Affinity Solutions. The Manufacturers Life Insurance Company. Advisor s Product and Rate Guide

Transcription

1 Affinity Solutions Advisor s Product and Rate Guide Personal Accident Disability Insurance and Cash Hospital The Manufacturers Life Insurance Company

2 Table of Contents Personal Accident Disability Insurance and Cash Hospital at a Glance...3 Cash Hospital Plan Details Hour Compensation Plan Details...7 Optional Coverage and Riders Key Definitions and Glossary Contact Information

3 Personal Accident Disability Insurance and Cash Hospital at a Glance Product Name Personal Accident Disability Insurance Cash Hospital Insurance Product Overview Target Markets Premium Structure Our 24 Hour Compensation Plan offers flexible coverage that provides a monthly benefit if an accident or sickness results in a total or partial disability. Benefits can include income replacement, funding for medical costs, and income and business expense coverage for self-employed individuals. Designed to provide simplified issue accident coverage provided the applicant satisfies two (2) qualifying questions. Available to non-working (students, at-homes, unemployed, seniors) and working (full or part-time employees, or self-employed) individuals. Sickness coverage is optional and subject to full underwriting. There are no totally uninsurable occupations. Premiums are level and guaranteed renewable to age 90; premiums can be changed on a class (not individual) basis only. Guaranteed issue coverage that provides a daily benefit if hospitalized as a result of an accident or sickness. All individuals, couples and families. No eligibility questions, no integration with other government, travel, or health insurance, and medical or financial underwriting. Premiums are level and guaranteed renewable to age 90; premiums can be changed on a class (not individual) basis only. Issue Ages 5 to to 80, primary insured or eldest spouse for spouse/family coverage; children from 31 days up to 21 years old or to age 25 if full-time student. What triggers payment of benefits? When does payment begin? Total Disability If working prior to disability inability to engage in regular occupation and not gainfully employed elsewhere. If not employed at time of disability inability to perform most of his or her routine daily activities. Partial Disability If employed prior to the accident, cannot perform one or more important duties. If not employed, inability to perform a significant number of routine daily activities. For working individuals, Personal Accident has a 5-year regular occupation definition for disability, moving to any occupation definition. For accident, as early as 1st day or after 30 days, or 120 days from onset of disability. For sickness, subject to full underwriting, 15 day retroactive, 30 or 120 day elimination period. Daily benefit payable if hospitalized within 90 days of an accident or sickness for up to one full year. If admitted to intensive care, outside of Canada or as a result of cancer or heart attack, the payable benefit received is doubled up to 30 days. Convalescence benefit for up to 30 days is payable if still totally disabled after hospitalization discharge. As of the first day of hospitalization continued on page 4» 3

4 Product Name Personal Accident Disability Insurance Cash Hospital Insurance Benefits Payable Benefit Maximum Standard Benefits Optional Riders (age restrictions may apply) Monthly benefits payable during the selected benefit period while disability lasts: 2 years (24 Hour Compensation Plan base plan) Can be extended to a 5-year benefit or to age 65 Maximum, if working prior to the disability, monthly benefit is limited to 75% of the pre-disability income or 1% of business income up to a maximum of $6,000 per month up to age 64, up to $4,000 per month from ages 65 to 68 and up to $1,000 from ages 69 through 80. If not employed at time of disability, monthly benefit payable cannot exceed $2,000 (or $1,000 if over 70). Partial disability (6 month maximum) No integration with other government or disability insurance at time of underwriting or claim for any monthly benefit up to $2,000. Recurrent disability (within 6 months considered continuation) Vocational or physical rehabilitation (3 month maximum) Non-occupational disability reduces coverage cost by wrapping around existing WSIB $100 per day accident hospitalization benefit (1 year maximum) Up to $100 ambulance benefit (reimbursement of costs, 1 per Accident) $10,000 accidental death benefit which increases $1,000 per year in force up to $20,000; reduces to $10,000 at age 70 Waiver of premiums after 30 days of consecutive total disability Assumed disability benefit Death benefit up to 3 times last monthly benefit if death occurs while on claim Accidental Death and Dismemberment Accidental Death Accident Excess Medical Non-Occupational Loss of Income Sickness Hospitalization Sickness Disability Sickness Disability Extension 24 Hour Compensation Rider (additional coverage) 24 Hour Accident Disability Extension Non-Occupational Accident Disability Extension Strain and Sprain Rider Premium Refund Rider Return of Premium on Death Daily benefits are paid during hospitalization up to a maximum of: Regular daily hospitalization: up to 365 days Supplementary daily hospitalization: up to 30 days Convalescence: up to 30 days Select from $20 up to $100 per day (multiples of $10) Note: Children receive 50% of selected daily benefit. Daily hospitalization benefit Supplementary benefit Convalescence benefit 4

5 Personal Accident Disability Insurance Cash Hospital Plan Details Key Features Ages 18 80, primary, couple, primary + children, family Dependent children aged from 31 days to 21 years old (or until age 25 if a full-time student) Guaranteed renewable to age 90 Guaranteed to issue hospital coverage is available to anyone. Available to anyone working or non-working on an individual, couple and family basis Guaranteed to issue No financial underwriting No medical tests or exams required No eligibility questions for your client to answer Available in addition to other coverage including government health insurance plans, health and travel insurance Sickness or accident hospitalization coverage from the very first day paid directly to your client Daily hospitalization benefits up to $100 per day for up to one full year Supplementary hospitalization benefits are doubled for up to 30 days if hospitalized outside of Canada, in the ICU, or due to cancer or heart attack Convalescence benefits for up to 30 days after discharge if still disabled No limit on the number of hospital stays Worldwide coverage No elimination period Minimum and Benefit Increments Amounts From $20 up to $100 a day ($10 increments) Maximum Issue Limits Children s benefits are 50% of those described Note: When the client is applying on a primary + spouse or family basis, the primary insured on the application must always be the older of the two applicants; therefore, the premium is based on the older age. Benefits for children are 50%. Guaranteed Renewable to Age 90 As long as premiums are paid on time: We cannot cancel the policy; and We cannot make any changes to the terms of the contract. However, we do reserve the right to change premiums on all policies in the same classification of risk. By classification of risk, we mean age, plan, province, amount, occupation, or any combination of these, based on experience. Only one change in premium may be made in any 12-month period. Also, benefits can be reduced because of a change to a more hazardous occupation. All policies are guaranteed renewable to age 90. The policy expires at age 90. Benefit Period (BP) Up to one (1) full year Modal Factors and Policy Fee There are no modal factor charges. Annual premium is 12 times the monthly premium. There is no policy fee. 5

6 Premiums Premiums are based on your client s age and the monthly benefit for which they qualify. Premiums are level for the duration of coverage. Your client can pay premiums with an annual cheque OR monthly direct withdrawal OR monthly credit card payments. Cash Hospital Monthly Premiums Age Coverage Option $20 Per Day Benefit $50 Per Day Benefit $80 Per Day Benefit $100 Per Day Benefit Primary Insured Primary Insured + Spouse Primary Insured + Children Family Primary Insured Primary Insured + Spouse Primary Insured + Children Family Primary Insured Primary Insured + Spouse Primary Insured + Children Family Primary Insured Primary Insured + Spouse Primary Insured + Children Family Primary Insured Primary Insured + Spouse Primary Insured + Children Family Primary Insured Primary Insured + Spouse Primary Insured Primary Insured + Spouse Primary Insured Primary Insured + Spouse Primary Insured Primary Insured + Spouse Exclusions No benefits are payable for hospitalization that results from war; elective medical treatment; suicide or self inflicted injuries; committing or attempting to commit a criminal offence or while in prison; the misuse of medication or the abuse of drugs or intoxicants; air travel (other than on a commercial aircraft); participation in professional sports or hazardous activities including but not limited to: scuba diving, boxing, parachuting, parasailing, rock/cliff climbing, skydiving, hang For complete wording of all exclusions consult the sample contract on Repsource. gliding, bungee jumping or a motorized contest of speed; a pre-existing condition during the 12 months before your coverage came into effect; a condition due to HIV or AIDS or ARC if the condition first manifested itself prior to the effective date, pregnancy, childbirth or abortion. See policy wording for the complete list of exclusions. Pre-existing conditions For accidents, loss due directly or indirectly to a pre-existing condition is not covered during the 12-month period following the effective date of coverage. For sickness, pre-existing conditions are excluded for 12 months if not disclosed on the application. Pre-existing condition means any disease or physical condition, whether diagnosed or not, for which symptoms first occurred or treatment was sought during the 12-month period before the coverage effective date. There is a 12/12 pre-ex on this coverage. 6

7 Personal Accident Disability Insurance 24 Hour Compensation Plan Details Personal Accident Disability Insurance (PADI) offers accident disability coverage to a broad market, including almost all occupations, seniors, and even the unemployed. Key Features Monthly total disability benefit up to $6,000 per month (up to 75% of insurable income or 1% of business income) payable for up to 24 months based on your client s own regular occupation definition Benefits can be extended for a total of 5 years or to age 65 for more information, see the Optional Coverage & Riders Section Customize coverage with benefits from the first day of disability or with 30 or 120 day elimination periods Maximum benefit amount reduced to $1,000 at age 70 Anyone between the ages of 5 and 80 is eligible for a monthly benefit of $1,000 Self-employed individuals may use both personal income and business income as eligible qualifying income Coverage is guaranteed renewable to age 90 Partial disability benefits, equal to half the total disability benefits, for up to 6 months if an accident leaves your client unable to perform one or more of their important duties Accidental death benefit of $10,000 increasing yearly by $1,000 up to $20,000 if your client dies as a result of an accident Death benefit of up to 3 times the last monthly benefit paid if your client dies while receiving disability claim benefits Assumed disability benefit will begin immediately if your client suffers a permanent loss of sight, hearing, speech or the use of two limbs Rehabilitation benefits following a period of total disability, of up to 3 times your monthly accident total disability benefits Accident hospitalization benefits of $100 for each day your client is in the hospital as a result of an accident, for up to 1 full year Ambulance benefit of up to $100 per accident, which reimburses the costs your client has incurred for this service Premiums will be waived after 30 consecutive days of total disability or the elimination period, if later, while your client is receiving total disability benefits No proof of income is required until time of claim (applies to amounts greater than $2,000 per month) No proof of business overhead expenses No income qualification or integration on monthly benefit amounts less than $2,000 Optional sickness disability coverage (subject to full medical underwriting) Optional additional riders PADI allows you to offer your client lots of choice and flexibility: coverage can start immediately, after one month or after 4 months and can extend for a total of 5 years or to age 65. Proof of income required at claim time for amounts greater than $2,000 per month. Minimum and Benefit Increments Amounts Minimum monthly benefit of $300 ($100 increments) We offer monthly benefit amounts up to $6,000 which covers the needs of most working people. 7

8 Maximum Issue Limits Limited Benefits Category: $1,000 of Monthly Benefit For applicants in the Limited Benefits category (e.g., high risk or transient occupations) Non-Working Individuals: $1,000 for ages 5 to 80 Including children, students, seniors, at-homes, unemployed, retired persons and individuals working less than 30 hours per week The maximum issue limit for limited occupations, students, seniors and unemployed individuals is $1,000. Employed Individuals: $6,000 of Monthly Benefit for ages 18 to 64 Working 30+ hours per week; up to 75% of insurable monthly income, rounded down to nearest $100 $4,000 of Monthly Benefit for ages 65 to 68 Working 30+ hours per week; up to 75% of insurable monthly income, rounded down to nearest $100 Guaranteed Renewable to Age 90 As long as premiums are paid on time: We cannot cancel the policy; and We cannot make any changes to the terms of the contract. All policies are guaranteed renewable to age 90. However, we do reserve the right to change premiums on all policies in the same classification of risk. By classification of risk, we mean age, plan, province, amount or occupation, or any combination of these based on our experience. Only one change in premium may be made in any 12-month period. Also, benefits can be reduced or rated because of a change to a more hazardous occupation. The policy expires at age 90. Some riders expire at younger ages. Elimination Period (EP) 0 days or you can select a 30 or 120 day elimination period. The elimination period options are typically selected to reduce cost and/or wrap around Employment Insurance (EI) The EP is the number of consecutive days of total disability that must be satisfied before benefits are payable to your client. Benefit Period (BP) 2 years for the base plan May be extended for 3 more years or to age 65 as described in the Optional Coverage and Riders section The BP is the maximum length of time for which disability benefits will be paid for any given claim. Modal Factors and Policy Fee There are no modal factor charges. Annual premium is 12 times the monthly premium. There is no policy fee. The benefit period is 2 years. Your client can customize their coverage by choosing the elimination period and optional riders to extend the benefit period. 8

9 Premiums Premiums are based on your client s age and the monthly benefit for which they qualify. Premiums are level for the duration of coverage. Your client can pay premiums with an annual cheque OR monthly direct withdrawal OR monthly credit card payments. Note: Premium rating or limitations may apply to benefit amounts over $1,000 per month. Refer to the Financial and Medical Underwriting Guide for more information. 24 Hour Compensation Monthly Premiums Ages EP/BP $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6, / / / / / / / / / *2 Year 24 Hour Compensation base plan expires at age 90 Exclusions No benefits are payable where the accident results directly or indirectly from suicide or selfinflicted injuries; committing or attempting to commit a criminal offence or while in prison; the misuse of medication or the abuse of drugs or intoxicants; from participation in professional sports or hazardous activities including but not limited to: scuba diving, boxing, parachuting, parasailing, rock/cliff climbing, skydiving, hang-gliding, bungee jumping or a motorized contest of speed; air travel (other than on a commercial aircraft); elective medical treatment; or an act of war. For complete wording, see the sample contract available on Repsource. No benefits are payable for sickness unless the sickness disability rider is included. Subject to full underwriting. For complete wording of all exclusions consult the sample contract on Repsource. During our underwriting process, we may add an exclusion for a condition that would make your client otherwise uninsurable. Pre-existing conditions For accidents, loss due directly or indirectly to a pre-existing condition is not covered during the 12-month period following the effective date of coverage. For sickness, pre-existing conditions are excluded for 12 months if not disclosed on the application. Pre-existing condition means any disease or physical condition, whether diagnosed or not, for which symptoms first occurred or treatment was sought during the 12-month period before the coverage effective date. Limitations The maximum benefit period for each event of disability (total or partial) related to sprains and strains or injury to the neck and back is two months. Additional benefits may be paid for neck or back injuries if there is evidence of the injury on an x-ray, CT Scan or MRI. There is no limitation to the number of events payable. There is a 12/12 pre-ex on this coverage. Maximum benefit period for sprains and strains and neck and back injuries is 2 months. No limit on the number of events payable. 9

10 Optional Coverage and Riders Premium Refund Rider Ages Available on an individual basis only Guaranteed renewable Provides the insured with a premium refund of 50% of the premiums paid, less any claims, providing that the total claims paid is less than 20% of the total premiums paid for the 10 year accumulation period Accumulation period: the ten (10) consecutive years following the effective date for each coverage issued with the Premium Refund Rider option Premium rates will be calculated at 45% of the coverage premium and will be level for the duration of the coverage period Available for new issues and to inforce policies when adding new coverage with PRR or ROPD at the same time Sample Calculations Example 1: Eligible for Refund (With Claims) Annual premium ($2,542.92) x 10 years $25, Claims must be less than 20% of total premiums paid ($25, x 20%) $5, Total claims paid during 10-year accumulation period $4, % of premium paid ($25, x 50%) $12, Minus total claims paid during accumulation period of premiums paid -$4, Premium Refund $ 8, Example 2: Eligible for Refund (Without Claims) Annual premium ($2,542.92) x 10 years $25, No claims incurred $0.00 Eligible Refund: 50% of premiums paid ($25, x 50%) $12, Example 3: Not Eligible for Refund Annual premium ($2,542.92) x 10 years $25, Claims must be less than 20% of total premiums paid ($25, x 20%) $5, Total claims paid during 10-year accumulation period $6, Total claims exceeds 20% of total premiums paid No Refund 10

11 Non-Occupational Loss of Income Rider Issue Ages: Guaranteed renewable to age 70 Elimination period: 0 or 120 days Benefit period: 2 years. Can be extended for 3 more years or to age 65 Built-in assumed disability benefits and death benefit if your client dies while in receipt of total disability payments $300 per month minimum 24 Hour Compensation required prior to selecting this rider Used to wrap around workers compensation coverage Must be covered by WSIB or workers compensation in order to add this coverage Premium rating or limitations may apply to benefit amounts over $1,000 per month. See the Financial and Medical Underwriting Guide. Non-Occupational Loss of Income coverage provides similar disability protection to the base 24 Hour Compensation plan except it excludes accidents that occur while your client is at work. This coverage is used when your client is protected by workers compensation for work-related injuries, but needs protection for off-the-job injuries. The definitions for total and partial disability are the same as the base plan. This coverage is also subject to a relationship to earnings test and integration with other benefits as described in Financial and Medical Underwriting Guide. Non-Occupational Rider Monthly Premiums An affordable disability option for clients with WSIB/WC coverage. Ages EP/BP $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4, / / / / *2 Year Non-occ rider expires at age 70 Strain and Sprain Rider (up to 4 months) Issue Ages: 5-80 Coverage terminates at age 90 Elimination period: 0, 30 or 120 days Increases the maximum period (up to 4 months) for accident total or accident partial disability benefits resulting from a strain or sprain Premium rates are level for the duration of the coverage period Can only be sold with total accident disability coverages such as the 24 Hour Compensation Plan/Rider or Non-Occupational Loss of Income Rider Monthly benefit must be equal to the monthly accident total disability benefit When offering both 24 Hour Compensation and Non Occupational Loss of Income, add the monthly benefit amounts with the same EP to get the rate below. Sprain and Strain Rider (4-Month Benefit) Monthly Premiums Ages EP $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,

12 Extension Riders to 5 years or to age 65 for Employed Individuals Issue Ages: for the 3 more years option, for the to age 65 option Benefit amount must be equal to the 24 Hour Compensation/Non-Occupational Loss of Income total disability benefit $300 per month minimum required for 24 Hour Compensation base plan prior to selecting Non-Occupational Loss of Income Rider & Extension Client must work 30 hours or more per week at time of application Must be covered by WSIB or workers compensation in order to add Non-Occupational Accident Disability Extension Rider Expiry: coverage is available to age 65. However, premiums cease at age 63 3-year extension benefit, when combined with your 24 Hour Compensation/Non-Occupational Loss of Income coverage, will provide a total of 5 years based on regular occupation definition Not available to occupations that fall into the limited benefits category. Refer to the Financial and Medical Underwriting Guide for Occupations NOT insurable for coverage under the 24 Hour and Non-Occupational Accident Disability Extension Subject to eligibility, your client can extend the benefit period for the base 24 Hour Compensation coverage beyond 2 years with an extension rider. If your client does so, a similar extension rider would automatically be added to any Non-Occupational Loss of Income coverage. Your client can also elect to extend any sickness disability coverage: the extended benefit period for sickness cannot exceed the extended benefit period for accident coverage. During the extended benefit period, a regular occupation definition applies for the first 36 months, followed by any occupation definition of total disability thereafter. If your client was employed prior to the accident (or sickness if applicable), total disability means he or she is wholly and continually unable to engage in any occupation for which he or she is or may become reasonably fitted by education, training or experience. Otherwise, your client must be wholly and continually unable to perform all of his or her routine daily activities. In either case, your client must be under the regular care of a physician and following the recommended treatment. During the extended benefit period, the benefit amount continues to be subject to the relationship to earnings test and potential integration with other benefits as described in the Financial and Medical Underwriting Guide. The exclusions continue to apply. 24 Hour Extended Benefit period to age 65 Monthly Premiums 5 year regular occupation definition with extension riders. Ages $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6, Non-Occupational Accident Disability Extension to age 65 Monthly Premiums Ages $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4, *Benefit option & rates to extend coverage to 5 years available on Diamond View If your client is eligible, he or she can increase their 24 Hour Compensation coverage and/or add an elimination period. 12

13 Employed Individuals up to $6,000 per month; subject to income qualification rules 24 Hour Compensation Rider Adding second EP or increasing inforce coverage Monthly Premiums Ages EP/BP $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000 $5,500 $6,000 0/ / / / / / / / / *EP must be greater than the selected plan Non-working, Students, Seniors maximum benefit available is a total of $1,000 per month 24 Hour Compensation Base Plan Monthly Premiums Ages EP/BP $500 $1,000 Students EP/BP $500 $1,000 Seniors EP/BP $500 $1,000 0/ / / / / / / / / / / / / / / *2 Year 24 Hour Compensation base plan expires at age Hour Compensation Rider Adding second EP or increasing inforce coverage Monthly Premiums Ages EP/BP $500 $1,000 Students EP/BP $500 $1,000 Seniors EP/BP $500 $1, / / / / / / / / / / / / / / /

14 Sickness Disability Coverage Issue Ages: Subject to medical insurability. Refer to Financial and Medical Underwriting Guide Coverage is guaranteed renewable to age 70 Match your client s accident protection with 24 hour sickness protection anywhere in the world Monthly benefit amount: Minimum $300. Maximum is the total amount of accident protection Maximum benefit amount for non-working, students, seniors is $1,000 Maximum benefit amount of $6,000 (multiples of $100); subject to aggregate maximum of $6,000 for all sickness disability coverages Benefits reduced by 50% at age 65 Partial disability benefits of 50% up to a maximum of 6 months Death benefit of up to 3 times the last monthly disability benefit will be paid if your client dies while receiving disability claim benefits Flexible coverage Elimination period: 15 days retroactive to the date of claim, or a 30 day or 120 day elimination Benefit period: 2 years. Can be extended for 3 more years or to age 65 Consult the Financial and Medical Underwriting Guide to make sure your client is eligible for coverage. Sickness Disability coverage provides benefits for total and partial disability due to sickness. The definitions for total and partial disability are otherwise the same as the base plan. The sickness coverage amount is also subject to a relationship to earnings test and may be integrated with other benefits as described in the Financial and Medical Underwriting Guide. Note that any monthly benefits for sickness payable after age 65 will be reduced by one-half. In addition to the exclusions under your client s accident coverage, no benefits are payable for: pregnancy, childbirth or voluntary abortion except for life threatening complications; the misuse of medication or the abuse of drugs or intoxicants; mental, nervous or emotional disorders; or an accident. Sickness Disability Extend Benefit to 5 years or to age 65 Extends the 2 year total sickness disability benefit period to 5 years or to age 65 5 year regular occupation total disability definition Benefit amount must be equal to the total sickness disability benefit and cannot exceed accident benefits Client must work 30 hours or more per week Client must have 24 Hour Compensation, 24 Hour Extension and Sickness Disability coverage Sickness Disability Coverage 2 Year Benefit Rate per $100 Your client must be working at least 30 hours per week. Sickness Disability Rate Monthly Premiums Issue Ages 15 Day Retro Waiting Period 30 Day Elimination Period 120 Day Elimination Period Male Female Male Female Male Female *Benefit option & rates to extend coverage to 5 years available on Diamond View Sickness Disability Extension to Age 65 Rate per $100 Sickness Disability Extension Monthly Premiums for Employed Individuals Issue Ages Male Female

15 Accidental Death and Dismemberment Issue Ages: Guaranteed renewable to age 90 Coverage is subject to eligibility questions Some occupations are not eligible for this coverage see Financial and Medical Underwriting Guide for list of uninsurable occupations Available in increments of $50,000 Provides a lump-sum benefit up to $300,000 for accidental death All benefits reduce by 50% at age 70 Your client can combine Accidental Death and Dismemberment with Accidental Death up to a maximum benefit of $600,000. This coverage can be combined with optional accidental death coverage up to an aggregate maximum of $600,000 This benefit is payable in addition to the accidental death benefit that is built in to 24 Hour Compensation coverage Supplementary accidental death benefit if your client has any dependent children, this rider pays an additional accidental death benefit of 2% of the chosen benefit amount multiplied by the number of dependent children Accidental death and dismemberment benefit up to $300,000 for a covered loss (outlined below), this rider pays a percentage of the Accidental Dismemberment/Loss of Use benefit, which is the selected accidental death benefit amount. Only one benefit, whichever is largest, will be paid per accident Covered Loss Percentage Covered Loss Percentage Both hands or both feet Sight in both eyes One hand or foot Sight in one eye 50% One hand and one foot 100% Speech or hearing in both ears One hand or foot and one eye Hearing in both ears and speech Hearing in one ear All toes on one foot 25% One finger or toe 2.5% Accidental Death and Dismemberment Monthly Premiums $50,000 $100,000 $150,000 $200,000 $250,000 $300, Accidental Death No eligibility questions required to apply; however some occupations may not be eligible for this coverage. Refer to the list of uninsurable occupations in the Financial and Medical Underwriting Guide. Ages Guaranteed renewable to age 65 Accidental death coverage provides your client s beneficiary with a lump-sum payment if your client dies as a result of an injury sustained in an accident. Refer to the standard exclusions under this coverage in the sample policy Benefit amounts $10,000 $300,000 (in increments of $10,000) This coverage can be combined with optional accidental death coverage up to an aggregate maximum of $600,000 This benefit is payable in addition to the accidental death benefit that is built in to 24 Hour Compensation coverage Can be added to 24 hour Compensation or Cash Hospital coverage only This coverage can be purchased in addition to the built-in accidental death benefit. Accidental Death Monthly Premiums $50,000 $100,000 $200,000 $300,

16 Accident Excess Medical Ages Guaranteed renewable to age 90 Coverage anywhere in North America 3 benefit plan options to choose from to help pay for medical expenses, provided that they are incurred within 1 year of the accident. Depending on the plan your client chooses, this coverage can help to reimburse expenses your client has incurred as a result of an accident, including expenses for: Paramedical services of a licensed physiotherapist, osteopath, masseur/masseuse and/or chiropractor, speech therapist and podiatrist, up to the limit shown below Services of a dentist or dental surgeon, up to the limit shown below, for the repair of natural teeth or treatment of a fractured/dislocated jaw Medical equipment up to the limit shown below. This includes expenses for hospital beds, oxygen equipment, wheelchairs (including home and vehicle modification if required for use of wheelchair), crutches, canes, walkers, etc. Medical supplies and prosthesis up to the limit shown below. This includes artificial limbs or eyes, hearing aids, surgical stockings, orthopaedic appliances (excluding teeth), braces, collars, splints, casts, trusses, pressure garments, burn garments, medical dressings etc. Prescription drugs up to $800, maximum 30 day supply of medication per prescription (this benefit is not available to residents of Quebec) Full cost of 1 pair of prescription eyeglasses or a 1 year supply of prescription contact lenses, if not previously required or worn within 90 days of accident (up to a maximum of $1000 for all 3 plans). Up to $300 payable for the repair or replacement of prescription eyeglasses and/or contact lenses, including eye exam, within 90 days of accident Nursing care, up to $100/day for up to 25 days for care provided by a nurse or personal support worker Semi-private or private hospital room, up to $100 per day for up to 1 full year Up to $100 per initial claim form up to a maximum of 3 forms within 365 days TV, radio and/or telephone rental while hospitalized, up to $15 per day Payable over and above any other coverage you may have Can only be added to the 24 Hour Compensation plan This coverage is payable in addition to any other coverage your client has. Accident Excess Medical Rider Options Benefit Note: Amounts listed are per accident Plan A Up to Plan B Up to Accident Paramedical Services $400 $600 $800 Plan C Up to Accident Dental Care $1,500 $2,500 $3,500 Accident Medical Equipment $2,500 $5,000 $7,500 Accident Medical Supplies and Prosthesis $2,500 $5,000 $7,500 Accident Prescription Drug same for all plans (not available in Quebec) $800 $800 $800 Accident Vision Care replacement or repair same for all plans $300 $300 $300 Accident Nursing and Personal Support Worker Care same for all plans $100 $100 $100 Accident Hospital Accommodation same for all plans $100 $100 $100 Claim Forms same for all plans $100 $100 $100 Accident Hospital Room Services same for all plans $15 $15 $15 Accident Excess Medical Monthly Premiums Plan A Plan B Plan C

17 Sickness Hospitalization Ages Available on an individual basis only Can only be added to a 24 Hour Compensation coverage Guaranteed renewable to age 90 Simplified issue No medical or financial underwriting, as long as your client can answer no to the two eligibility questions Benefit period up to 12 months if your client is hospitalized due to sickness Sickness hospitalization benefit covers hospitalization costs up to $100 per day for up to a year Supplementary sickness hospitalization hospitalization benefits increase by 50% if due to cancer, heart attack or a stay in ICU for up to 1 year or up to 60 days if your client is over 65 Out-of-country sickness hospitalization double benefits for up to 60 days if hospitalized in Australia, New Zealand, Western Europe or the United States Sickness convalescence convalescence benefits of 3 days for each day hospitalized up to 1 full year if your client remains disabled after hospital discharge The definition for total disability is the same as the base plan except that disability must be due to sickness. In addition to the exceptions listed in your client s 24 Hour Compensation plan, the following will not be covered under sickness hospitalization coverage: Pregnancy, childbirth or abortion except for complications during pregnancy that are life-threatening AIDS, HIV, or ARC if manifested prior to the effective date of coverage Mental, nervous or emotional disorders, Accidents Sickness Hospitalization is not subject to medical or financial underwriting. Sickness Hospitalization Rider Options Benefit $25 Per Day $50 Per Day $75 Per Day $100 Per Day Sickness Hospital Supplementary Sickness Hospital Out-of-country Sickness Hospital Sickness Convalescence Sickness Hospitalization Monthly Premiums Ages $25 Per Day $50 Per Day $75 Per Day $100 Per Day

18 Personal Accident Disability Insurance Key Definitions and Glossary Accident means a sudden, unexpected, unforeseeable, unavoidable external event. Employed means actively engaged in an occupation for compensation or profit at least 30 hours per week. Injury means bodily harm resulting directly from an accident and independent of all other causes including sickness. Sickness means illness or disease. Total Disability (Injury) If your client was employed prior to the accident, totally disabled means that they are unable to perform their regular occupation and are not working elsewhere. Otherwise, it means they are unable to perform most of their routine daily activities. After 5 years of disability*, totally disabled means your client is unable to engage in their regular occupation or any occupation or employment for compensation for which they are reasonably fitted by education, training or experience, if they were employed prior to the accident. Otherwise, it means they are wholly and continually unable to perform most of their routine daily activities. *Note that if the sickness hospitalization Rider is attached, this definition is applicable. Partial Disability (Injury) Personal Accident Disability Insurance also includes partial disability benefits for injury**. If your client was employed prior to the accident, partial disability means your client is prevented from working full time and/or performing one or more of the important duties of his or her regular occupation. If your client was not employed prior to the accident, total disability means your client must be unable to perform a significant number of his or her routine daily activities. Your client must be under the regular care of a physician and following the recommended treatment. **Note that if a Sickness Disability Rider is attached, partial disability benefits are also available for sickness. Assumed Disability If your client is deemed totally disabled because he or she suffered a permanent loss of speech, sight in both eyes; hearing in both ears; the use of both hands or both feet or the use of one hand and one foot, the Company will automatically assume that they are permanently totally disabled and benefit payment will begin immediately. This benefit operates regardless of your client s ability to engage in an occupation or perform routine daily activities and care and attendance of a physician is also not required. If a permanent loss is suffered, premiums will be waived and benefits paid out immediately for the duration of the benefit period. Death Benefit If your client dies while in receipt of monthly total disability or partial disability benefits, the Company will pay a lump sum amount equal to three times the last total disability benefit to the primary insured s estate. This benefit can provide your client s survivors with funds to help deal with final expenses. If your client dies while on claim, we will pay 3X the last monthly benefit paid to the insured s estate. Recurrent Disability A recurrent disability is one that occurs within 6 months of an earlier disability claim and results from the same or related causes. In such cases, we consider the second disability to be a continuation of the first. Benefits will be payable from the date of the recurrence for up to the balance of the benefit period. If your client is off claim for at least 6 months, any subsequent disability is considered a new disability. A new benefit period will begin and any applicable elimination period will need to be satisfied. Rehabilitation Benefit Following a period during which your client was in receipt of accident total disability benefits, the Company may, at its discretion, pay a rehabilitation benefit. If your client was employed on the date the Injury occurred, Vocational Rehabilitation Benefits will be payable. If your client was not employed on the date the Injury occurred, physical rehabilitation benefits may be payable. Payment is subject to the Company receiving original invoices or other acceptable documentation for such expenses or services. 18

19 Waiver of Premium While Disabled*** We will waive premiums that fall due after 30 consecutive days of total disability or the elimination period, if later, while the client is receiving total disability benefits. Waiver will continue while disability lasts and as long as the client continues to receive total disability benefits. 30 day waiver of premium if total disability occurs is embedded into the coverage. *** This provision waives premiums for the base plan and all riders. Contact Information Send all completed Applications and Mail for Personal Accident Disability Insurance to: For regular mail: Manulife P.O. Box 670, Stn. Waterloo Waterloo, ON N2J 4B8 For courier: Affinity Markets New Business Manulife 500 King Street North Delivery Station 500-GB Waterloo, ON N2J 4C6 Note: If you are contracted through a Managing General Agency or National Account Firm please forward your application to their office. To inquire on the status of a pending Personal Accident Disability Insurance application: Call toll free at 1 (877) or AM_brokersupport@manulife.com 19

20 PA 09/2015 INTENDED FOR ADVISOR USE ONLY NOT TO BE REPRODUCED OR DISTRIBUTED WITHOUT AUTHORIZATION Personal Accident Disability Insurance and Cash Hospital are offered through The Manufacturers Life Insurance Company (Manulife). Plans underwritten by The Manufacturers Life Insurance Company. Manulife, the Block Design, the Four Cube Design, and Strong Reliable Trustworthy Forward-thinking are trademarks of The Manufacturers Life Insurance Company and are used by it and its affiliates under licence. / Trademarks held by The Manufacturers Life Insurance Company The Manufacturers Life Insurance Company. All rights reserved. Manulife, P.O. Box 4213, Stn A, Toronto, ON M5W 5M3. PADI.Guide.P&R.A.EN (09/2015)