Employee Term Life Accidental Death & Dismemberment. Dependent Term Life. Short-Term Disability. Long-Term Disability

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1 Lafayette Life Insurance Company True Group Product Information For Groups with 10+ Employees Employee Term Life Accidental Death & Dismemberment Dependent Term Life Short-Term Disability Long-Term Disability The Lafayette Life Insurance Company C/0 Financial Designs, Inc High Pointe Blvd., Suite #400 Novi, MI (800)

2 Employee Term Life and Accidental Death & Dismemberment Benefits Flat Amounts Function of Salary (Limited to 4 times Base Annual Earnings) Class Carve-out 1. Minimum Benefit Amount is $15, Maximum Benefit Amount is 4 times Base Annual Earnings. 3. Standard Reduction schedule: Benefits reduce to 65% at age 65, to 40% at age 70, to 30% at age 75, to 20% at age 80, to 15% at age 85, to 10% at age 90, and to 5% at age 95. All reductions are applied to the pre-65 age amount. Other reductions schedules are available. 4. Benefits automatically terminate at retirement. 5. Benefits are subject to satisfactory evidence of insurability for benefit amounts in excess of the guaranteed issue amount printed on proposal. These amounts apply to employees under age 65. Guarantee Issue amounts above 65 reduce according to the schedule shown in #3 above. 6. Coverage is extended without payment of premium if the employee becomes totally & continuously disabled prior to age 60 while insured under this policy. This extension terminates at age Conversion Privilege- Employees may convert Term Life benefit to an individual policy. Employees can convert during the 31-day period following the date their insurance terminates. Conversions will be offered without evidence of insurability. 8. Living Benefits Feature- Insured employees diagnosed as terminally ill with less than 12 months to live may elect to receive a lump-sum benefit equal to 50% of the death benefit provided under the Term Life Insurance Benefit. Available at no additional cost to the employer or employee (requires $15,000 minimum benefit amount.) Accidental Death and Dismemberment Benefits 1. Coverage is the same amount chosen for Term Life amount and is offered non-occupational or 24-hour coverage. 2. Benefits are paid if death or dismemberment occurs within 365 days of a covered accident. 3. Includes benefits for certain injuries not resulting in death: Loss of two or more members (hand, foot or eye) full benefit amount. Loss of one hand, foot or eye- one-half benefit amount.

3 Dependent Term Life Can be either Basic or Supplemental Dependent Life coverage. Spouse Coverage cannot exceed 50% of employee s amount with a maximum of $65,000. Children maximum is $15, Dependent Term Life is available only in conjunction with Employee Term Life % participation of all eligible dependents is required. 3. Dependent refers to an insured s spouse and unmarried children. Children means each child, stepchild or adopted child to age 19 (25 if enrolled as fulltime student). 4. Dependents may only be insured under one insured employee and may not be insured employees themselves. 5. All Schedules must comply with state regulations. Short-Term Disability Percentage of salary, 66 2/3% of salary to a maximum of $500 weekly benefit, unless in force maximum is greater than $650. Percentage of salary, 60% of salary to a maximum of $500 weekly benefit, unless in force maximum is greater than $650. Flat Schedule, not to exceed 66 2/3% of salary, maximum of $500 weekly benefit, unless in force maximum is greater than $ Short-Term Disability is available only with your choice of an employee Term Life/AD&D plan. 2. Salary includes base salary; overtime and bonuses are excluded. 3. Coverage is for non-occupational accidents or sicknesses. 4. Elimination periods of 1/8, 1/15, 8/8, 15/15, or 30/30 are available. 5. Benefit durations of 13, 26, or 52 weeks are available. 6. Reductions for age 70 or older- maximum 13 weeks of benefits. 7. For groups with no prior STD coverage, a 3/12 pre-existing conditions clause will apply. 8. Benefits are subject to satisfactory evidence of insurability for amounts in excess of Guaranteed issue amounts. (Shown on proposal) 9. Benefits terminate at retirement. 10. Benefits are payable while the employee is under a doctor s care. 11. STD is not available in states which have state-sponsored, short-term disability programs, such as New York, New Jersey, Rhode Island, Hawaii, California, and Puerto Rico.

4 Long-Term Disability 66 2/3% of Monthly Salary to a maximum of $10,000 monthly benefit 60 % of Monthly Salary to a maximum of $10,000 monthly benefit 50 % of Monthly salary to a maximum of $10,000 monthly benefit 1. Long-Term Disability is available only with your choice of an employee Term Life/AD&D plan. 2. Salary includes base salary; overtime and bonuses are excluded. 3. Coverage is for non-occupational injuries or sicknesses. 4. Elimination period options are 90 days, 180 days, or 360 days. 5. Benefits begin on the first day after elimination period has been fulfilled. 6. Standard Rate Guarantee periods are 2 years for 500 or less lives, and 1 year for 500+ lives. 7. Participation requirements are based on plan design, exact number is shown on proposal. 8. Own Occupation Definition standard is 24 months, other options available upon request. 9. Benefit durations of 5years, RBD, SSNRA or to age 65 are available. 10. Pre-existing conditions clause will apply. 11. Class Carve-out is an option available upon request. 12. Benefits are subject to satisfactory evidence of insurability if required by an underwriter. 13. Benefits terminate at retirement. 14. Benefits are payable while the employee is under a doctor s care. General Guidelines for Group Employers w/ 10+ Employees Eligibility Groups - with at least 10 full-time employees are eligible, unless noted as a restricted industry. Employees - All fulltime employees actively at work, working at least 30 hours per week, are eligible to participate. Seasonal employees and temporary employees are not eligible. Relatives (father, mother, spouse, children, etc.) cannot comprise of 50% or more of the employees insured. Participation When the employer pays the entire cost of the benefits package (a non-contributory program), all (100%) eligible employees must enroll. When the employees share in the cost of the benefits package (contributory program), participation requirements are determined by the number of eligible employees and printed on the proposal. The employer must contribute at least 25% of the total cost of the benefits selected. Employee must be actively at work at the time benefits become effective. Dependents must not be hospital confined or disabled.

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