Lincoln Voluntary Accident Plan Highlights

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1 Lincoln Voluntary Accident Plan Highlights With Voluntary Accident Benefits from Lincoln Financial Group, employees are empowered to protect their income from unexpected expenses related to an accident. Why choose Lincoln for Voluntary Accident Protection? Coverage is Guarantee Issue. Coverage is Guarantee Renewable. The option to continually build participation through annual enrollment. Benefits are paid directly to the covered employee. Benefits are paid for multiple injuries related to a single accident. Attractive group rates are offered. Employees may keep their Accident coverage after separation from their employer. Premiums can be paid by employee on a pre-tax or post-tax basis. COST SUMMARY Rates shown are Monthly and guaranteed renewable. Final rates are subject to Lincoln Financial Group approval. Employee Only $16.04 Employee + Spouse $23.35 Employee + Child(ren) $27.56 Employee + Family $37.34 *Additional benefits selected by employer for all enrolled employees - cost included in base coverage rates above. *On-the-job Accident Coverage included. Page 1 of 5

2 Requirements There is no minimum enrollment requirement for dependent coverage. Employees must be actively at work on the effective date of coverage. To be eligible for accident coverage, employees must work a minimum of 20 hours per week. Coverage election is available to individuals between the ages of 17 and 80. Treatment must be received within the required timelines set forth in the policy. Base coverage is required for every insured electing optional benefits. Benefits may be subject to taxes. This determination should be made under the advice of a tax consultant. EMERGENCY CARE Ambulance $150 Air Ambulance $600 Initial physician office visit $75 Emergency room $150 Major diagnostic care $100 TREATMENT CARE Hospital admission $1,000 Hospital confinement daily benefit $200 Intensive care unit daily benefit $400 Alternate care and rehabilitative facility daily benefit $100 Follow-up doctor/patient care up to 6 sessions $50 Transportation for care (up to 3 times per accident) $300 Companion lodging (up to 30 days per accident) $100 Family care per child up to 30 days $20 FRACTURES (PER FRACTURE) NON-SURGICAL/SURGICAL Ankle, arm, collarbone, elbow, foot, hand, jaw, $600/$1,200 kneecap, shoulder blade, sternum, wrist Hip $2,800/$5,600 Skull (depressed) $2,500/$5,000 Leg, pelvis, skull nondepressed, vertebral column $1,500/$3,000 Bones of face, vertebrae, coccyx, rib, nose $450/$900 Finger, toe $100/$200 Chip Fracture 25% of fracture benefit Page 2 of 5

3 DISLOCATIONS (PER INJURY) NON-SURGICAL/SURGICAL Ankle, collarbone sternoclavicular, foot $800/$1,600 Collarbone acromio and separation, elbow, hand, $500/$1,000 lower jaw, shoulder, wrist Finger, toe $150/$300 Hip $2,400/$4,800 Knee, except kneecap $1,500/$3,000 Partial dislocation 25% of dislocation benefit SPECIFIC INJURIES OR TREATMENTS Transfusions $300 Burns $100-$12,800 Skin grafts 25% of burn benefit Joint replacement $1,500-$2,000 Coma $7,500 Concussion $100 Dental crown once per accident $150 Dental extraction once per accident $50 Eye (removal of foreign body) once per $100 eye/accident Eye (surgical repair) once per eye/accident $300 Laceration $50-$400 SURGERY Arthroscopic $250 Abdominal or Thoracic $1,000 Surgical, per repair Ligaments/tendons, knee $450 cartilage Rotator cuff $450 Ruptured disc $600 TRANSITIONAL CARE BENEFITS Crutches $25 Wheelchair for temporary use $50 Wheelchair for permanent use $350 Walker for temporary use $25 Walker for permanent use $50 Prosthesis per limb/device $500 Other medical appliances $25 Reasonable modifications to home or vehicle in $2,500 the case of catastrophic loss Page 3 of 5

4 ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) Employee Accidental Death $75,000 Spouse Accidental Death $25,000 Child Accidental Death $12,500 Common carrier enhanced death benefit 2x benefit amount Transportation of remains $5,000 Seat belt/helmet AD&D benefit 10% of AD&D Common disaster enhanced death benefit 2x benefit amount Loss of or loss of use of one: hand, foot, arm, leg, $7,000 eye Loss of or loss of use of any one finger, thumb, or $300 toe Catastrophic loss $50,000 *Accident EAP and TravelConnect services Included EXCLUSIONS This accident policy will not cover losses caused by or as a result of: Injury occurring prior to the effective date of coverage or after termination of the coverage Duty as a member of any military, including Reserves or National Guard Travel or flight in or on any Aircraft, except as a fare paying passenger on a regularly scheduled commercial flight Participating in high risk or extreme sports Having cosmetic or elective surgery Participating in or attempting to commit a felony Being incarcerated in any type of penal or detention facility Having a blood alcohol level of.08 grams of alcohol or more per 100 milliliters of blood Deliberately using poison, gas, fumes, or drugs (except when prescribed by a Physician and administered appropriately) Committing or attempting to commit suicide or any other self-inflicted injury Any sickness, disease (physical or mental), or medical or surgical treatment of these Participating in, practicing for, or officiating a semi-professional or professional sport Riding in or driving any motor-driven vehicle for race, stunt show, or speed test War, act of war, or participation in a riot, insurrection or rebellion An injury sustained while residing outside the U.S., U.S. territories, Canada or Mexico for more than 12 months Page 4 of 5

5 THIS IS NOT A CONTRACT: This illustration was prepared based on the information provided in the Request for Proposal. It is a description of accident coverage available from Lincoln Financial Group and not an offer to contract. More detailed information is available upon request concerning the terms, conditions, and limitations contained in the master policy, if issued. If there are discrepancies between the information contained in this proposal and the master policy, the terms of the master policy will control. State-specific restrictions and requirements may not be addressed in this proposal. An Application for Group Insurance must be completed by the Employer and approved by Lincoln Financial Group before coverage can become effective. This proposal is subject to revision if not accepted on or before the Proposed Effective Date shown on the Benefits and Cost Summary page of this proposal. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates, including insurance company affiliates The Lincoln National Life Insurance Company (Fort Wayne, IN), which does not solicit business in New York, nor is it licensed to do so; and Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Limitations and exclusions may apply. Affiliates are separately responsible for their own financial and contractual obligations. Please contact your licensed insurance agent, or call the Small Business Association of Michigan at (800) for enrollment information. Page 5 of 5

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