lifetime Maximum (per person)
Waiting Period
U&C
50%
$1,000
6 months
Sample Procedure Listing (Current Dental Terminology © American Dental Association.)
Type 1
Routine Exam
(2 per benefit period)
Bitewing X-rays
Full Mouth/Panoramic X-rays
(1 in 5 years)
Cleaning
Fluoride for Children 13 and under
Sealants (age 13 and under)
Type 2
Space Maintainers
Restorative Amalgams
Restorative Composites
Simple Extractions
Monthly Rates
Employee Only (EE)
EE + Spouse
EE + Children
EE + Spouse & Children
Type 3
Onlays
Crowns
(1 in 8 years per tooth)
Crown Repair
Endodontics (nonsurgical)
Endodontics (surgical)
Periodontics (nonsurgical)
Periodontics (surgical)
Denture Repair
Implants
Prosthodontics (fixed bridge; removable
complete/partial dentures)
(1 in 8 years)
Complex Extractions
Anesthesia
$29.96
$63.88
$70.12
$103.96
Ameritas Information
We're Here to Help
This plan was designed specifically for the associates of CORSICANA ISD. At Ameritas Group, we do more than provide coverage - we make sure
there's always a friendly voice to explain your benefits, listen to your concerns, and answer your questions. Our customer relations associates will be
pleased to assist you 7 a.m. to midnight (Central Time) Monday through Thursday, and 7 a.m. to 6:30 p.m. on Friday. You can speak to them by calling
toll-free: 800-487-5553. For plan information any time, access our automated voice response system or go online to ameritas.com.
Dental Health Scorecard
How would you rate your dental health?
In 2016, you can receive your Dental Health Report Card by signing into your secure member account online. Your assessment is based on claims
submitted. The report card also offers suggestions if you strive to improve your dental health. Ameritas members can access the personalized report
card by going to ameritas.com, click Account Access in the top right corner and choose the Dental/Vision/Hearing drop down. Select the Secure Member
Account link and sign in to see your report.
43
FFGA TEXAS STATE SCHOOL PLAN
CORSICANA ISD
Dental Highlight Sheet
Rx Savings
Our valued plan members and their covered dependents (even their pets) can save on prescription medications through any Walmart or Sam's Club
pharmacy across the nation. This Rx discount is offered at no additional cost, and it is not insurance.
To receive the Walmart Rx discount, Ameritas plan members just need to visit us at ameritas.com and sign into (or create) a secure member account
where they can access and print an online-only Rx discount savings ID card.
Eyewear Savings
Ameritas plan members may receive up to 15% off eyewear frames and lenses purchased at any Walmart Vision Center nationwide. Members may also
bring in their current vision prescription from any vision care provider and purchase eyewear at Walmart. This savings arrangement is not insurance: it is
available to members at no additional cost to their plan premium.
To receive the eyewear savings identification card, Ameritas plan members can visit ameritas.com and sign-in (or create) a secure member account.
Members must present the Ameritas Eyewear Savings Card at time of purchase to receive the discount.
Dental Rewards®
This dental plan includes a valuable feature that allows qualifying plan members to carryover part of their unused annual maximum. A member earns
dental rewards by submitting at least one claim for dental expenses incurred during the benefit year, while staying at or under the threshold amount for
benefits received for that year. Employees and their covered dependents may accumulate rewards up to the stated maximum carryover amount, and
then use those rewards for any covered dental procedures subject to applicable coinsurance and plan provisions. If a plan member doesn't submit a
dental claim during a benefit year, all accumulated rewards are lost. But he or she can begin earning rewards again the very next year.
Benefit Threshold
$500
Dental benefits received for the year cannot exceed this amount
Annual Carryover Amount
$250
Dental Rewards amount is added to the following year's maximum
Maximum Carryover
$1,000
Maximum possible accumulation for Dental Rewards
Dental Network Information
To find a provider, visit ameritas.com and select FIND A PROVIDER, then DENTAL. Enter your criteria to search by location or for a specific dentist or
practice. California Residents: When prompted to select your network, choose the Ameritas Network found on your ID Card or contact Customer
Connections at 800-487-5553.
Pretreatment
While we don't require a pretreatment authorization form for any procedure, we recommend them for any dental work you consider expensive. As a
smart consumer, it's best for you to know your share of the cost up front. Simply ask your dentist to submit the information for a pretreatment estimate to
our customer relations department. We'll inform both you and your dentist of the exact amount your insurance will cover and the amount that you will be
responsible for. That way, there won't be any surprises once the work has been completed.
Open Enrollment
If a member does not elect to participate when initially eligible, the member may elect to participate at the policyholder's next enrollment period. This
enrollment period will be held each year and those who elect to participate in this policy at that time will have their insurance become effective on
September 1.
Late Entrant Provision
We strongly encourage you to sign up for coverage when you are initially eligible. If you choose not to sign up during this initial enrollment period, you
will become a late entrant. Late entrants will be eligible for only exams, cleanings, and fluoride applications for the first 12 months they are covered.
Section 125
This plan is provided as part of the Policyholder's Section 125 Plan. Each employee has the option under the Section 125 Plan of participating or not
participating in this plan. If an employee does not elect to participate when initially eligible, he/she may elect to participate at the Policyholder's next
Annual Election Period.
Language Services
We recognize the importance of communicating with our growing number of multilingual customers. That is why we offer a language assistance program
that gives you access to: Spanish-speaking claims contact center representatives, telephone interpretation services in a wide range of languages, online
dental network provider search in Spanish and a variety of Spanish documents such as enrollment forms, claim forms and certificates of insurance.
This document is a highlight of plan benefits provided by Ameritas Life Insurance Corp. as selected by your employer. It is not a certificate of
insurance and does not include exclusions and limitations. For exclusions and limitations, or a complete list of covered procedures, contact
your benefits administrator.
44
Allstate
Cancer
45
Group Voluntary Cancer (Texas)
benefits and amounts
HOSPITAL AND RELATED BENEFITS
Continuous Hospital Confinement (daily)
Government or Charity Hospital (daily)
Private Duty Nursing Services (daily)
Extended Care Facility (daily)
At Home Nursing (daily)
Freestanding Hospice Care Center (daily) or
Hospice Care Team (per visit)
RADIATION, CHEMOTHERAPY, AND RELATED BENEFITS
Radiation/Chemotherapy for Cancer (every 12 months)
Blood, Plasma, and Platelets (every 12 months)
Hematological Drugs (yearly)
Medical Imaging (yearly)
SURGERY AND RELATED BENEFITS
Surgery (maximum, depending on surgery)
Anesthesia (% of Surgery Benefit)
Ambulatory Surgical Center (daily)
Second Opinion
Bone Marrow or Stem Cell Transplant - Autologous¹
Non-autologous¹
Non-autologous for Leukemia¹
MISCELLANEOUS BENEFITS
Inpatient Drugs and Medicine (daily)
Physician’s Attendance (daily)
Ambulance (per confinement)
Non-Local Transportation (per trip or mile)
$0
Outpatient Lodging (daily, $2,000 max/12 months)
Family Member Lodging (daily) and
Transportation (per trip or mile)
$0
Physical or Speech Therapy (daily)
New or Experimental Treatment (every 12 months)
Prosthesis (per amputation)
Hair Prosthesis (every 2 years)
Nonsurgical External Breast Prosthesis
Anti-Nausea Benefit (yearly)
Waiver of Premium (primary insured only)
OPTIONAL BENEFITS
Cancer Initial Diagnosis (one-time benefit)
Intensive Care - Intensive Care Confinement (daily)
Step-Down Confinement (daily)
Air/Surface Ambulance
Wellness (yearly)
#N/A
#N/A
#N/A
#N/A
¹ Yearly
$0
$0
$0
$0
#N/A
#N/A
#N/A
#N/A
46
OPTION 1
$200
$200
$200
$200
$200
$200
$200
$0
$10,000
$10,000
$200
$500
$0
$4,500
25%
$750
$600
$1,500
$3,750
$7,500
$0
$25
$50
$100
Coach Fare or
$0.40/Mile
$50
$50
Coach Fare or
$0.40/Mile
$50
$5,000
$2,000
$25
$50
$200
Yes
$0
$2,000
$0
$0
$0
$50
#N/A
#N/A
#N/A
#N/A
OPTION 2
$200
$200
$200
$200
$200
$200
$200
$0
$15,000
$15,000
$300
$750
$0
$4,500
25%
$750
$600
$1,500
$3,750
$7,500
$0
$25
$50
$100
Coach Fare or
$0.40/Mile
$50
$50
Coach Fare or
$0.40/Mile
$50
$5,000
$2,000
$25
$50
$200
Yes
$0
$2,000
$200
$100
Actual Charges
$50
#N/A
#N/A
#N/A
#N/A
$0
$0
$0
$0
#N/A
#N/A
#N/A
#N/A
Group Voluntary Cancer (Texas)
Premiums – Monthly
EE
PLAN DESIGN
F
Option 1
2 Units Hospital Benefits, 4 Units Radiation &
Chemotherapy Benefits, 3 Units Surgery Benefits, 1 Unit
Miscellaneous Benefits, 2 Units Wellness Benefit, 2 Units
Cancer Initial Diagnosis.
$23.76
$39.70
$30.30
$50.87
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Option 2
2 Units Hospital Benefits, 6 Units Radiation &
Chemotherapy Benefits, 3 Units Surgery Benefits, 1 Unit
Miscellaneous Benefits, 2 Units Wellness Benefit, 2 Units
Intensive Care Benefits, 2 Units Cancer Initial Diagnosis.
Option 3
1 Unit Hospital Benefits, 2 Units Radiation &
Chemotherapy Benefits, 1 Unit Surgery Benefits, 1 Unit
Miscellaneous Benefits.
Option 4
1 Unit Hospital Benefits, 2 Units Radiation &
Chemotherapy Benefits, 1 Unit Surgery Benefits, 1 Unit
Miscellaneous Benefits.
This Quote Expires on 5/12/2016
In addition to cancer, benefits (unless noted specifically for cancer) are also payable for: Muscular Dystrophy, Amyotrophic
Lateral Sclerosis (Lou Gehrig's Disease), Poliomyelitis, Multiple Sclerosis, Encephalitis, Rabies, Tetanus, Tuberculosis,
Osteomyelitis, Diphtheria, Scarlet Fever, Cerebrospinal Meningitis (bacterial), Brucellosis, Sickle Cell Anemia, Thalassemia,
Rocky Mountain Spotted Fever, Legionnaires' Disease (confirmation by culture or sputum), Addison's Disease, Hansen's
Disease, Tularemia, Hepatitis (Chronic B or Chronic C with liver failure or Hepatoma), Typhoid Fever, Myasthenia Gravis,
Reye's Syndrome, Primary Sclerosing Cholangitis (Walter Payton's Liver Disease), Lyme Disease, Systemic Lupus Erythematosus,
Cystic Fibrosis, Primary Biliary Cirrhosis.
EE=Employee and F = Family
47
Legal
Shield
48
FFGA 2016 - TX
HAVE YOU EVER?
¨Needed your Will prepared or updated
¨Been overcharged for a repair or paid an unfair bill
¨Had trouble with a warranty or defective product
¨Signed a contract
¨Received a moving traffic violation
¨Had concerns regarding child support
¨ Worried about being a victim of Identity theft
¨ Been concerned about your child’s identity
¨ Lost your wallet
¨Worried about entering personal information on-line ¨Feared the security of your medical information
¨Been pursued by a collection agency
WHAT IS LEGALSHIELD?
LegalShield was founded in 1972, with the mission to make equal justice under law a reality for all North Americans. The 3.5
million individuals enrolled as LegalShield members throughout the United States and Canada can talk to a lawyer on any
personal legal matter, no matter how trivial or traumatic, all without worrying about high hourly costs. LegalShield has provided
identity theft protection since 2003 with Kroll Advisory Solutions, the world’s leading company in ID Theft consulting and
restoration. We have safeguarded over 1 million members, provided more than 200,000 identity consultations, and helped
restore nearly 10,000 individual identities.
THE LEGALSHIELD®
LEGALSHIELD®
THE
MEMBERSHIP INCLUDES:
INCLUDES:
MEMBERSHIP
THE
THEIDSHIELD
IDSHIELD
MEMBERSHIP
MEMBERSHIPINCLUDES:
INCLUDES:
SM SM
Personal Legal
Legal advice
advice on
on unlimited
unlimited issues
issues
PPersonal
P
Letters/
calls
made
on
your
behalf
Letters/
calls
made
on
your
behalf
P
P
Contracts && documents
documents reviewed
reviewed (up
(up to
to 15
15 pages)
pages)
PContracts
P
Residential Loan
Loan Document
Document Assistance
Assistance
PResidential
P
Lawyers
prepare
your
Will,
your
Living Will
Will and
and your
your
Lawyers
prepare
your
Will,
your
Living
P
P
Privacy
Monitoring
Privacy
Monitoring
Moving Traffic
Traffic Violations
Violations (available
(available 15
15 days
days after
after
PMoving
P
enrollment)
enrollment)
SSN,
credit
cards
(up
toto
10),
and
bank
account
(up
toto
SSN,
credit
cards
(up
10),
and
bank
account
(up
10)10)
monitoring,
sex
offender
search,
financial
activity
monitoring,
sex
offender
search,
financial
activity
alerts
and
quarterly
credit
score
tracking
keep
you
alerts
and
quarterly
credit
score
tracking
keep
you
secure
from
every
angle.
With
the
family
plan,
Minor
secure
from
every
angle.
With
the
family
plan,
Minor
Identity
Protection
is is
included
and
provides
monitoring
Identity
Protection
included
and
provides
monitoring
forfor
upup
toto
8 children
under
the
age
of of
18.18.
8 children
under
the
age
Monitoring
your
name,
SSN,
date
of of
birth,
email
address
Monitoring
your
name,
SSN,
date
birth,
email
address
(up
toto
10),
phone
numbers
(up
toto
10),
driver
license
&&
(up
10),
phone
numbers
(up
10),
driver
license
passport
numbers,
and
medical
IDID
numbers
(up
toto
10)10)
passport
numbers,
and
medical
numbers
(up
provides
you
with
comprehensive
identity
protection
provides
you
with
comprehensive
identity
protection
service
that
leaves
nothing
toto
chance.
service
that
leaves
nothing
chance.
Health Care
Care Power
Power of
of Attorney
Attorney
Health
Security
Monitoring
Security
Monitoring
IRS Audit
Audit Assistance
Assistance
PIRS
P
Trial Defense
Defense (if
(if named
named defendant/
defendant/ respondent
respondent in
in aa
PTrial
P
covered civil
civil action
action suit)
suit)
covered
Uncontested Divorce,
Divorce, Separation,
Separation, Adoption
Adoption and/or
and/or
PUncontested
P
Consultation
Consultation
Name Change
Change Representation
Representation (available
(available 90
90 days
days after
after
Name
enrollment)
enrollment)
Your
identity
protection
plan
includes
24/7/365
live
Your
identity
protection
plan
includes
24/7/365
live
support
forfor
covered
emergencies,
unlimited
counseling,
support
covered
emergencies,
unlimited
counseling,
identity
alerts,
data
breach
notifications
and
lost
wallet
identity
alerts,
data
breach
notifications
and
lost
wallet
protection.
protection.
25% Preferred
Preferred Member
Member Discount
Discount (Bankruptcy,
(Bankruptcy, Criminal
Criminal
P25%
P
Charges, DUI,
DUI, Other
Other Matters,
Matters, etc.)
etc.)
Charges,
Full
Service
Restoration
Full
Service
Restoration
24/7 Emergency
Emergency Access
Access for
for covered
covered situations
situations
P24/7
P
Complete
identity
recovery
services
byby
Kroll
Licensed
Complete
identity
recovery
services
Kroll
Licensed
Private
Investigators
and
our
$5$5
million
service
Private
Investigators
and
our
million
service
guarantee
ensure
that
if your
identity
is is
stolen,
it will
bebe
guarantee
ensure
that
if your
identity
stolen,
it will
restored
toto
itsits
pre-theft
status.
restored
pre-theft
status.
LegalShield legal
legal plans
plans cover
cover the
the member;
member; member’s
member’s spouse;
spouse; never
never married
married
LegalShield
dependent children
children under
under 26
26 living
living at
at home;
home; dependent
dependent children
children under
under age
age
dependent
18 for
for whom
whom the
the member
member isis legal
legal guardian;
guardian; never
never married,
married, dependent
dependent children
children
18
up to
to age
age 26
26 ifif aa full-time
full-time college
college student;
student; and
and physically
physically or
or mentally
mentally disabled
disabled
up
IDShield
plans
areare
available
at at
individual
or or
family
rates.
A family
rate
IDShield
plans
available
individual
family
rates.
A family
rate
covers
thethe
member,
member’s
spouse
and
upup
to to
8 dependents
upup
to to
thethe
covers
member,
member’s
spouse
and
8 dependents
age
of of
18 18
age
dependent children.
children. An
An individual
individual rate
rate isis available
available for
for those
those enrollees
enrollees who
who are
are
dependent
not married,
married, do
do not
not have
have aa domestic
domestic partner
partner and
and do
do not
not have
have minor
minor children
children
not
or dependents.
dependents. No
No family
family benefits
benefits are
are available
available to
to individual
individual plan
plan members.
members.
or
Ask your
your Independent
Independent Associate
Associate for
for details.
details.
Ask
PayrollD eduction
M onthly
L egalShield
ID Shield
C om bined
Individual
Family
$18.
95
$18.
95
$8.
95
$18.
95
$27.
90
$33.
90
Jason Lavender
For more information, please call your independent associate:
512-740-3322
[email protected]
49
This is a general overview
and is for illustrative
purposes only. Plans
and services vary from
state to state. See a plan
contract for your state of
residence for complete
terms, coverage, amounts,
conditions and exclusions.
Assurant
Term Life
50
51
52
20-24
1.04
1.59
2.12
2.65
3.18
3.71
4.24
4.77
5.30
5.83
6.36
6.89
7.42
7.95
8.48
9.01
9.54
10.07
10.60
11.13
11.66
12.19
12.72
13.25
13.78
14.31
14.84
15.37
15.90
18.55
21.20
23.85
26.50
30-34
1.60
2.40
3.20
4.00
4.80
5.60
6.40
7.20
8.00
8.80
9.60
10.40
11.20
12.00
12.80
13.60
14.40
15.20
16.00
16.80
17.60
18.40
19.20
20.00
20.80
21.60
22.40
23.20
24.00
28.00
32.00
36.00
40.00
35-39
2.14
3.21
4.28
5.35
6.42
7.49
8.56
9.63
10.70
11.77
12.84
13.91
14.98
16.05
17.12
18.19
19.26
20.33
21.40
22.47
23.54
24.61
25.68
26.75
27.82
28.89
29.96
31.03
32.10
65.45
42.80
48.15
53.50
40-44
3.24
4.86
6.48
8.10
9.72
11.34
12.96
14.58
16.20
17.82
19.44
21.06
22.68
24.04
25.92
27.54
29.16
30.78
32.40
34.02
35.64
37.26
38.88
40.50
42.12
43.74
45.36
46.98
48.60
56.70
64.80
62.90
81.00
Age
45-49
4.34
6.51
8.68
10.85
13.02
15.19
17.36
19.53
21.70
23.87
26.04
28.21
30.38
32.55
34.72
36.89
39.06
41.23
43.40
45.57
47.74
49.91
52.08
54.25
56.42
58.59
60.76
62.93
168.90
75.95
86.80
97.65
108.50
50-54
6.92
10.38
13.84
17.30
20.76
24.22
27.68
31.14
34.60
38.06
41.52
44.98
48.44
51.90
55.36
58.82
62.28
65.74
69.20
72.66
76.12
79.58
83.04
86.50
89.96
93.42
96.88
100.34
103.80
121.10
138.40
155.70
186.00
55-59
9.12
13.68
18.24
22.80
27.36
31.92
36.48
41.04
45.60
50.16
54.72
59.28
63.84
68.40
72.96
77.52
82.08
86.64
91.20
95.76
100.32
104.88
109.44
114.00
118.56
123.12
127.68
132.24
136.80
159.60
182.40
360.90
228.00
60-64
20.72
31.08
41.44
51.80
62.16
72.52
82.88
93.24
103.60
113.96
124.32
134.68
145.04
155.40
165.76
176.12
186.48
196.84
207.20
217.56
227.92
238.28
248.64
259.00
269.36
279.72
290.08
300.44
310.80
362.60
414.40
466.20
518.00
Employee Life Premiums
Premiums are based on the employee's age on each policy anniversary
25-29
1.60
2.40
3.20
4.00
4.80
5.60
6.40
7.20
8.00
8.80
9.60
10.40
11.20
12.00
12.80
13.60
14.40
15.20
16.00
16.80
17.60
18.40
19.20
20.00
20.80
21.60
22.40
23.20
24.00
28.00
32.00
36.00
40.00
70-74
56.68
85.02
216.32
141.70
170.04
198.38
226.72
255.06
283.40
311.74
340.08
368.42
396.76
425.10
453.44
481.78
510.12
538.46
566.80
595.14
623.48
651.38
680.16
708.50
736.84
765.18
793.52
821.86
850.20
991.90
1133.60
1275.30
1417.00
800.788.2638
75+
208.00
312.00
416.00
520.00
624.00
728.00
832.00
936.00
1040.00
1144.00
1248.00
1352.00
1456.00
1560.00
1664.00
1768.00
1872.00
1976.00
2080.00
2184.00
2288.00
2392.00
2496.00
2600.00
2704.00
2808.00
2912.00
3016.00
3120.00
3640.00
4130.00
4680.00
5200.00
T 512.454.7685
65-69
33.28
49.92
66.56
83.20
99.84
116.48
133.12
149.76
166.40
183.04
199.68
216.32
232.96
249.60
266.16
282.88
299.52
316.16
332.80
349.44
366.08
385.72
399.36
416.00
432.64
449.28
465.92
482.56
499.20
582.40
665.60
748.80
832.00
Voluntary Life Monthly Premium Deduction Schedules For: Corsicana Independent School District
Benefit in
000’s
<20
$20
1.04
$30
1.59
$40
2.12
$50
2.65
$60
3.18
$70
3.71
$80
4.24
$90
4.77
$100
5.30
$110
5.83
$120
6.36
$130
6.89
$140
7.42
$150
7.95
$160
8.48
$170
9.01
$180
9.54
$190
10.07
$200
10.60
$210
11.13
$220
11.66
$230
12.19
$240
12.72
$250
13.25
$260
13.78
$270
14.31
$280
14.84
$290
15.37
$300
15.90
$350
18.55
$400
21.20
$450
23.85
$500
26.50
For premiums for benefit amounts not illustrated in this chart, please contact your Plan Administrator.
F 512.454.9042
Assurant Employee Benefits is the brand name used for insurance products underwritten and issued by Union Security Insurance Company.
53
Benefit in
000’s
<20
$5
0.27
$10
0.53
$15
0.80
$20
1.06
$25
1.33
$30
1.59
$35
1.86
$40
2.12
$45
2.39
$50
2.65
$60
3.18
$70
3.71
$80
4.24
$90
4.77
$100
5.30
$110
5.83
$120
6.36
$130
6.89
$140
7.42
$150
7.95
$160
8.48
$170
9.01
$180
9.54
$190
10.07
$200
10.60
$210
11.13
$220
11.66
$230
12.19
$240
12.72
$250
13.25
Child Amount
20-24
0.27
0.53
0.80
1.06
1.33
1.59
1.86
2.12
2.39
2.65
3.18
3.71
4.24
4.77
5.30
5.83
6.36
6.89
7.42
7.95
8.48
9.01
9.54
10.07
10.60
11.13
11.66
12.19
12.72
13.25
Child Life and AD&D Premium
40-44
0.81
1.62
2.43
3.24
4.05
4.86
5.67
6.48
7.29
8.10
9.72
11.34
12.96
14.58
16.20
17.82
19.44
49.27
22.68
24.30
25.92
27.54
29.16
30.78
32.40
34.02
35.64
37.26
38.88
40.50
Age
45-49
1.09
2.17
3.26
4.34
5.43
6.51
7.60
8.68
9.77
10.85
13.02
15.19
17.36
19.53
21.70
23.87
26.04
28.21
30.38
32.55
34.72
36.89
39.06
41.23
43.40
45.66
47.74
49.91
52.08
54.25
50-54
1.73
3.46
5.19
6.92
8.65
10.38
12.11
13.84
15.57
17.30
20.76
24.22
27.68
31.14
34.60
38.06
41.52
44.98
48.44
51.90
55.36
58.82
62.28
65.74
69.20
72.66
76.12
79.58
83.04
93.00
2.08
$10,000
35-39
0.54
1.07
1.61
2.14
2.68
3.21
3.75
4.28
4.82
5.35
6.42
7.49
8.56
9.63
10.70
11.77
12.84
13.91
14.98
16.40
17.12
18.19
19.26
20.33
21.40
22.47
23.54
24.61
25.68
26.75
1.04
$5,000
30-34
0.40
0.80
1.20
1.60
2.00
2.40
2.80
3.20
3.60
4.00
4.80
5.60
6.40
7.20
8.00
8.80
9.60
10.40
11.20
12.00
12.80
13.60
14.40
15.20
16.00
16.80
17.60
18.40
19.20
20.00
55-59
2.28
4.56
6.84
9.12
11.40
13.68
15.96
59.69
20.52
22.80
27.36
31.92
36.48
41.04
45.60
50.16
54.72
59.28
63.84
68.40
72.96
77.52
82.08
86.64
91.20
95.76
100.32
104.88
109.44
114.00
60-64
5.18
10.36
15.54
20.72
25.90
31.08
36.26
41.44
46.62
51.80
62.16
72.52
82.88
93.24
103.60
113.96
124.32
134.68
145.04
155.40
165.76
176.12
186.48
196.84
207.20
217.56
227.92
238.28
248.64
259.00
Spouse Life Premiums
Premiums are based on the employee's age on each policy anniversary
25-29
0.40
0.80
1.20
1.60
2.00
2.40
2.80
3.20
3.60
4.00
4.80
5.60
6.40
7.20
8.00
8.80
9.60
10.40
11.20
12.00
12.80
13.60
14.40
15.20
16.00
16.80
17.60
18.40
19.20
20.00
0.21
$1,000
70-74
14.17
28.34
42.51
56.68
70.85
85.02
99.19
113.36
127.53
141.70
170.04
198.38
226.68
255.06
283.40
311.74
340.08
368.42
396.76
425.10
453.44
481.78
510.12
538.46
656.80
595.14
623.48
651.82
680.16
708.50
800.788.2638
75+
52.00
104.00
156.00
208.00
260.00
312.00
364.00
416.00
468.00
520.00
624.00
728.00
832.00
936.00
1040.00
1144.00
1248.00
1352.00
1456.00
1560.00
1664.00
1768.00
1872.00
1976.00
2079.20
2184.00
2288.00
2392.00
2496.00
2600.00
T 512.454.7685
65-69
8.32
16.64
24.96
33.28
41.60
49.92
58.24
66.56
74.88
83.20
99.84
116.48
133.12
149.76
166.40
183.04
199.68
216.28
232.96
249.60
266.24
282.88
299.52
316.16
332.80
349.44
366.08
382.72
399.36
416.00
F 512.454.9042
54
Texas
Life
55
Life Insurance Highlights
purelife-plus
For the employee
Flexible Premium Life Insurance to Age 121
Policy Form PRFNG-NI-10
Voluntary permanent life insurance can be an ideal complement to the group term and optional term your
employer might provide. Designed to be in force when you die, this voluntary universal life product is yours to
keep, even when you change jobs or retire, as long as you pay the necessary premium. Group and voluntary term,
on the other hand, typically are not portable if you change jobs and, even if you can keep them after you retire,
usually costs more and declines in death benefit.
The policy, purelife-plus, is underwritten by Texas Life Insurance Company, and it has these outstanding features:
•
High Death Benefit. With one of the highest death benefits available at the worksite,1 purelife-plus gives your
loved ones peace of mind, knowing there will be significant life insurance in force should you die prematurely.
•
Minimal Cash Value. Designed to provide high death benefit, purelife-plus does not compete with the cash
accumulation in your employer-sponsored retirement plans.
•
Long Guarantees.2 Enjoy the assurance of a policy that has a guaranteed death benefit to age 121 and level
premium that guarantees coverage for a significant period of time (after the guaranteed period, premiums
may go down, stay the same, or go up).
•
Refund of Premium. Unique in the marketplace, purelife-plus offers you a refund of 10 years’ premium, should
you surrender the policy if the premium you pay when you buy the policy ever increases. (Conditions apply.)
•
Accelerated Death Benefit Rider. Should you be diagnosed as terminally ill with the expectation of death
within 12 months (24 months in Illinois), you will have the option to receive 92% (84% in Illinois) of the death
benefit, minus a $150 ($100 in Florida) administrative fee. This valuable living benefit gives you peace of mind
knowing that, should you need it, you can take the large majority of your death
benefit while still alive. (Conditions apply.) (Form ICC07-ULABR-07 or ULABR-07)
You may apply for this permanent, portable coverage, not only for
yourself, but also for your spouse, minor children and grandchildren.3
Like most life insurance policies, Texas Life policies contain certain exclusions, limitations, exceptions, reductions of benefits, waiting periods and terms for keeping them
in force. Please contact a Texas Life representative for costs and complete details.
Voluntary and Universal Whole Life Products, Eastbridge Consulting
Group, October 2012
2
Guarantees are subject to product terms, exclusions and limitations and
the insurer’s claims-paying ability and financial strength.
3
Policies not available for children and grandchildren in Washington.
1
See the purelife-plus brochure for details.
14M034-C 1025 (exp0316)
56
purelife-plus is not available in NJ, NY or PA.
monthly p r e m i u m s
PureLife-plus
—
Standard Risk Table Premiums
—
Non-Tobacco
—
Express Issue
GUARANTEED
Issue
Age
$50,000
14.00
14.50
18.50
19.00
19.00
19.50
20.00
20.50
20.50
21.00
21.50
22.50
23.50
24.50
26.00
27.00
28.00
29.50
31.50
33.50
36.00
39.50
43.00
46.50
50.50
54.50
58.00
62.00
66.50
72.00
78.50
86.50
94.50
102.50
109.50
114.50
118.00
122.00
127.00
130.50
142.00
156.00
171.50
192.00
206.50
PERIOD
Age to Which
Coverage is
Guaranteed at
$75,000
$100,000
$150,000
$200,000
$250,000
$300,000
27.00
27.75
27.75
28.50
29.25
30.00
30.00
30.75
31.50
33.00
34.50
36.00
38.25
39.75
41.25
43.50
46.50
49.50
53.25
58.50
63.75
69.00
75.00
81.00
86.25
92.25
99.00
107.25
117.00
129.00
141.00
153.00
163.50
171.00
176.25
182.25
189.75
195.00
212.25
233.25
256.50
287.25
309.00
35.50
36.50
36.50
37.50
38.50
39.50
39.50
40.50
41.50
43.50
45.50
47.50
50.50
52.50
54.50
57.50
61.50
65.50
70.50
77.50
84.50
91.50
99.50
107.50
114.50
122.50
131.50
142.50
155.50
171.50
187.50
203.50
217.50
227.50
234.50
242.50
252.50
259.50
282.50
310.50
341.50
382.50
411.50
52.50
54.00
54.00
55.50
57.00
58.50
58.50
60.00
61.50
64.50
67.50
70.50
75.00
78.00
81.00
85.50
91.50
97.50
105.00
115.50
126.00
136.50
148.50
160.50
171.00
183.00
196.50
69.50
71.50
71.50
73.50
75.50
77.50
77.50
79.50
81.50
85.50
89.50
93.50
99.50
103.50
107.50
113.50
121.50
129.50
139.50
153.50
167.50
181.50
197.50
213.50
227.50
243.50
261.50
86.50
89.00
89.00
91.50
94.00
96.50
96.50
99.00
101.50
106.50
111.50
116.50
124.00
129.00
134.00
141.50
151.50
161.50
174.00
191.50
209.00
226.50
246.50
266.50
284.00
304.00
326.50
103.50
106.50
106.50
109.50
112.50
115.50
115.50
118.50
121.50
127.50
133.50
139.50
148.50
154.50
160.50
169.50
181.50
193.50
208.50
229.50
250.50
271.50
295.50
319.50
340.50
364.50
391.50
oba
7.90
8.40
9.10
9.80
10.50
11.30
12.10
12.80
13.60
14.50
15.60
16.90
18.50
20.10
21.70
23.10
24.10
24.80
25.60
26.60
27.30
29.60
32.40
35.50
39.60
42.50
45.30
47.80
50.40
53.20
56.20
$25,000
7.75
8.00
10.00
10.25
10.25
10.50
10.75
11.00
11.00
11.25
11.50
12.00
12.50
13.00
13.75
14.25
14.75
15.50
16.50
17.50
18.75
20.50
22.25
24.00
26.00
28.00
29.75
31.75
34.00
36.75
40.00
44.00
48.00
52.00
55.50
58.00
59.75
61.75
64.25
66.00
71.75
78.75
86.50
96.75
104.00
n-T
$10,000
No
(ALB)
15D-10
11-16
17-20
21
22
23-25
26
27
28
29
30-31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
cco
Monthly Premiums for Life Insurance Face Amounts Shown
Includes Added Cost for
Accidental Death Benefit (Ages 17-59)
Table Premium
75
70
66
66
65
63
63
63
62
62
60
61
62
62
64
64
64
65
66
67
68
70
72
73
74
75
76
77
78
79
80
82
83
85
86
85
84
84
84
84
85
87
89
93
94
95
96
96
96
95
PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the
Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.
Form: 10M014-AZrplt EXP-K-M-1AD R 05-01-15
57
monthly p r e m i u m s
PureLife-plus
—
Standard Risk Table Premiums
—
Tobacco
—
Express Issue
GUARANTEED
Monthly Premiums for Life Insurance Face Amounts Shown
Includes Added Cost for
Accidental Death Benefit (Ages 17-59)
Issue
PERIOD
Age to Which
Coverage is
Age
11.80
12.50
13.40
14.80
15.60
16.70
17.70
18.70
19.70
21.30
22.40
24.10
26.20
27.90
30.00
31.50
32.80
33.80
35.60
37.10
38.10
40.70
44.00
47.40
51.10
53.60
56.40
59.20
62.30
65.50
69.00
$50,000
$75,000
$100,000
$150,000
$200,000
$250,000
$300,000
14.25
14.75
14.75
15.50
15.75
16.00
16.25
16.50
18.50
19.00
19.25
19.50
20.75
21.50
22.75
23.50
25.00
27.25
29.00
31.25
34.75
36.75
39.50
42.00
44.50
47.00
51.00
53.75
58.00
63.25
67.50
72.75
76.50
79.75
82.25
86.75
90.50
93.00
99.50
107.75
116.25
125.50
131.75
27.00
28.00
28.00
29.50
30.00
30.50
31.00
31.50
35.50
36.50
37.00
37.50
40.00
41.50
44.00
45.50
48.50
53.00
56.50
61.00
68.00
72.00
77.50
82.50
87.50
92.50
100.50
106.00
114.50
125.00
133.50
144.00
151.50
158.00
163.00
172.00
179.50
184.50
197.50
214.00
231.00
249.50
262.00
39.75
41.25
41.25
43.50
44.25
45.00
45.75
46.50
52.50
54.00
54.75
55.50
59.25
61.50
65.25
67.50
72.00
78.75
84.00
90.75
101.25
107.25
115.50
123.00
130.50
138.00
150.00
158.25
171.00
186.75
199.50
215.25
226.50
236.25
243.75
257.25
268.50
276.00
295.50
320.25
345.75
373.50
392.25
52.50
54.50
54.50
57.50
58.50
59.50
60.50
61.50
69.50
71.50
72.50
73.50
78.50
81.50
86.50
89.50
95.50
104.50
111.50
120.50
134.50
142.50
153.50
163.50
173.50
183.50
199.50
210.50
227.50
248.50
265.50
286.50
301.50
314.50
324.50
342.50
357.50
367.50
393.50
426.50
460.50
497.50
522.50
78.00
81.00
81.00
85.50
87.00
88.50
90.00
91.50
103.50
106.50
108.00
109.50
117.00
121.50
129.00
133.50
142.50
156.00
166.50
180.00
201.00
213.00
229.50
244.50
259.50
274.50
298.50
103.50
107.50
107.50
113.50
115.50
117.50
119.50
121.50
137.50
141.50
143.50
145.50
155.50
161.50
171.50
177.50
189.50
207.50
221.50
239.50
267.50
283.50
305.50
325.50
345.50
365.50
397.50
129.00
134.00
134.00
141.50
144.00
146.50
149.00
151.50
171.50
176.50
179.00
181.50
194.00
201.50
214.00
221.50
236.50
259.00
276.50
299.00
334.00
354.00
381.50
406.50
431.50
456.50
496.50
154.50
160.50
160.50
169.50
172.50
175.50
178.50
181.50
205.50
211.50
214.50
217.50
232.50
241.50
256.50
265.50
283.50
310.50
331.50
358.50
400.50
424.50
457.50
487.50
517.50
547.50
595.50
o
$25,000
acc
$10,000
Tob
(ALB)
15D-10
11-16
17-20
21
22
23-25
26
27
28
29
30-31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
Guaranteed at
Table Premium
66
66
65
63
63
63
62
62
60
61
62
62
64
64
64
65
66
67
68
70
72
73
74
75
76
77
78
79
80
82
83
85
86
85
84
84
84
84
85
87
89
93
94
95
96
96
96
95
PureLife-plus is permanent life insurance to Attained Age 121 that can never be cancelled as long as you pay the necessary premiums. After the
Guaranteed Period, the premiums can be lower, the same, or higher than the Table Premium. See the brochure under ”Permanent Coverage”.
Form: 10M014-AZrplt EXP-K-M-1AD R 05-01-15
58
Corsicana ISD
2200 W 4th Avenue
Corsicana, TX 75110
(903) 874-7441
www.cisd.org
First Financial Administrators, Inc.
Superior Vision
Supplemental and Retirement Benefits
1200 W. Walnut Hill Lane, Suite 3400
Irving, TX 75038
Ryan Hancock, Account Manager
[email protected]
Customer Service: [email protected]
469-417-0505 • 1-800-883-0007 office • 469-417-0509 fax
Vision Insurance
1-800-883-5747
www.superiorvision.com
Allstate
Cancer Insurance
Flexible Spending Accounts
P.O. Box 670329
Houston, TX 77267-0329
1-866-853-3539 • 1-800-298-7785 fax
www.ffga.com
(800) 521-3535
www.allstatework.com
AFLAC
Critical and Hospital Indemnity Insurance
1-800-433-3036
www.aflac.com
American Fidelity
Assurance Company
Disability and Accident
1-800-654-8489
www.americanfidelity.com
Texas Life Insurance Company
Permanent Life Insurance
1-800-283-9233
www.texaslife.com
Ameritas Dental
Dental Insurance
1-800-487-5553
www.ameritasgroup.com
Assurant
Group Life Insurance
1-800-788-2638
www.assurantemployeebenefits.com

Corsicana ISD Benefit Summary 2016.pub

Transcription

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