Group Products Marketing Tool Kit · Trucking Companies engaged in hauling logs, gravel, pulpwood,...

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Group Products Marketing Tool Kit

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This guide is for training purposes only. Not for use with consumer sales. Not to be disseminated to the public.

Table of Contents Section 1 Proposal, Sales & Installation Information Page 3 Product Approval List, Ineligible Industries & Occupations, Enrollment/Participation Requirements, Proposal Request

Requirements, Sold Case/Group Submission Requirements

Section 2 Group Voluntary Cancer/Specified Disease 8

Section 3 AHL minimedical® Page 30

Section 4 Group Voluntary Dental Page 39

Section 5 Group Voluntary Accident Page 42

Section 6 Group Voluntary Disability – STD/LTD (25+ Lives) Page 45

Section 7 Group Voluntary Life (25+ Lives) Page 47

Section 8 Group Employer Paid Life and STD (10 – 24 Lives) Page 49

Section 9 Group Voluntary S.H.O.P. (5+ Lives) Page 52 (Supplemental Health Options Plan)

Section 10 Group Voluntary Critical Illness Page 56

Section 11 EyeMed VISION CARE® Page 59

Section 12 Group Indemnity Medical (GIM) Page 62

Section 13 Group Universal Life (GUL) Page 66

Section 14 The Major Complement (GAP) Page 70 (Major Medical Complement Insurance)

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SECTION 1

PROPOSAL, SALES & INSTALLATION

INFORMATION

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Group Voluntary Product Approval List

This list is continuously updated throughout the year. To determine which products are approved in the states you solicit, please visit the AWD Agent Website at https://agent.ahlcorp.com. Once you have logged into the website, follow the directions below:

1. Select Agent Resource Center

2. Select Agent Communications from drop down menu

3. Click on Agency Bulletins

4. Look for most recent AWD Product Approval List

5. Click on the PDF file

6. The Table of Contents on page 2 will show you the page for Group Voluntary Products

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Group Voluntary Products Industries & Occupations to Avoid

Product Name Industries & Occupations to Avoid Group Voluntary Cancer, Accident, S.H.O.P. & Critical Illness

Amusement Parks & Arcades Armed Forces and Federal Government employees including postal employees Asbestos Companies or Miners Asphalt Paving Contractors Associations (Individual Memberships) Babysitting Services Bars, Saloons, Taverns and Cocktail Lounges Barber/Beauty Shops Operating Out of the Home Bowling Alleys, Pool Halls Building and Wrecking Companies Car Washes Circus or Carnival Employees Construction and Maintenance of Overhead Power Lines Convenience Stores (except for Clerical Personnel and Corporate Management) Corrosive Chemical Industry Crop Dusters Explosives and Fireworks Companies Exposure to Radiation in Employment or Hazardous Waste Fast Food Establishments (except for Corporate Management and Clerical Personnel) Fraternal Organizations, Lodges and Clubs Garbage Collection Services Gas and Oil Workers Junk Dealers Lawn Maintenance, Gardeners, and Landscape Logging/Saw Mills Longshoremen Multiple Employer Credit Unions (member companies whose business is on the list will not be considered) Musicians and Entertainers Offshore Oil Drilling Outside Building and Window Cleaning PEOs – Professional Employees Organizations Police or Firefighters without the entire Municipality Professional Athletic Teams/Clubs (except for Corporate Management and Clerical Personnel) Roofing Companies (except for Allstate approved roofing contractors) Roustabouts Taxi Cab Companies Trucking Companies engaged in hauling logs, gravel, pulpwood, explosives, garbage, oil field equipment, or livestock Underground Miners

Group AHL minimedical®, Voluntary Short Term Disability (STD) & Term Life

Convenience Stores Employees temporarily or permanently located outside the United States Fast Food Establishments Municipal Bids Off Shore occupations including Oil Rigs, Shipping and Tug Boat operations PEOs – Professional Employees Organizations Professional Athletes and Entertainers Strip Mining, Subterranean Mining, Oil and Gas Exploration Vendors and Support Industries to Strip Mining, Subterranean Mining, Oil and Gas Exploration

Group Voluntary Long Term Disability (LTD)

Visit Agent Website for Industry Listing & Risk Factors for Group LTD, form AWDSIC.

Group Voluntary Dental

PEOs – Professional Employees Organizations

EyeMed VISION CARE®

Non payroll sales PEOs – Professional Employees Organizations must be preapproved prior to submission Associations & Unions must have true employer/employee relationship

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Product Name Industries & Occupations to Avoid Group Indemnity Medical (GIM)

Anyone permanently or temporarily situated outside of the United States Anyone not legally working and residing in the United States Contract, 1099 employees – employees who do not receive a W2 from the policyholder

Require Prior Home Office Approval: Strip Mining, Subterranean Mining, Oil and Gas Exploration and Recovery Vendors and Support Industries to Strip Mining, Subterranean Mining, Oil and Gas Exploration and Recovery Off Shore occupations including Oil Rigs, Shipping and Tug Boat operations Professional and Semi-Professional Athletes and Entertainers PEOs – Professional Employees Organizations

Group UL (Universal Life)

Amusement Parks & Arcades Asbestos Companies or Miners Associations (Individual Memberships) Babysitting Services Bars, Saloons, Taverns and Cocktail Lounges Barber/Beauty Shops Operating Out of the Home Bowling Alleys, Pool Halls Car Washes Circus or Carnival Employees Corrosive Chemical Industry (heavy acids, poisons and lethal gases) Crop Dusters Exposure to Radiation in Employment or Hazardous Waste Fraternal Organizations, Lodges and Clubs Garbage Collection Services Musicians and Entertainers Offshore Oil Drilling Outside Building and Window Cleaning Professional Athletic Teams/Clubs (except for Corporate Management and Clerical Personnel) Roofing Companies (except for Allstate approved roofing contractors) Taxi Cab and Limousine Rental Companies Trucking Companies engaged in hauling logs, gravel, pulpwood, explosives, garbage, oil field equipment, or livestock, or any trucking company with less than 20 employees or companies where the number of employees who are drivers is more than half of the total

Acceptable with one year employment and 25 or more permanent full-time employees: Construction Companies Gas Stations and Convenience Stores (permanent full-time employees only) Janitorial Companies Landscape Maintenance Companies Logging or Sawmill Companies Motels, Hotels or Inns Restaurants and Fast Food Outlets (permanent full-time employees only) Structural Iron and Steel Erection (working at heights of one to two stories only)

The Major Complement (GAP)

Deep Sea Divers Ironworkers Mining & Quarrying Professional Athletes Window Washers Temporary Staffing Agencies

Requires Prior Home Office/Carrier Approval: Employee Leasing Companies (PEO)

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Group Voluntary Products Enrollment Requirements

Product Name Enrollment/Participation Requirements Group Voluntary Cancer / Specified Disease

Number of Eligible 1 Year Rate 2 Year Rate 3 Year Rate Employees Guarantee Guara ntee Guara ntee 200 to 499 25% 30% 35% 500 to 999 20% 25% 30% 1,000+ 15% 20% 25%

Groups with less than 200 eligibles must be submitted through underwriting. Florida sitused cases must have a minimum of 51 enrolled, unless sold as a Buy Up Option to the AHL minimedical®.

Group AHL minimedical® The greater of 51 enrolled or 15% of the Eligible Employees When offering Group Voluntary Term Life, Group Voluntary Dental, Group Voluntary Critical Illness, Group Voluntary Accident or Group Voluntary STD as a buy-up option to AHL minimedical®, at least 10 employees must elect the buy-up option(s). There is no percentage participation requirement for the buy-up option(s).

Group Voluntary Dental The greater of 10 enrolled or 25% of the Eligible Employees. Florida sitused cases must have a minimum of 51 eligible, unless sold as a Buy Up Option to the AHL minimedical® or GIM.

Group Voluntary Accident Number of Eligible 1 Year Rate 2 Year Rate 3 Year Rate Employees Guarantee Guara ntee Guara ntee 5 - 200* 1st Year Only N/A N/A 200 to 499 25% 30% 35% 500 to 999 20% 25% 30% 1,000+ 15% 20% 25%

* Subject to Evidence (EOI) of Insurability as allowed by law-minimum requirement of 5 enrolled. Florida and New Jersey sitused cases must have a minimum of 51 enrolled, unless sold as a Buy Up Option to the AHL minimedical®.

Group Voluntary Disability STD and LTD (25+ Lives)

The greater of 10 enrolled or 25% of the Eligible Employees. Minimum number of eligible lives is 25. Florida sitused cases must have a minimum of 51 eligible, unless sold as a Buy Up Option to the AHL minimedical®. Employees must work 30 or more hours per week in order to be eligible for coverage. Special underwriting approval required if employees work less than 30 hours per week.

Group Voluntary Term Life (25+ Lives)

10 to 24 Eligible Employees – Not Available 25 to 199 Eligible Employees – 30% 200 to 499 Eligible Employees – 25% 500 to 999 Eligible Employees – 20% 1,000+ Eligible Employees – 15%

Group Voluntary S.H.O.P. (Employer Groups)

Number of Eligible 1 Year Rate Employees Guarantee 5 to 199* Minimum of 5 Applications 200 to 499 25% 500 to 999 20% 1,000+ 15% *Subject to Evidence of Insurability (EOI). Florida sitused cases must have a minimum of 51 enrolled. Not available to Health Savings Account (HSA) participants, refer to AWD Bulletin 1207710

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Product Name Enrollment/Participation Requirements Group Voluntary S.H.O.P. (Association & Unions) Available in most states. Contact the Regional Office for availability.

Number of Eligible 1 Year Rate Employees Guarantee 5 to 1,000+ Subject to Underwriting and Minimum of 5 Applications

Evidence of Insurability (EOI) required on all members. Florida sitused cases must have a minimum of 51 enrolled. Not available to Health Savings Account (HSA) participants, refer to AWD Bulletin 1207710

Group Voluntary Critical Illness (Employer Groups)

My Lifeline – issue age banded premium Number of Eligible 1 Year Rate 2 Year Rate 3 Year Rate Employees Guarantee Guara ntee Guara ntee 5-199* 1st Year Only N/A N/A 200 to 499** 25% 30% 35% 500 to 999** 20% 25% 30% 1,000+** 15% 20% 25%

*Subject to Evidence of Insurability (EOI)-minimum requirement of 5 enrolled **Subject to EOI if not meeting participation, minimum requirement of 5 enrolled. Florida and New Jersey sitused cases must have a minimum of 51 enrolled. GI: Benefit amount $10,000 - $20,000 with participation Level 1 EOI: Benefit amount $10,000 - $20,000 and did not meet participation. Level 1 & 2 EOI: Benefit amount $21,000 - $50,000 Level 1 & 2 & 3 EOI: Benefit amount $51,000 - $100,000 New Generation – composite rated premium Number of Eligible 1 Year Rate 2 Year Rate 3 Year Rate Employees Guarantee Guara ntee Guara ntee 200 to 499 25% 30% 35% 500 to 999 20% 25% 30% 1,000+ 15% 20% 25% GI: Benefit amount $10,000 - $20,000 with participation Level 1 EOI: Benefit amount $10,000 - $20,000 and did not meet participation Level 1 & 2 EOI: Benefit amount $21,000 - $50,000 Level 1 & 2 & 3 EOI: Benefit amount $51,000 - $100,000

Group Voluntary Critical Illness (Association & Unions)

My Lifeline – issue age banded premium

Number of Eligible 1 Year Rate Members Guarantee 5 to 1,000+ Subject to Underwriting and Minimum of 5 Applications

Evidence of Insurability (EOI) required on all members as allowed by law. Level 1 EOI: Benefit amount $10,000 - $20,000 Level 1 & 2 EOI: Benefit amount $21,000 - $50,000 Level 1 & 2 & 3 EOI: Benefit amount $51,000 - $100,000 Florida and New Jersey sitused cases must have a minimum of 51 enrolled Not available in TX; must use New Generation New Generation – composite rated premium

Number of Eligible 1 Year Rate Members Guarantee 200+ Subject to Underwriting and Minimum of 51 Applications

Evidence of Insurability (EOI) required on all members as allowed by law. Level 1 EOI: Benefit amount $10,000 - $20,000 Level 1 & 2 EOI: Benefit amount $21,000 - $50,000 Level 1 & 2 & 3 EOI: Benefit amount $51,000 - $100,000 Not available to groups sitused in CT, FL, MD, MT, NH, NY, PR, VT, WA Case specific filing required for CO, LA, ME, OK, OR, SD, TX

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Product Name Enrollment/Participation Requirements EyeMed VISION CARE®

Underwritten by Fidelity Security Life Insurance Company

Group must have 10 eligible lives, with 10 enrolled (except where state mandates require higher levels)

Florida & Vermont sitused groups require 51 eligible, with 10 enrolled

Not available for groups sitused in MN, NY, WA or PR

Guarantee Issue for all approved groups

Issue Age: 18+, with primary insured actively at work

24-month rate guarantee

Product can be sold on a stand alone basis or in conjunction with other products

Enrollment methods: Paper, Call Center*, IVR* & Benefit Selection*

*Requires prior Home Office Approval

Group Indemnity Medical (GIM)

Groups must have 10 eligible lives, with 10 enrolled to place in force (except where state mandates higher levels)

Groups with 10,000+ eligible lives will need prior Home Office review/approval

Groups sitused in FL & OK require 51 eligible, with 10 enrolled; not available for groups sitused in AR, CT, DC, KS, MN, NH, NJ, NY, East TX, UT, WA, WI; currently not approved in ID, KY, PR; may not be written as primary coverage for groups sitused in CA

Not available to Health Savings Account (HSA) participants, refer to AWD Bulletin 1207710

Guarantee Issue for all approved groups at initial enrollment

Issue Age: 18+, with primary insured actively at work; STD Buy-up: 18-69

12-month rate guarantee

Product can be sold with AHL minimedical in the same group as an “either/or” sale; employee cannot purchase both products

Product cannot be sold with Group SHOP

Takeover groups are considered on an individual basis*

Enrollment methods: Paper, Call Center*, IVR*, Benefit Selection*

*Requires prior Home Office Approval

Group UL (Universal Life) Number of Eligible 1 Year Rate 2 Year Rate 3 Year Rate Lives Guarantee Guarantee Guarantee 5 – 199 1st Year Only N/A N/A 200 – 499 25% 30% 35% 500 – 999 20% 25% 30% 1,000+ 15% 20% 25% Not available for groups sitused in NY Issue Ages: 18 – 80; CGI: 0 - 65 5 to 49 Simplified Issue (SI); Limits: EE $250,000 / DEP $150,000 50 to 999 Contingent Guarantee Issue (CGI)*; Limits: EE $150,000 / SP $100,000 / CH amount purchased by $3/wk 1000+ Guarantee Issue*; Limits: EE $150,000 / SP & CH are not eligible for GI issue Enrollment methods: Paper, Call Center*, IVR*, Benefit Selection* & AllApp

*Requires prior Home Office Approval; above guidelines based on expected participation requirements

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Product Name Enrollment/Participation Requirements


Groups must have 10 eligible employees (meaning, are eligible to be covered by the employer’s major medical or comprehensive health plan), with 10 enrolled employees (except where state mandates require higher levels)

FL and VT require 51 eligible employees at inception and every policy anniversary, with 10 employees enrolled

Not available for groups sitused in CT, IN, KS, MA, MN, MO, NH, NY, UT, WA

Guarantee Issue for all approved groups

Issue Age: 18+, with primary insured actively at work

One TMC plan may be selected for each major medical plan offered by the employer

Only employees covered under one of the employer’s (policy holder’s) major medical or comprehensive health plans are considered eligible

Available to payroll groups only

Coverage is not Health Savings Account (HSA) compatible; cannot be written with a HSA

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Group Voluntary Products Proposal Request Requirements

Product Name Proposal Request Requirements Group Voluntary Cancer

Complete the Request for Group Insurance form (AWD4040) & send to the Regional Office.

Census data – include age or date of birth, gender and date of hire

Include a cover memo with any information relevant to the case not found on the form (competitive climate, facts about the employer, etc.)

Group AHL minimedical®

Complete the Request for Proposal form (AWD279) & send to the Regional Office.

Census data – include age or date of birth, gender and zip codes of the eligible employees


Minimum size to quote/write: 51 eligible employees / 51 enrolled employees No Employer Contribution Requirement Minimum Participation Requirement: The greater of 51 enrolled, or 15% of the total eligible employees 3 Standard PPO plans – employer chooses one Available to full time active employees and permanent part-time employees working 20 hours or more per week. For groups that have a limited benefit plan currently in place, please provide plan description, current/renewal rates, and prior claims experience if available.

Group Voluntary Dental

Product has shelf rates; no customization is available

Five different plans to choose from

Plan Benefits & rates can be generated on AllApp®

Group Voluntary Accident


Census data – include salary, age or date of birth and gender

Include a cover memo with any information relevant to the case not found on the form (facts about the employer, etc.)

Plan Benefits & rates can be generated on AllApp®

Group Voluntary Short Term Disability (STD) (25+ Lives)

Complete the Request for Proposal form (AWD279) & send to the Regional Office.

Census data – include salary, age or date of birth and gender (include class if benefits differ between classes and indicate current coverage for replacement coverage)

For replacement coverage include: 1) A copy of the current plan booklet, certificate or contract. 2) Current rates, renewal rates and the effective dates. 3) Experience data needed for groups with 100+ Eligible Employees ■ Effective date of coverage with current carrier ■ Number of insured lives per year (preferably by month) ■ 2 years of paid premium (preferably by month), paid claims (preferably by month), and rate history


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Product Name Proposal Request Requirements Group Voluntary Long Term Disability (LTD) (25+Lives)

Complete the Request for Proposal Form (AWD279) & send to the Regional Office.

Census data – include salary, age or date of birth, gender and occupation (include class if benefits differ between classes and indicate current coverage for replacement coverage)

For replacement coverage include: 1) A copy of the current plan booklet, certificate or contract. 2) Current rates, renewal rates and the effective date. 3) Experience data requested for groups with 300+ Eligible Employees on Proposal (required if 500+ Eligible Employees) ■ Effective date of coverage with current carrier ■ Number of insured lives per year (preferably by month) ■ 3 years of paid premium (preferably by month), paid claims (preferably by month), rate history, and details of current open claims



Complete the Request for Proposal Form (AWD279) & send to the Regional Office.

Census data – include salary, age or date of birth and gender (include class if benefits differ between classes and indicate current coverage for replacement coverage)

For replacement coverage include: 1) A copy of the current plan booklet, certificate or contract. 2) Current rates, renewal rates and the effective dates. 3) Experience data needed for groups with 1,000+ Eligible Employees ■ Effective date of coverage with current carrier ■ Number of insured lives per year ■ 3 years of paid premium, paid claims, waiver claims and rate history


Employer Paid Life and STD (10 – 24 Lives)

Contact Regional Office to obtain a proposal.

Census data – include name, gender, date of birth and date of hire

Not available in FL

Group Voluntary S.H.O.P.


Census data – include salary, age or date of birth and gender


Group Voluntary Critical Illness New Generation

Complete the Request for Proposal Form (AWD279) and send to the Regional Office.

Census data – include age or date of birth, gender, date of hire

If case has existing Critical Illness coverage, include the effective date of that coverage. The Critical Illness Cancer benefit must be included in all GA cases (it is not optional). Wellness benefit must be included in all CA cases (it is not optional) and benefit amount must be $100.

Group Voluntary Critical Illness My Lifeline

Complete CGI Request Form, AWD7914G and submit to AWD New Business

Rate Illustrations are generated using AllApp® through the Regional Office.

Census data – include age or date of birth, gender, date of hire

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Product Name Proposal Request Requirements EyeMed VISION CARE®

The Employer (ER) Proposal (benefits & monthly rates) are located on the Agent Website

There are “most states” rates, FL/VT rates & MA rates

ER can choose from 3-tier (EE only, EE+1 [SP or CHild], family [EE+2 Dep]) or 4-tier rates (EE only, EE+SP, EE+CHild[ren], family [EE+SP+CH])

Out-of-Network benefits for MA option differ from other options


The product is packaged and sold in 8 pre-designed plans, no customization is available for groups of less than 10,000 eligible lives

Groups of 10,000 or more eligible lives will need to be submitted to the Home Office for review and pricing

The Employer (ER) Brochure, AWD13765, and Employee (EE) Brochure, AWD13676 are available on the Agent Website

Rates are provided on a rate card in monthly & weekly deduction modes, and are located on the Agent Website; instructions to convert the deduction mode to bi-weekly or semi-monthly will be provided as well

Brochures and rate cards must be presented together at time of presentation


Complete CGI Request Form, AWD7914G and submit to AWD New Business

Receive determination from New Business if group will be issued as SI, CGI or GI

Provide enrollee with brochure AWD13457 and appropriate rate from GUL rate card (monthly or weekly, tobacco or non-tobacco) from the Agent Website

Proposal illustrations can also be generated through AllApp®

Provide enrollee with Quotation for Life Insurance Plan, AWD3495, if non-guaranteed cash surrender value is given from GUL rate card or AllApp®


Quotes for this product are self-service, allowing the agent/broker or regional field personnel to run proposals at their convenience. Proposals are created using the Rate Generator located on the Agent Website (Agent Resource Center > Rate Generators > Major Medical Complement Insurance [GAP]) and presented to the employer with Brochure, AWD15504. Specific instructions for creating a proposal are located on the Agent Website under Supply Manual/Forms Online > Download/Order Forms (state) > Major Medical Complement - Major Medical Complement Employer Forms, and clicking on AWDMMCINS.

In order to create a proposal you will need the following information:

Name of employer

Situs state of employer

Employer contribution (if any) towards the employee premium

Employee census with only age and level of major medical coverage* (i.e., employee, employee + spouse, employee + child(ren), family)

Copy of major medical plan specifications showing individual, in-network out-of-pocket maximum

*A census is only needed if the employer would like composite rates, which requires at least 25 eligible employees, a 50% employer contribution toward the employee premium and employees in all 4 coverage level tiers (employee, employee + spouse, employee + child(ren), family).

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Request for Proposal AWD279

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Obtain the most current forms from the Agent Website

Submit this form to AWD New Business via fax at 866-428-2513 or email at [email protected]. AWD7914G-1 (10/08)

American Heritage Life Insurance Company 1776 American Heritage Life Drive Jacksonville, Florida 32224 1-800-521-3535

UNDERWRITING Request Form

Account Information 1. Account Name: 2. Account No.:

3. a. Account Contact Person: b. Phone:

c. E-mail Address: d. Fax:

e. Address:

4. Are there multiple locations? □ Yes □ No If Yes:

a. List state location of headquarters (situs state for group policies):

b. List locations by state and indicate number of employees at each:

5. Nature of Business:

Product Information 6. CGI Requested for: □ AP2 □ DI5W □ UL20 □ Horizon 20 Year Term □ GUL22 ( □ CGI or □ GI ) □ AP3 □ SHOP □ UL21 □ Other

7. Other AWD products: □ GVA □ GVS □ GVC □ GVCI □ GVD □ OTHER _______________________

8. Special requests:

Employee Information 9. Total Number of Employees:

10. Total Number of Eligible Employees:

“Eligible Employee” is an employee working 20 hours per week or more, with at least 3 months of service.

11. Average Annual Employee Turnover: □ Under 10% □ 10%-20% □ 20-30% □ Over 30%

Enrollment Information 12. Enrollment Start & End Dates: 13. Requested Effective Date of Coverage:

14. Enrollment Type: (check all that apply)

□ Group meetings □ One-on-one meetings □ Call Center □ Internet/Intranet

□ Paper Application □ Benefit Selection □ AllApp® □ Other

15. Will enrollment involve electronic signatures? □ Yes □ No If yes, explain:

16. If you require customized sales material, please see your Regional Office to complete form AWD8145.

Producer Information

17. Is an Allstate Exclusive Agent or Exclusive Financial Specialist involved with this account? □ Yes □ No 18. 19. Enrollment Firm Name and Number Agent of Record Name and Number 20. 21. TPA Name (if applicable) Servicing Agent Name and Number 22. AWD Sales Manager Name Submitted By Date Submitted

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kbagby

Contingent Guaranteed Issue Request AWD7914G

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Submit this form to AWD New Business via fax at 866-428-2513 or email at [email protected]. AWD7914-2 (5/08)

American Heritage Life Insurance Company 1776 American Heritage Life Drive Jacksonville, Florida 32224 1-800-521-3535

CONTINGENT GUARANTEED ISSUE REQUEST

Account Information 1. Account Name: 2. Account No.:

3. a. Account Contact Person: b. Phone:

c. E-mail Address: d. Fax:

e. Address:

4. Are there multiple locations? □ Yes □ No If Yes:

a. List state location of headquarters (situs state for group policies):

b. List locations by state and indicate number of employees at each:

5. Nature of Business:

Product Information 6. CGI Requested for: □ AP2 □ DI5W □ UL20 □ Horizon 20 Year Term □ AP3 □ SHOP □ UL21 □ Other

7. Other AWD products offered:

8. Special requests:

Employee Information 9. Total Number of Employees:

10. Total Number of Eligible Employees:

“Eligible Employee” is an employee working 20 hours per week or more, with at least 3 months of service.

11. Average Annual Employee Turnover: □ Under 10% □ 10%-20% □ 20-30% □ Over 30%

Enrollment Information 12. Enrollment Start & End Dates: 13. Requested Effective Date of Coverage:

14. Enrollment Type: (check all that apply)

□ Group meetings □ One-on-one meetings □ Call Center □ Internet/Intranet

□ Paper Application □ Benefit Selection □ AllApp □ Other

15. Will enrollment involve electronic signatures? □ Yes □ No If yes, explain:

16. If you require customized sales material, please see your Regional Office to complete form AWD 8145-2.

Producer Information

17. Is an Allstate Exclusive Agent or Exclusive Financial Specialist involved with this account? □ Yes □ No 18. 19. Enrollment Firm Name and Number Agent of Record Name and Number 20. 21. TPA Name (if applicable) Servicing Agent Name and Number 22. AWD Sales Manager Name Submitted By Date Submitted

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kbagby

Simplified Contingent Guaranteed Issue Request AWD7914

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Group Voluntary Products Sold Case/Group Submission Requirements

Product Name Sold Case/Group Submission Requirements Group Voluntary Cancer / Specified Disease

Request for Group Insurance AWD4040

Group Insurance Enrollment Form AWD5017 (may be state specific)

Payroll Allotment New Account Set Up/Employer Acceptance AWD003A & B

AWD13007 COBRA User Service Order Form, if employer wants CobraGuard, Inc. to administer COBRA (groups of 20 or more)

Group AHL minimedical® Request for Group Insurance AWD4040


Group Commission Agreements AWD423


Copy of Sold Plan and Rates

Group Voluntary Dental Request for Group Insurance AWD4040

Group Insurance Enrollment Form AWD5017-stand alone or AWD5018-if sold with AHL minimedical® (may be state specific)

Payroll Allotment New Account Set Up/Employer Acceptance AWD003A & B (stand alone only)


Provide information if group has current dental benefits (current carrier, effective date of group, current rates and/or renewal rates)

Group Voluntary Accident



Evidence of Insurability (200 or less Eligible Employees) AWD4502* (may be state specific)



*Evidence of Insurability in states where Group Voluntary Cancer has not been approved would be AWD4503

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Product Name Sold Case/Group Submission Requirements Group Voluntary Disability STD and LTD (25+ Lives)




Group STD/LTD & Life/AD&D Case Set-up Sheet AWD5086


Copy of Premium Rate Charts



Group Insurance Enrollment Form AWD5018



Evidence of Insurability–excess of Guaranteed Issue AWD4500 (may be state specific)


Copy of Premium Rate Charts

Group Voluntary S.H.O.P.



If there are less than 200 employees, or it is a union/association group, each individual will have to complete an Evidence of Insurability form AWD4502 in states where GVCP2 is approved, and AWD4503 where GVCP2 in not approved, instead of the AWD5017.



Group Critical Illness My Lifeline (age banded)


Group Insurance Enrollment Form (200+ eligible employees, $5,000 to $15,000) AWD5017 (may be state specific)

If there are less than 200 eligible employees, or it is a union/association group, each individual will have to complete an Evidence of Insurability form AWD4504 (may be state specific)



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Product Name Sold Case/Group Submission Requirements Group Critical Illness New Generation (composite rated)


Group Insurance Enrollment Form (200+ eligible employees, $5,000 to $15,000) AWD5018 (may be state specific)

For a group that doesn’t meet participation, each individual will have to complete an Evidence of Insurability form AWD4504 (may be state specific)


AWD13007 COBRA User Service Order Form, if employer wants CobraGuard, Inc. to administer COBRA (groups of 20 or more) Copy of Sold Plan and Rates

Group Employer Paid STD and Life (10 to 24 Lives)


Group Insurance Enrollment Form or Group Census supplied by Employer AWD5018 (may be state specific)




EyeMed VISION CARE® Request for Group Insurance AWD4040

Group Insurance Enrollment Form AWDVISION EyeMed Enrollment/Change Form if sold on stand alone basis AWD5018 (may be state specific) if sold with other Genelco (true group) products AWD5017 (may be state specific) if sold with other Life 70 (ordinary) products

ER Proposal (most states, FL/VT or MA) signed by ER indicating benefits and rates

ER Application (may be state specific) completed by ER and agent



FSL Appointment Data Sheet completed by each agent writing the business along with a copy of their resident and non-resident licenses for states they wish to write business in – this paperwork needs to be submitted 20+ days prior to writing the group to the AWD Regional Support Center

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Product Name Sold Case/Group Submission Requirements Group Indemnity Medical (GIM)


Group Insurance Enrollment Form AWD5018 (may be state specific) AWD5017 (may be state specific) if sold with other Life 70 (ordinary) products



A copy of sold plan and rates


CGI Request Form (should be submitted and pre-approved by New Business prior to the following paperwork being submitted for installation) AWD7914G



Group Insurance Enrollment and Evidence of Insurability Form AWD4553 (may be state specific)

Quotation for Life Insurance Plan (if providing non-guaranteed cash surrender values) AWD3495* (if needed)

Illustration Certification (if illustration is not used or certificate applied for is different from illustration used) AWD3496* (if needed)

Certification that illustration was reviewed (if illustration was reviewed on computer screen) AWD3497* (if needed)

Replacement of Life Insurance or Annuities (if replacing current policy) AWD5380* (if needed)

Statement of Sales Material Used in Solicitation AWD5381*

Disclosure Form for Accelerated Death Benefit for Terminal Illness AWD13513*

*To be provided with each enrollment form submitted as required


Refer to The Major Complement New Business Checklist AWD15690

Use the Forms Quick Search box under Supply Manual/Online Forms > Download/Order Forms on the Agent Website.

FSL appointment must be completed prior to conducting enrollment.

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Request for Group Insurance AWD4040 (pages 1-3)

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Request for Group Insurance AWD4040 (pages 4-7)

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"10-24 Life" Request for Group Insurance Employer Paid AWD4045

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Group New Business Group Set Up Sheet AWD5086

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Group Commission Agreement AWD423

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CobraGuard User Agreement AWD13007

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Employer's Acceptance of Voluntary Insurance Program/New Account Set Up Instructions AWD003A&B-2 Use only with the following products: cancer, stand alone dental, accident, SHOP, My Lifeline critical illness & universal life

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SECTION 2

GROUP VOLUNTARY CANCER/SPECIFIED DISEASE

AWD8454X-3 of 73


Group Voluntary Cancer Specified Disease Plan

Base Benefit Benefit Range (Base benefits in bold)

Hospital Benefits Also includes extended hospital confinement, private duty nursing, extended care facility, at home nursing care, & hospice.

Actual charges up to $100 / day 1 unit: $100/day

2 units: $200/day 3 units: $300/day

Radiation/Chemotherapy Also covers Blood Plasma and Platelets

Actual charges up to $5,000 max. per 12 mos. (2 units)

2 units: $5,000 3 units: $7,500 4 units: $10,000 (every 12 months)

Surgery & Related Benefits

Actual charges up to $1,500 per surgery, depends on surgery

1 unit: $1,500 2 units: $3,000 3 units: $4,500 (per schedule)

Below benefit ranges are linked to # of Surgery units above:

Anesthesia schedule Actual charges up to 25% of allowed surgery amount

25% of surgery

Bone marrow or stem cell transplant

Actual charges up to $500- $2,500 max per calendar year, depending on type of transplant.

1 unit: $ 500-$2,500 2 units: $1,000-$5,000 3 units: $1,500-$7,500

Ambulatory Surgery Center Actual charges up to $250/day $250/$500/$750 per day

Second Surgical Opinion Actual charges up to $200 $200/$400/$600

Miscellaneous Inpatient drugs………………. Physician attendance ……….. Ambulance………………….. Non-local Transportation & Outpatient Lodging ………… Family transport & lodging … Experimental Treatment ……. Prosthesis …………………... Waiver of Premium ...……….

Actual charges up to $25/day $50/day $100/confinement $.40/mile; Lodging $50/day up to a maximum of $2,000/12 months Coach fare or $.40/mile; $50/day $5,000 per 12 months $2,000 After 90 days of employee’s disability due to cancer.

1 unit only

OPTIONAL BENEFITS:

Cancer Initial Diagnosis $1,000 - $5,000 per person ($1,000 increments) 1-5 units

Intensive Care Unit $200 - $800 per day ($100 increments) 2-8 units

Cancer Screening $25 - $100 per person, per year ($25 increments) 1-4 units

Refer to Sales Guide (AWD5093) for additional information. Benefits listed are subject to state variation.

Please contact your Regional Sales Office with questions.

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SECTION 3

AHL minimedical®

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Sample - Standard Plans

Allstate Benefits

Medical Expense InsuranceAnnual Maximum Benefit (per insured)

Limits Within the Annual MaximumInpatient Facility Maximum (other than room & board per insured) Applies only to the hospital bill, not to physician services provided in a hospital.

Daily Allowance for Hospital Room & Board Charges Intensive Care Unit All Other Accommodations If the actual charge is more, the excess over the day limit is not covered.

Outpatient Services (per insured)

Office Visit Benefit (not subject to deductible) Co-payment by insured person, per visit.Insured percent - after co-paymentIn Network Office Visit Charge Other Charges in the Doctor’s OfficeOut of Network Office Visit Charge Other Charges in the Doctor’s Office

Inpatient/Outpatient Charges Other Than Office Visits Deductible for Each Person Family Deductible Limit Co-Insurance In Network Co-Insurance In Out of Network

Accidental Death and DismembermentEmployee Amount Spouse Amount Child Amount (for children age 6 mos+)

Monthly Premium Employee Employee and One Dependent Family

Weekly Premium Employee Employee and One Dependent Family

Premiums

$10,000 $5,000 $2,500

$2,000 $1,500 $500

$800 $600 $400 $400 $300 $200

$2,000 $1,500 $1,000

$20 $20 $25

100% 100% 100% 100% 100% 100%

100% 100% 100% 70% 70% 70%

$200 $200 $250 $600 $600 $600 80% 80% 80% 60% 60% 60%

$20,000 $20,000 $20,000 $5,000 $5,000 $5,000 $5,000 $5,000 $5,000

TBD TBD TBD based on based on based on census census census

TBD TBD TBD based on based on based on census census census

Advantage Extra Advantage Essential

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Additional Enhancement Options

Wellness Benefit (per insured) Subject to co-pay during office visit



$150 $100 $50

$5.46 $3.64 $1.82 $11.70 $7.80 $3.90 $15.21 $10.14 $5.07

$1.26 $0.84 $0.42 $2.70 $1.80 $0.90 $3.51 $2.34 $1.17

Advantage Extra Advantage EssentialWellness Benefit

Generic Rx Co-Pay Benefit $10 co-pay on covered Generic Drugs $15 co-pay on covered Oral Contraceptives



$1,500 $1,500 $1,500

$10.68 $10.68 $10.68 $18.55 $18.55 $18.55 $24.00 $24.00 $24.00

$2.46 $2.46 $2.46 $4.28 $4.28 $4.28 $5.54 $5.54 $5.54

Catalyst Rx (Underwritten by Fidelity Security Life Insurance Company)

Advantage Extra Advantage Essential

AWD8454X-3 of 73


Dental Insurance

Benefits* Year 1 Year 2 Year 3

Coverage Year Deductible Wellness Visit Co-pay

Elimination Period Category I Wellness Benefit Category I Other Preventative Category II Category III Orthodontia**

Co-Insurance Percentage Category I Category II Category III Orthodontia**

Annual Benefit Maximum Categories I, II and III Orthodontia**

Lifetime Orthodontia Maximum Categories I, II and III

$50 $50 $50 $15 $15 $15

none none none 6 mos. none none 6 mos. n/a n/a 6 mos. n/a n/a 6 mos. n/a n/a

100% 100% 100% 50% 60% 80% 25% 35% 50% 25% 35% 50%

$500 $750 $1,000 $500 $500 $500

$1,500

*Plan variation is in covered dental amount (fee schedule). **Available to dependent children under age 19.Buy-up Options are available in most states. Benefits may vary according to state-specific requirements. Rates are based on the most state version of benefits. Rates may vary according to situs state of group.

Dental Plan and Rates are based on the Plan Series 1000 EmployeeWeekly: $3.85 Monthly: $16.67

Employee Plus One DependentWeekly: $7.39Monthly: $32.01

FamilyWeekly: $12.93Monthly: $56.01

Buy-Up Options Employee must enroll in AHL minimedical® in order to purchase buy-up options. (Minimum 10 enrolled employees per plan.)

Hospital Indemnity Insurance

Benefits are payable directly to the insured for Inpatient Hospital Confinement unless assigned. This is in addition to the Inpatient Facility and Room & Board benefits covered by Medical Expense Insurance.

Payment of the Daily Benefit begins on the first day of confinement. It will be paid for each day after, up to the Maximum Benefit Period, per Coverage Year. No benefits will be paid for fractional part of a day.

Daily Benefit Amount (per insured)

All Plans - $500 per day (Maximum of 15 days)

$3.45/Employee $14.95/Employee

$7.53/Employee + One $32.63/Employee + One

$10.11/Family $43.81/Family

Weekly Monthly

AWD8454X-3 of 73


Group Voluntary Term Life Insurance

Plan Benefit Amounts

All Plans $20,000/Employee $5,000/Spouse or Child

Weekly Monthly

$1.20/Employee

$5.20/Employee

$1.80/Employee + One $7.80/Employee + One$3.60/Family $15.60/Family

Group Voluntary Short Term Disability Insurance

Plan Benefit Amounts

All Plans - 7/7/13 $650 per month (7 day elimination period for accidents or illness - maximum 13 week payout period

$1.20/Employee $5.20/Employee

Weekly Monthly

Buy-Up Options Employee must enroll in AHL minimedical® in order to purchase buy-up options. (Minimum 10 enrolled employees per plan.)

Group Voluntary Accident Insurance

Features

$20,000 $10,000 $5,000

$100,000 $50,000 $25,000

$2,000 - $20,000* $1,000 - $10,000* $500 - $5,000*

$60 - $2,000* $30 - $1,000* $15 - $500*

Employee Spouse Children

$500

$100/day (up to 90 days)

$200/day (up to 90 days)

Ground $100 Air $300

Up to $250

$25/visit (2/person/calendar year. 4/family)

Benefit amounts shaded in blue are the same for employee, spouse and children. *Depending on type of loss.Buy-up Options are available in most states. Benefits may vary according to state-specific requirements. Rates are based on the most state version of benefits. Rates may vary according to situs state of group.

Accidental Death

Common Carrier Accidental Death

Dismemberment

Dislocation/Fracture

Initial Hospital Confinement

Hospital Confinement

Intensive Care

Ambulance Services

Medical Expenses

Outpatient Physician’s Treatment

AWD8454X-3 of 73


Buy-Up Options Employee must enroll in AHL minimedical® in order to purchase buy-up options. (Minimum 10 enrolled employees per plan.) Buy-Up Options

The list below shows covered injury benefits for one unit of coverage and one occurrence. An insured spouse gets 50% of the amounts shown; insured children get 25% of the amount shown.

For the loss of:Life, or both eyes, or both hands or arms, or both feet or legs, or one hand or arm and one foot or leg.

One eye, or one hand or arm, or one foot or leg.

One or more entire toes, or one or more entire fingers

$20,000

$10,000

$60

For complete dislocation of:Hip joint

Knee joint†, bone or bones of the foot†, ankle joint

Wrist joint

Elbow joint

Shoulder joint

$2,000

$800

$700

$600

$400

Employee must enroll in AHL minimedical® in order to purchase buy-up options. (Minimum 10 enrolled employees per plan.)

Bone or bones of the hand†, collarbone

Two or more fingers or toes

One finger or toe

$300

$140

$60

††Pelvis (except coccyx).

Foot (except toes).

Skull (except bones of face or nose).

Hand or wrist (except fingers).

Lower jaw (except alveolar process).

For complete, simple or closed fracture of bone or bones of:Hip, thigh (femur), pelvis††

Skull††

Arm, between shoulder and elbow (shaft), shoulder blade (scapula), leg (tibia or fibula)

Ankle, knee cap (patella), collarbone (clavicle), forearm (radius or ulna)

$2,000

$1,900

$1,100

$800

Foot††, hand or wrist††

Lower jaw††

Two or more ribs, fingers or toes, bones of the face or nose

One rib, finger or toe, Coccyx

$700

$600

$300

$140

Weekly**Monthly**

Employee Employee$8.84 $2.04

Employee + 1 Employee + 1$20.72 $4.79

Family Family$20.72 $4.79

**Rates may vary according to situs state of group.

†Knee joint (except patella).

Bone or bones of the foot (except toes). Bone or bones of the hand (except fingers).

Group Voluntary Accident Insurance (cont.) - Injury Benefits Schedule

Buy-up Options are available in most states. Benefits may vary according to state-specific requirements. Rates are based on the most state version of benefits. Rates may vary according to situs state of group.

AWD8454X-3 of 73


Buy-Up Options

Group Voluntary Critical Illness Insurance

Employee must enroll in AHL minimedical® in order to purchase buy-up options. (Minimum 10 enrolled employees per plan.)

• Basic benefit amount of $5,000 for Categories 1, 2 and 3.

• Benefits paid directly to the covered person at time of diagnosis unless assigned to someone else.

• Employee, spouse and child(ren) coverage is available. Spouse and child(ren) basic benefit amount is 50% of the employee.

The product offers group critical illness coverage which only provides benefits as defined in the policy and certificate. The amount paid for each illness is the percentage shown below for each illness multiplied by the basic benefit amount chosen. The maximum basic benefit amount payable by AWD, per category of illnesses, is 100%.

Buy-up Options are available in most states. Benefits may vary according to state-specific requirements. Rates are based on the most state version of benefits. *Rates may vary according to situs state of group.

Features

Benefit Category 1

Heart AttackHeart TransplantStrokeCoronary Artery By-Pass Surgery

Benefit Category 2

Major Organ Transplant (other than heart)End Stage Renal FailureParalysis (not as a result of a stroke)Alzheimer’s Disease

Benefit Category 3

Invasive CancerCarcinoma in Situ

$5,000 Basic Benefit Amount PremiumsEmployee OnlyEmployee Plus OneFamily

Percent of Basic Benefit Amount

100%100%100%25%


100%100%100%25%


100%25%

Weekly Rates*$2.20$3.25$3.30

Maximum Amount Payable

100%


100%


100%

Monthly Rates*$9.51$14.08$14.28

AWD8454X-3 of 73


AHL minimedical® ANSWERS TO THE MOST

FREQUENTLY ASKED QUESTIONS 1. AHL minimedical® is only available as an “employer sponsored” benefit. AWD can

only issue a policy if a minimum of 51 employees are enrolled. 2. The employees must receive a W-2 Form from the employer group in order to qualify

for coverage. For instance, AWD CANNOT quote:

Associations Multiple Employer Welfare Trusts Contract Employees Franchises

3. AHL minimedical® is a true group health plan and, as such, includes all of the

applicable state-mandated benefits of the state in which the policy is written. 4. All expenses are subject to deductible and coinsurance except for the physician

office visit charge, which is covered at 100% with a copay (subject to reasonable & customary limits if out of network).

5. The office visit copay covers the office visit charge and is subject to the outpatient

maximum. Copayment and coinsurance percentages may depend on the provider accessed (in- and out-of-network benefits).

6. Prescription drug benefit will differ depending on which of the two prescription

programs are selected; ScriptSave or Catalyst Rx. Under the ScriptSave program, Rx charges are covered through the outpatient services portion of the plan and are subject to deductible and coinsurance. The Catalyst Rx program offers a prescription copay benefit for select generic drugs. Copays are covered through the outpatient services portion of the plan and are subject to deductible and coinsurance.

7. The Inpatient Facility Maximum is a coverage year limit for Hospital

miscellaneous/ancillary charges such as medications, supplies, etc. that are billed by the hospital. This accrues toward the overall coverage year Maximum Benefit.

8. Inpatient Physician Charges (such as the surgeon’s charges, the anesthesiologist’s

charges, doctor visits in the hospital, etc.) accrue toward the coverage year Maximum Benefit. They are NOT capped under the Inpatient Facility maximum.

9. Room and Board charges are capped at a “daily limit”, and accrue toward the

Annual Maximum Benefit. They are NOT capped under the Inpatient Services maximum.

10. Plan benefits and deductibles accrue on a Coverage Year Basis.

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11. “Wellness” benefits are covered when specifically mandated by state law, or when the Employer chooses the Wellness Benefit as an enhancement to the core benefit.

12. There is no lifetime maximum on the Medical Expense Insurance core benefit. It

resets each coverage year. 13. A Pre-existing Condition Exclusion will apply to anyone who did not have prior

Creditable Coverage. For the 12 month period following a person’s eligibility date, no benefit will be paid for a condition (other than pregnancy) for which the person received a diagnosis, treatment or medical advice in the 6 months right before the eligibility date.

14. COBRA and HIPAA apply. A third party vendor, CobraGuard, Inc., performs

COBRA administration services for the employer at no cost to the employer. AHL issues Certificates of Creditable Coverage at no additional cost.

15. Upon termination of employment, a covered person can continue the plan on

COBRA. The COBRA rates will be equal to the group rate with an additional 2% administration fee (additional 50% for coverage from the 18th to 29th month for continuation that is due to total disability).

16. Portability - Upon exhaustion of COBRA, the benefits are portable. After someone

elects the portability coverage, they can continue it indefinitely, as long as they continue to pay their premiums directly to the Home Office. Their benefits will not be linked to the group policy. Therefore, changes to the group policy rates or benefits will not affect those currently enrolled under portability. Even if the original group policy terminates, the people on portability continue to have their original benefits.

17. COBRA is linked directly to the group policy. If changes occur in the group’s plan

design or rates, it will affect the COBRA participants as well, since they are linked back to the group policy. If the group policy terminates, then all COBRA enrolleesterminate as well. At this point, they would be eligible to elect the portabilitycoverage.

18. The plan is Section 125 Qualified, meaning payroll deductions can be set up on a

pre-tax basis and the employer can save money on payroll taxes. 19. An employer contribution is strongly recommended, but not required. A contribution

demonstrates that the employer is endorsing the plan and helps drive better participation.

AWD8454X-3 of 73


SECTION 4

GROUP VOLUNTARY DENTAL

AWD8454X-3 of 73


Group Voluntary Dental Plan Plan Benefit

Coverage Year Benefit Maximums Category 1, 2 and 3 Services Year One - $500 Year Two - $750 Year Three - $1,000

Deductible – Coverage Year Employee $50 Family $100

Applies to all covered services except for those covered under the Wellness Benefit

Elimination Period First Six months – no benefits paid

Applies to all covered services except for those covered under the Wellness Benefit

Category 1 – Wellness Benefit (No Deductible)

100% after $15 Copay

Payable two times during a coverage year with at least 150 days between each visit. Based on amount listed in the Schedule of Dental Procedures.

Category 1 – Other Preventive Services

100% coinsurance

Coverage Year Deductible and Elimination Period apply. Based on amount listed in the Schedule of Dental Procedures.

Category 2 – General Services Year One - 50% coinsurance Year Two - 60% coinsurance Year Three - 80% coinsurance


Category 3 – Special Services Year One - 25% coinsurance Year Two - 35% coinsurance Year Three - 50% coinsurance


Category 4 – Orthodontic/Braces Services (Available to Dependent Children under the age of 19 only)

Year One - 25% coinsurance Year Two - 35% coinsurance Year Three - 50% coinsurance Maximum Coverage Year Benefit - $500 Maximum Lifetime Ortho Benefit - $1,500


If this is replacement coverage, credit is given for time employee was insured under the client’s prior group dental coverage.



AWD8454X-3 of 73


Heritage Choice Dental Plan Dental Plan Advantages:

It's Voluntary, employee-paid insurance - no cost to employer See any dentist - No networks to deal with 5 sets of benefit levels with corresponding rates- choose the one that fits best Composite rates (no age-banding) No Coordination of Benefits with other dental plans No 12 or 24 month elimination periods (6 month for services other than Wellness) 2 checkups each year with no deductible (exam, cleanings, x-rays, sealant…) $500 per year Orthodontia benefit (for dependents under 19) under ALL plans,

from year 1 (after a six-month elimination period) One-year rate guarantee Credit for prior coverage - Employees who were enrolled under the prior group

dental plan receive credit for prior coverage COBRA administration is handled by third party vendor, CobraGuard, Inc., at no

cost to the employer Portable following exhaustion of COBRA coverage, or upon plan termination if no

new plan replaces this coverage

Target Markets: Best targets:

o Primarily smaller companies (<200) that don't have dental o Companies who are in rural areas or scattered across the country and

cannot use a DHMO o Companies who can no longer afford to pay for a core dental plan and

cannot maintain 60+% participation o Larger companies with classes of employees who are not offered dental

AWD’s dental plan can be a good replacement for companies that are downgrading, because it provides credit for prior coverage. Therefore, many of their current participants could jump to coverage year 3 benefit level which has a maximum annual benefit of $1,000.

Some employers are feeling the pinch of rate increases right now and are ready to downgrade from an employer paid dental plan to a voluntary (or smaller employer contribution) dental plan.

Hard to sell it in a strong DHMO market unless the employer is unhappy with DHMO. Many dental HMO networks have been falling apart lately, creating gaps in networks and aggravation for employers.

Do NOT try to go up against a core employer-paid dental plan (like Guardian) unless the employer is having difficulty paying for the plan or reaching minimum participation standards.

HUGE DEMAND FOR DENTAL INSURANCE-- #2 MOST REQUESTED BENEFIT EASY “BACK POCKET” SALE

JUST ASK FOR THE BUSINESS AND YOU’LL BE SURPRISED!!! Refer to Sales Guide (AWD6022) for additional information. Please contact your Regional Sales Office with questions

AWD8454X-3 of 73


SECTION 5

GROUP VOLUNTARY ACCIDENT

AWD8454X-3 of 73


Group Voluntary Accident Plan

Base Benefit (One Unit)

Benefit Range (Base benefits in bold)

Accidental Death Insured Employee $20,000 Insured Spouse $10,000 Insured Child $5,000

1 Unit - $20,000/$10,000/$5,000 11⁄2 Units - $30,000/$15,000/$7,500

2 Units - $40,000/$20,000/$10,000

Common Carrier Accidental Death

Insured Employee $100,000 Insured Spouse $50,000 Insured Child $25,000

1 Unit - $100,000/$50,000/$25,000 11⁄2 Units - $150,000/$75,000/$37,500

2 Units - $200,000/$100,000/$50,000

Dismemberment Insured Employee up to $20,000 Insured Spouse up to $10,000 Insured Child up to $5,000

Benefit amount depends on type of loss.

1 Unit - $20,000/$10,000/$5,000 maximum 11⁄2 Units - $30,000/$15,000/$7,500 maximum 2 Units - $40,000/$20,000/$10,000 maximum

Dislocation or Fracture

Insured Employee up to $2,000 Insured Spouse up to $1,000 Insured Child up to $500

Benefit amount depends on type of loss.

1 Unit - $2,000/$1,000/$500 maximum 11⁄2 Units - $3,000/$1,500/$750 maximum

2 Units - $4,000/$2,000/$1,000 maximum

Initial Hospitalization Confinement

One time benefit of $500 1 Unit - $500 11⁄2 Units - $750

2 Units - $1,000

Hospital Confinement

$100/day to a maximum of 90 days per injury

1 Unit - $100/day 11⁄2 Units - $150/day 2 Units - $200/day

Intensive Care $200/day to a maximum of 90 days 1 Unit - $200/day 11⁄2 Units - $300/day 2 Units - $400/day

Ambulance Service Ground $100/Air $300 (Needed as the result of accidental injury)

1 Unit - Ground $100/Air $300 11⁄2 Units - Ground $150/Air $450 2 Units - Ground $200/Air $600

Medical Expenses Actual Cost up to $250 for medical expenses as a result of injury.

1 Unit - Up to $250 11⁄2 Units – Up to $375 2 Units – Up to $500

Outpatient Physician Treatment

$25/visit

Yearly limit of 2 visits for each covered person and 4 visits for family coverage.

1 Unit - $25/visit 11⁄2 Units - $37.50/visit

2 Units - $50/visit



AWD8454X-3 of 73


OPTIONAL DISABILITY RIDERS

Plan A – Off the Job Accident Disability

$1,000/month Elimination period: 3 days (retroactive) Benefit period: 12 months

1 Unit - $1,000/month

11⁄2 Units - $1,500/month

2 Units - $2,000/month

Plan B – On & Off the Job Accident Disability

$1,000/month Elimination period: 3 days (retroactive) Benefit period: 12 months

1 Unit - $1,000/month



Plan C – Off the Job Accident & Sickness Disability

$1,000/month Accident Sickness Elimination period: 3 days (retroactive) 7 days Benefit period: 12 months 12 months

1⁄2 Unit - $500/month 1 Unit - $1,000/month



Plan D – On & Off the Job Accident & Sickness Disability

$1,000/month Accident Sickness Elimination period: 3 days (retroactive) 7 days Benefit period: 12 months 12 months

1⁄2 Unit - $500/month 1 Unit - $1,000/month



OPTIONAL SPOUSE DISABILITY RIDERS

Employee must elect Optional Disability Rider for themselves to elect Spouse Rider

Option 1 – On & Off the Job Accident Disability

$500/month Elimination period: 3 days (retroactive) Benefit period: 12 months

1⁄2 Unit - $250/month 1 Unit - $500/month 11⁄2 Units - $750/month

Option 2 – On & Off the Job Accident & Sickness Disability

$500/month Accident Sickness Elimination period: 3 days (retroactive) 7 days Benefit period: 12 months 12 months

1⁄2 Unit - $250/month 1 Unit - $500/month 11⁄2 Units - $750/month



AWD8454X-3 of 73


SECTION 6

GROUP VOLUNTARY DISABILITY

STD/LTD

AWD8454X-3 of 73


Group Voluntary Short Term Disability (25+ Lives Only)

Plan Benefit

Benefit (Employee Only) Minimum Monthly Benefit Maximum Monthly Benefit

$400 (Additional benefits only in $100 increments) $2,500

Benefit amount cannot exceed 60% of monthly earnings.

Elimination Period Accident / Sickness 0 days / 7 days, 7 days / 7 days, 14 days / 14 days, 30 days / 30 days

Determined by employer, not individual employee.

Maximum Payment Period 3 months, 6 months, 12 months or 24 months


Premium Rates Based on employer’s Male/Female content Prior Experience or Case characteristics Uni-sex Age-Banded One Year Rate Guarantee

Group Voluntary Long Term Disability (25+ Lives Only)

Plan Benefit

Benefit (Employee Only) Minimum Monthly Benefit Maximum Monthly Benefit

$400 (Additional benefits only in $100 increments) $6,000

Benefit amount cannot exceed 60% of monthly earnings.

Elimination Period Standard The later of: 1) 90 or 180 days; or 2) the date accumulated sick pay or

salary continuation ends.

Determined by employer, not individual employee. Non standard elimination periods must be approved.

Benefit Duration 2 years, 5 years, or NSSR


Premium Rates Based on industry and plan design Prior Experience or Case characteristics Uni-sex Age-Banded Two Year Rate Guarantee



AWD8454X-3 of 73


SECTION 7

GROUP VOLUNTARY LIFE

AWD8454X-3 of 73



Plan Benefit

Benefit Maximum Employee Spouse Dep endent Child

$500,000 in $10,000 increments (Maximum 5 times Salary) $100,000 in $10,000 increments (Maximum 50% of Employee Amount) $10,000 in $2,500 increments

(Employee must elect coverage to obtain Spouse or Dependent Child insurance)

Guarantee Issue Amount Employee (No Evidence of Insurability)

# Eligible Employees Under Age 60 Ages 60 to 69 Ages 70 &Up 25 to 49 $50,000 $20,000 $5,000 50 to 199 $80,000 $20,000 $5,000 200 to 499 $100,000 $20,000 $5,000 500 to 999 $100,000 * $20,000 $5,000 1,000+ $100,0 00 * $20,000 $5,000

* Higher amounts must be approved by underwriting

Guarantee Issue Amount Spouse (No Evidence of Insurability)

# Eligible Employees Under Age 60 Ages 60 to 69 Ages 70 & Up 25 to 1,000+ $20,000 $10,000 $2,500

Optional Group Voluntary Accidental Death & Dismemberment Insurance

For Loss of Benefit

Life Full amount of insurance Both Hands Full amount of insurance Both Feet Full amount of insurance Sight of Both Eyes Full amount of insurance One Hand and One Foot Full amount of insurance One Hand and Sight of One Eye Full amount of insurance One Foot and Sight of One Eye Full amount of insurance

One Hand One-Half of full amount of insurance One Foot One-Half of full amount of insurance Sight of One Eye One-Half of full amount of insurance

Addition of benefit determined by employer, not individual employee.

Premium Rates

2 Life Rate Options

Industry Factor Applies Uni-Sex Age Banded Smoker, Non-Smoker & Uni-Smoker Rates Available

Rate Set 1 (under 200 lives rate) with or without AD&D Rate Set 2 (over 200 lives rate) with or without AD&D


Please contact your Regional Sales Office with questions

AWD8454X-3 of 73


SECTION 8

GROUP EMPLOYER PAID LIFE & STD

AWD8454X-3 of 73


Group Term Life (10 - 24 Lives Only)

Plan Benefit (ONLY SOLD AS PACKAGE)

Benefit Maximum 3 Life with AD&D Option s

$15,000 $25,000 $50,000

Employer chooses one benefit plan for all employees Employer pays all premiums Plan must cover all full time eligible employees working 25+ hours per week

No other group Life options will be available for groups with 10 – 24 lives

Group Short Term Disability (10 - 24 Lives Only)

Plan Benefit (ONLY SOLD AS PACKAGE)

Benefit Monthly Maximum $900 per month

Benefit amount not to exceed 67% of monthly earnings

Elimination Period Accident or Sickness 7 Days

Maximum Payment Period 3 Months or 6 Months Employer chooses one benefit payment period for all employees Employer pays all premiums Plan must cover all full time eligible employees working 25+ hours per week

No other STD or LTD options will be available for groups with 10 – 24 lives

Employer Paid Term Life and STD package not available in California, Florida, Hawaii, New Jersey, New York, Puerto Rico or Rhode Island.

Benefits listed are subject to state variation. Please contact your Regional Sales Office with questions.

AWD8454X-3 of 73


Group Term Life (25+ Lives)

Plan Benefit

Benefit Maximum Employee Spouse Dependent Child

$500,000 in $10,000 increments (Maximum 5 times Salary) $100,000 in $10,000 increments (Maximum 50% of Employee Amount) $10,000 in $2,500 increments

(Employee must elect coverage to obtain Spouse or Dependent Child insurance)

Guarantee Issue Amount Employee (No Evidence of Insurability)

# Eligible Employees Under Age 60 Ages 60 to 69 Ages 70 & Up 25 to 49 $50,000 $20,000 $5,000 50 to 199 $80,000 $20,000 $5,000 200 to 499 $100,000 $20,000 $5,000 500 to 999 $100,000 * $20,000 $5,000 1,000+ $100,0 00 * $20,000 $5,000

* Higher amounts must be approved by underwriting

Guarantee Issue Amount Spouse (No Evidence of Insurability)

# Eligible Employees Under Age 60 Ages 60 to 69 Ages 70 & Up 25 to 1,000+ $20,000 $10,000 $2,500

Optional Group Voluntary Accidental Death & Dismemberment Insurance

For Loss of Benefit

Life Full amount of insurance Both Hands Full amount of insurance Both Feet Full amount of insurance Sight of Both Eyes Full amount of insurance One Hand and One Foot Full amount of insurance One Hand and Sight of One Eye Full amount of insurance One Foot and Sight of One Eye Full amount of insurance

One Hand One-Half of full amount of insurance One Foot One-Half of full amount of insurance Sight of One Eye One-Half of full amount of insurance

Addition of benefit determined by employer, not individual employee.

Premium Rates 2 Life Rate Options

Regular employer paid life rate

Reduced rate if sold in conjunction with any other AWD plan of coverage (This option applies to new groups only)



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SECTION 9

GROUP VOLUNTARY S.H.O.P.

(Supplemental Health Options Plan)

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Group Voluntary S.H.O.P. Mandatory Benefit Benefit Range

Category 1

Initial Hospitalization Confinement $250 per year/ per unit 1 – 6 units $250 per unit

Daily Hospital Confinement $100 per day/ per unit 180 day maximum

1 – 6 units $100 per unit 180 day maximum

Hospital Intensive Care $100 per day/ per unit 60 day maximum

1 – 6 units $100 per unit 60 day maximum

Category 2

Surgery

$20 - $500 per unit Amount paid depends on type of surgery.

1 unit: $20 - $500 2 units: $40 - $1,000 3 units: $60 - $1,500 4 units: $80 - $2,000 5 units: $100 - $2,500 6 units: $120 - $3,000

Anesthesia Actual charges up to 25% of allowed surgery amount

1 – 6 units

Inpatient Physician’s Treatment $25 per day/ per unit Payable for the number of days the Daily Hospital Confinement Benefit is payable.

1 – 6 units $25 per unit

Category 3

Outpatient Emergency Accident $250 each occurrence/ per unit Payable to a maximum of 2 times each coverage year, for each covered person.


Outpatient Physician’s Treatment $25 each occurrence/ per unit Limited to 5 visits each coverage year for each covered person, with a maximum of 10 visits each year if policy is in force as Individual & Spouse or Individual & Children coverage; maximum of 15 visits each coverage year if the policy is in force as Family coverage.




AWD8454X-3 of 73


Group Voluntary S.H.O.P. Mandatory Benefit Benefit Range

At Home Nursing $50 each day/ per unit Must be required & authorized by attending physician; Benefit is only payable for one visit each day, and a total of 30 visits within the 60 days following a covered hospital confinement.


Ambulance $150 each occurrence/ per unit ($300 per unit of coverage if air ambulance) Benefit is limited to a maximum of 3 trips for each covered person, each coverage year.


Non-Local Transportation $150 each trip/ per unit Treatment must be received beyond the 100 mile radius of the home of the covered person. This benefit is limited to 3 round trips for each covered person, each coverage year.


MISCELLANEOUS (OPTIONAL) BENEFITS

Outpatient Diagnostic X-ray and Laboratory

$25 each covered test/ per unit Benefit is limited to one test per day; 3 tests per coverage year, per covered person; and not payable if a benefit is payable under the Wellness and Preventive Test Benefit.


Wellness and Preventive Test $50 each year/ per unit Benefit is limited to 1 examination or test per coverage year, per covered person; and is not payable if a benefit is payable under the Outpatient Diagnostic X-ray and Laboratory Benefit.


Prescription Drug $10 each prescription/ per unit Benefit is limited 12 prescriptions (initial or refilled) per covered person, each coverage year with a maximum of 24 prescriptions (initial or refilled) each coverage year if the insured elected Individual & Spouse coverage or Individual and Children coverage; maximum of 36 prescriptions (initial or refilled) per coverage year if the insured elected Family coverage.




AWD8454X-3 of 73


MISCELLANEOUS (OPTIONAL) BENEFITS

Term Life (only available to Groups with 200+ eligible employees)

Death Benefit per unit of coverage: Insured Employee - $10,000 Insured Spouse - $5,000 Insured Child(ren) 6 months to dependent age limit - $5,000 Insured Child(ren) 15 days but less than 6 months - $1,000 Amounts are reduced 25% at ages 65-70; amounts reduced to 50% at ages 70 or over.

1 – 2 units

Off-the-Job Accident and Sickness Disability (only available to Employer Groups with 200+ eligible employees; not available with Unions-Associations)

Covered person must have written proof of total disability and meet the (7 day) elimination period. Benefit will be payable up to a maximum of 3 months. For any period of disability less than one month for which a benefit is payable, 1/30th of the monthly amount is paid for each day of total disability. Coverage terminates on the coverage anniversary following the insured employee’s 70th birthday.

1 unit $650 each month

Heritage Choice Dental Plan (a minimum of 10 lives is required before a dental contract will be issued to the employer)

Dental plan will pay benefits for covered dental procedures a covered person receives while insured under the group policy. The covered percent paid by the plan increases the 2nd and 3rd coverage year. There are no networks of dentists. The plan has a built-in wellness benefit and orthodontic services/braces coverage for insured children under the age of 19. Some categories of services require continuous coverage during the elimination period before a benefit is payable, and may be subject to a copayment or deductible. Credit is given for previous group coverage, sponsored by the same employer.

Choose from five levels of benefits and corresponding premiums.



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SECTION 10

GROUP VOLUNTARY CRITICAL ILLNESS

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Group Voluntary Critical Illness

Basic Benefit Benefit Range

Category 1

The maximum basic benefit amount payable by AWD, per category of illnesses, is 100%.

$10,000 to $100,000 (in increments of $1,000)

Dependent Benefit is 50% of Employee Benefit

25% or 100%

Heart Attack Basic Benefit Amount Chosen


100%

Heart Transplant Basic Benefit Amount Chosen Dependent Benefit is 50% of Employee Benefit

100%

Stroke Basic Benefit Amount Chosen Dependent Benefit is 50% of Employee Benefit

100%

Coronary Artery By-Pass Surgery Basic Benefit Amount Chosen


25% (paid only once)

Category 2 The maximum basic benefit amount payable by AWD, per category of illnesses, is 100%.

$10,000 to $100,000 (in increments of $1,000)


25% or 100%

Major Organ Transplant (other than heart)

Basic Benefit Amount Chosen


100%

End Stage Renal Failure Basic Benefit Amount Chosen


100%

Paralysis (not as a result of stroke)

Basic Benefit Amount Chosen


100%

Alzheimer’s Disease Basic Benefit Amount Chosen





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Optional Benefits

Category 3 (Cancer) The maximum basic benefit amount payable by AWD, per category of illnesses, is 100%.

$10,000 to $100,000 (matches category 1 or 2 benefit amount)


25% or 100%

Invasive Cancer Basic Benefit Amount Chosen


100%

Carcinoma in Situ Basic Benefit Amount Chosen



Wellness Benefit $25 per unit each calendar year, per insured

1 to 4 units

Recurrence Benefit Pays if insured is diagnosed more than once with the same specified critical illness listed in Category 1 or 2 for which a benefit was previously paid if more than 18 months since last diagnosis. Pays no more than one recurrence benefit per previously paid specified critical illness under Category 1 and 2. See Brochure for additional details.

25% of previously paid Category 1 or 2 benefit

After 100% of the basis benefit amount of the policy has been paid within each category (1, 2 or 3), AWD does not pay any more benefits for any illness associated with that category for the insured. Once the insured has exhausted all basic benefit maximums in Categories 1, 2 and 3 and the Optional Recurrence Benefit, the policy is terminated.



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SECTION 11

EyeMed VISION CARE® Underwritten by Fidelity Security Life (FSL) Insurance

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EyeMed VISION CARE®

“Most states” benefits shown below. Rates and benefits differ for FL/VT & MA. Three and four-tier rates available.

Refer to Sales Guide (AWD13894) for additional information. Benefits listed are subject to state variations.

Services Member Cost Out of Network AllowanceEye Exam (with Dilation as necessary) $10 Copay $30Exam Options

Standard contact lens fit & follow up* Up to $40Premium contact lens fit & follow up** 10% off Retail

Frames (any available frame at provider location)

$0 Copay, $130 Allowance20% off balance over $130

Standard Plastic LensesSingle Vision $25 Copay $25Bifocal $25 Copay $40Trifocal $25 Copay $55

Lens OptionsUV Coating $15Tint (Solid & Gradient) $15Standard Scratch-Resistance $15Standard Polycarbonate $40Standard Anti-Reflective Coating $45Standard Progressive (Add-on to Bifocal) $65Other Add-Ons & Services 20% off Retail

Contact Lenses (allowance includes materials only)

Conventional $0 Copay, $130 Allowance15% off balance over $130

$104

Disposable $0 Copay, $130 Allowanceplus balance over $130

$104

Medically Necessary$0 Copay

Paid in Full $200

FrequencyExaminationFrameLenses or Contact Lenses

Exclusions & Limitations

• Aniseikonic lensesSome provisions, benefits, exclusions or limitations listed may vary by state.

EyeMed Vision Care® is underwritten by Fidelity Security Life Insurance Company of Kansas City, Missouri, provided by Policy numbers VC-77/VC-78, form number M-9083.

• Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered • Plano non-prescription lenses and non-prescription sunglasses (except for 20% discount)• Services or materials provided by any other group benefit providing for vision care• Two pair of glasses in lieu of bifocals

• Orthoptic or vision training, subnormal vision aids, and any associated supplemental testing• Medical and/or surgical treatment of the eye, eyes, or supporting structures• Services provided as a result of any Worker’s Compensation law• Benefit is not available on certain frame brands in which the manufacturer imposes a no discount policy

**Premium Contact Lens Fitting - all lens designs, materials and specialty fittings other than Standard Contact Lenses*Standard Contact Lens Fitting - spherical clear contact lenses in conventional wear & planned replacement

$65

N/A

N/A

Once every 12 monthsOnce every 24 monthsOnce every 12 months

AWD8454X-3 of 73


• Groups must have a minimum of 10 eligible lives, with 10 enrolled to place and maintain contract

• Florida & Vermont sitused groups require 51 eligible, with 10 enrolled to place and maintain contract

• Can be sold on a stand alone basis or in conjunction with other AWD products

• Product has shelf rates – “most states”, FL/VT & MA

• ER can select a 3-tier or 4-rating structure; rates & benefits are available on the Agent Website

• Out-of-Network benefits for MA option differ from other options

• AWD groups will use the EyeMed Select Network for Preferred Providers

• Contract is based on ER’s situs state

• Product is not available to groups sitused in MN, NY, PR or WA

• Product has 24 month rate guarantee

• Product is COBRA eligible, but not portable

• Commissions are paid by AWD; flat 15% commission for all states except FL & VT; FL & VT flat 10% commission

• Participants will receive ID card & benefit description at their home address from EyeMed

• Contract is generated and mailed by EyeMed to the ER

• Agent appointment paperwork should be completed and submitted to AWD Regional Support Center 20 days prior to taking enrollment

Refer to Sales Guide (AWD13894) for additional information. Benefits listed are subject to state variations.

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SECTION 12

GROUP INDEMNITY MEDICAL (GIM)

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Plan 1

Plan 2

Plan3

Plan4

Plan 5

Plan 6

Plan 7

Plan 8

Plan 9

Plan 10

Hospitalization Benefit FL & CO ONLY

Initial Hospital Confinement (1 time/year, excludes pregnancy & birth)

$250 $250 $250 $500 $500 $500 $750 $750 $750 $1,000

Daily Hospital Confinement (max. 180 days)

$100 $100 $100 $200 $200 $200 $300 $300 $300 $400

Hospital Intensive Care (max. 60 days)

$100 $100 $100 $200 $200 $200 $300 $300 $300 $400

Surgery Benefit

Surgery & Anesthesia Benefit (according to schedule)

From $20

To $500

From $20

To $500

From $20

To $500

From $20

To $500

From $40

To $1,000

From $40

To $1,000

From $60

To $1,500

From $60

To $1,500

From $60

To $1,500

From $80

To $2,000

Anesthesia Benefit (pays for anesthesia received by covered person during covered surgical operation)

Pays 25% of surgical benefit

Inpatient Physician’s Benefit (while receiving DHC benefit – 1/day)

$25 $25 $25 $25 $50 $50 $75 $75 $75

$100

Outpatient Benefit

Emergency Accident Benefit (max. 2 times/person/yr)

$250 $250 $500 $500 $500 $500 $750 $750 $1,000 $1,000

At-Home Nursing Benefit (max. 30 days in 60 days after hospitalization)

$50 $50 $100 $100 $100 $100 $150 $150 $200 $200

Transportation Benefit Ambulance (double for Air Ambulance; max. 3 times/ person/yr) Non-Local Transportation (max. 3 Times/person/yr)

$150

$150

$150

$150

$300

$300

$300

$300

$300

$300

$300

$300

$450

$450

$450

$450

$600

$600

$600

$600

Outpatient Physician’s Benefit (5 times/person, 10 max. for E+1, 15 max. for Family)

$25 $25 $50 $50 $50 $50 $75 $75 $100 $100

Diagnostic & Wellness Benefit

Outpatient Diagnostic X-ray & Laboratory Benefit (max. 3 times/yr)

$25 $25 $25 $25 $50 $50 $25 $50 $75 $100

Wellness & Preventive Test Benefit (1 time/yr)

$50 $50 $50 $50 $100 $100 $50 $100 $150 $200

Refer to Sales Guide (AWD13894) for additional information. AWD8454X-3 of 73



Plan 1

Plan 2

Plan3

Plan4

Plan 5

Plan 6

Plan 7

Plan 8

Plan 9

Plan 10

Prescription Drug Benefit FL & CO ONLY

(12 times/person/yr, 24 max. for E+1, 36 max. for Family)

N/A $10 $10 $10 $10 $20 $10 $20 $20 $20

Optional Riders

Short Term Disability (7 Day Elimination for Accident & Sickness, 3 Month Benefit Duration)

$650

Term Life Insurance Employee Spouse Child(ren)* *Insured children 15 days old, but less than 6 months - $2,000

$20,000 $10,000 $10,000

EyeMed Vision Discount and ScriptSave Prescription Discount plans are additional discount programs included at no cost

Catalyst Rx, Catalyst Rx Plus, Dental and EyeMed Vision Care are additional Buy Up options that the employer can choose to offer their employees; Dental and EyeMed Vision Care can be sold as stand alone options

Product is Guarantee Issue if enrolled when first eligible; late entrants must complete AWD4500 (may be state specific)

For all benefits except the STD & Term Life rider, the benefit amount payable increases by 5% of the initial benefit on each of the first five coverage anniversaries, up to a maximum of 125% of the initial benefit

Plans 1 through 8 are available in most states where GIM is approved; for CO & FL sitused groups, only plans 3 through 10 are available

Product has a 12 / 12 Pre-existing Conditions limitation; 12 month look back & 12 month exclusion; state variations exist

Product utilizes the Beech Street PPO Network; it is not the same network as the AHL minimedical® plan

CA sitused groups must have major medical in force prior to enrolling this product

Product is available to both associations, unions & employers

Can be sold with AHL minimedical® as an “either/or” sale, an individual cannot enroll in both plans

Four tier rate structure – EE, EE+SP, EE+Child(ren), F; STD is EE only coverage

Core coverage is COBRA eligible in all states where GIM is approved, but not portable except in FL, NC & VT

STD & Term Life riders are neither COBRA eligible nor portable

There is a conversion privilege for the Term Life benefit, but not the STD



AWD8454X-3 of 73


Not available to Health Spending Account (HSA) participants per IRS Ruling; refer to AWD Bulletin #1207710

Takeovers must receive prior Home Office approval

Normal pregnancy & childbirth are excluded from the Initial Hospitalization Benefit; complications of pregnancy or childbirth are covered same as any other illness subject to pre-existing condition exclusion



AWD8454X-3 of 73


SECTION 13

GROUP UNIVERSAL LIFE (GUL)

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Group Voluntary Universal Life (GUL)

Features Details

Gender Unisex

Issue Ages/Classes 0-80 Non-tobacco; 19-80 Tobacco

Maturity Age 95

Minimum Face Amount $10,000

Minimum Premium Amount $3/wk Juvenile; $5/wk Adult without regard to riders

Underwriting* Max Specified Amount Employee: $150,000 GI & CGI; $250,000 SI; Spouse: $100,000 CGI; $150,000 SI; Children: money purchase $3/wk CGI; $150,000 SI. GI/CGI issue ages – 65; Max is limited by the max. weekly premium

Cost of Insurance Rates Current COI: A percentage of the 2001 CSO table that varies by attained age; Guaranteed max. COI based on the 2001 CSO table

Guaranteed Minimum Interest Rate 4% per annum

Current Interest Rate Declared at least quarterly at AWD’s discretion

Policy Loans (may vary by state) Charged 8% in arrears; Portion of fund value attributable to the current loan value is credited interest at 4% annually

Policy Charges Per Policy/Per Month - $2.00 years 1-20 Percent of Premium – 5% for all years Per 1,000 issued/increased – varies by age/duration

Surrender Charges Max. Surrender Charge/$1,000 issued or increased, multiplied by a percentage that grades to 0 over a period that varies by age at issue or increase (less than 20 years)

Partial Surrenders Minimum $250. Service charge $25 per partial surrender. Max. is limited by net surrender value, minimum specified amount, and guideline premium test.

Reduced Paid-Up Option Certificate holder can, at any time, elect to surrender the certificate and use the net surrender value to purchase reduced paid up insurance, if the amount of paid up insurance would be is at least $1,000.

Premium Modes Normal Payroll modes: Weekly, Bi-Weekly, Semi-monthly, Monthly, Tenthly, Ninthly, Quarterly, Semi-annual, Annual

Subject to availability and variation by state. Riders will vary by state. *Some states impose specific limits on dependent coverage amounts, refer to guide AWD13678.


Please contact your Regional Sales Office with questions

.AWD8454X-3 of 73


Group Voluntary Universal Life (UL)

Settlement Options The death benefit proceeds will be paid in a lump sum

Illustrations Illustrations will be provided with every certificate issued

Optional Riders

Rider Issue Ages

Terminates at Age

Benefit per Unit

Minimum Maximum

Total Disability Premium Waiver Waives planned premium in the event of a continuous total disability of at least 6 months.

18-55 60 N/A Planned Premium

Planned Premium

Accidental Death Benefit Pays in addition to certificate death benefit if insured dies as a result of an accident.

18-55 65 $1,000 $10,000 Base Certificate Face Amount

Children’s Term Level term to 25 life insurance on certificate insured’s children. Convertible to cash value life insurance when coverage terminates.

18-65 T erminates at earlier of youngest

child’s age 25 or

insured’s age 70

$1,000 $2,00 0 $20,000

Other Insured Person (Spouse) Level Term Level term to 65 life insurance on certificate insured’s spouse. Convertible before age 65. Not available under CGI/GI.

18-55 Spous e’s age 65 or insured’s age 95

$1,000 $5,000 50% of Base Certificate Face

Amount

Future Purchase Option Automatically increases the annual planned premium by $52 annually for the first five (three) rider anniversaries when attached to a certificate with a weekly premium of at least $5/wk ($3/wk). The additional premium is used to increase the specified amount using current purchase rates.

18-60 After the 5th (or 3rd) rider anniversary or when the certificate-

holder declines an

increase

N/A N/A N/A

Level Term Insurance Level Term to 65 life insurance on the certificate insured. Limited to CGI/GI.

18-55 65 $1,000 $5,000 Base Certificate Face Amount (50% CGI/GI)

Accelerated Death Benefit for Terminal Illness Provides advance of up to 75% of the certificate death benefit when diagnosed with a terminal illness.

0-75 93 N/A Can be attached

to any size certificate

Maximum advanced $100,000

GUL Accelerated Death Benefit for Long Term Care (LTC) Allows death benefit to be used to provide monthly benefits for qualified long term care (confined or non-confined) after the insured has satisfied the 90 day elimination period.*

18-70 95 Or when

death benefit has been exhausted

N/A 4% of death

benefit per month

4% of death benefit per month

*Check state availability


Please contact your Regional Sales Office with questions. .

AWD8454X-3 of 73


Rider Issue Ages

Terminates at Age

Benefit per Unit

Minimum Maximum

Long Term Care Extension of Benefits Can be sold with the Accelerated Death Benefit for Long Term Care rider. After the certificate death benefit has been exhausted by exercising the LTC rider, the Extension of Benefits rider works to extend the period an insured can collect LTC benefits by increasing the certificate death benefit by one month’s LTC benefit amount so that the LTC benefit can be paid.*

18-70 95 Or when insured ceases

receiving qualified

LTC services

N/A N/A When cumulative increase

equals the death benefit

GUL Continuation of Coverage During a Strike or Layoff Covers an employee when he/she is affected by a covered strike or layoff as defined in the rider. This rider waives the monthly deductions for the certificate for up to 6 months.*

18-59 60 N/A N/A N/A

GUL Total Disability Payor Waiver of Premium Waives the planned periodic premium in the event of the payor’s continuous total disability lasting for at least 6 months. Can be attached to spouse certificates so that the planned premiums for that coverage will be paid (after 6 months) if the employee becomes totally disabled.*

Insured’s age

18-55

Insured’s age 60

N/A Plan ned Premium

Planned Premium

*Check state availability



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SECTION 14

THE MAJOR COMPLEMENT (GAP)

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The Major Complement (GAP) Benefit Description Benefit Amount

Required Coverage

Hospital Confinement Benefit (HCB)

Coverage for in-hospital confinement out-of-pocket expenses, including emergency room treatment for an injury or for a sickness if confined within 24 hours of treatment

Coverage for eligible out-of-pocket expenses resulting form the treatment of an injury of sickness

Benefits are paid per person, per calendar year and must not be excluded under the major medical or comprehensive health plan

$500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $6,000 $7,000 $8,000

$10,000* *Requires 100 eligible lives.

Optional Riders

Outpatient Benefit Rider (OPB) Coverage for outpatient treatment of an injury or sickness under the regular care and attendance of a physician at a hospital, physician’s office, outpatient surgical or emergency facility, or diagnostic testing facility licensed to provide outpatient treatment

Covers treatment, supplies and other non physician related outpatient charges

Physicians office visit charges are not covered

Durable medical equipment is not covered, unless dispensed to the insured person in the hospital or provider’s office

For all coverage other than employee only, the total maximum benefit is 2 times the per person, per calendar year benefit

Benefit is 50% of the Inpatient Hospital Confinement Benefit to a maximum of $2,500

$250 $500 $750

$1,000 $1,250 $1,500 $1,750 $2,000 $2,250 $2,500

Physician Office Visit Rider (POV) Coverage for physician’s services for treatment of an injury or sickness

Services must be received in a physician’s office, hospital, emergency facility or outpatient facility

$15 per visit (up to $120 or 8 visits per family, per calendar year)

$20 per visit (up to $240 or 12 visits per family, per calendar year)



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The Major Complement (GAP) Benefit Description Benefit Amount

Optional Riders Wellness Benefit Rider (WB) Coverage for routine health and check-up

exams, charges incurred in relation to these exams and routine well-child visits

Benefits covered include services performed at a laboratory or diagnostic testing facility

$100 per family, per calendar year



This product coordinates with a major medical or comprehensive health plan being offered by an employer.

An employee must be covered under their employer’s major medical or comprehensive health plan in order to be eligible for this coverage.

Product is Guarantee Issue and must have a minimum of 10 enrolled employees to place a contract.

FL, NJ & VT sitused groups require 51 eligible employees at inception and every policy anniversary, with a minimum of 10 enrolled.

Provider services must be medically necessary for the treatment of an injury or sickness and cannot be excluded under the major medical or comprehensive health plan.

Covered persons must have eligible out-of-pocket expenses that are applied to a deductible, copay or coinsurance in order to receive reimbursement under this plan.

The employer chooses the plan design; employer may choose one GAP plan for every major medical or comprehensive health plan being offered.

Plan will not cover 100% of out-of-pocket expenses.

Plan is available with Health Reimbursement Account (HRA) but not with Health Savings Account (HSA).

Pre-existing conditions are not excluded under this policy, but a condition must be covered under the covered person’s major medical or comprehensive health plan in order for benefits to be payable under this plan.

Product is COBRA eligible, but not portable.

Rates can be age-banded or composite rated. In order to get composite rates, a group must have at least 25 eligible employees, the employer must contribute 50% of the employee premium and there must be employees in all 4 coverage level tiers (ee only, ee+sp, ee+ch, ee+f).

Associations and unions do not qualify for this product.

Eligibility, enrollment, certificates, ID cards, billing and commissions are handled by Allstate Benefits.

Benefits and claims are handled by Special Insurance Services (SIS) in Plano, TX.

ID cards and certificates are mailed to the employer for distribution to the employee.

Product is underwritten by Fidelity Security Life Insurance Company of Kansas City, Missouri.

Agent appointment paperwork should be completed and submitted to Licensing & Contracting 10 days prior to taking enrollment.



AWD8454X-3 of 73


Rev. 06/11 Allstate Benefits is the marketing name for American Heritage Life Insurance Company, a wholly-owned subsidiary of The Allstate Corporation. Coverage is provided by the following forms or state variations thereof: Group Voluntary Life by form GVL-4000, Group Voluntary Disability by form GVD-4000, Group Voluntary Cancer by form GVCP2, Group Voluntary Accident by form GVAP1, Medical Expense by form G-3000, Group Voluntary Dental by form G-DEN-P, Group Voluntary SHOP and Group Indemnity Medical by form GVSP1, Group Voluntary Critical Illness by form GVCIP1 and Group Voluntary Universal Life by form GUL22P. All products (except EyeMed VISION CARE® and The Major Complement) are underwritten by American Heritage Life Insurance Company, (Home Office, Jacksonville, Florida). For Allstate Benefits Field Representative Use Only. Use of this material to solicit or advertise AB products to prospective insureds is strictly prohibited. The policy and riders have exclusions, limitations and reductions of benefits at specific ages, and may not be available for sale in all states. ©2011 Allstate Insurance Company EyeMed VISION CARE® and The Major Complement are underwritten by Fidelity Security Life Insurance Company of Kansas City, Missouri and are provided by policy number VC-77/VC-78, form M-9059 and policy number MG-108, form M-9054 respectively.

AWD8454X-3 of 73


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