Disability Income Insurance ContinuON Income SolutionsSM Marketing Guide ecause life doesn t stop SM at disability
Headline Introduction... 4 Products & Features Individual Non Cancellable, Classes: 5M,,, 5, 4, 3,... 5 Individual Non-Cancellable Maximum enefit Variations... 8 Individual Guaranteed Renewable, Classes:,... 9 Optional Riders... 11 usiness Overhead Expense (OE), Classes: 5M,,, 5, 4, 3,,,... 14 usiness uy-sell, Classes: 5M,,, 5, 4, 3,,,... 17 Issue & Participation Limits Income Qualification Guide... 20 Special Limits... 22 Underwriting Medical Underwriting... 23 Financial Underwriting... 26 uy-sell Underwriting... 27 Submitting DI pplications... 29 Employment... 30 General Information Discounts... 31 usinessowner Matrix... 32 Risk Classifications Guidelines... 33 Occupation Listing... 35 Miscellaneous... 46 Please refer to ON-Net (http://onnet.ohionational.com) for illustration software, state specific application forms and more. 3
ContinuON Income Solutions SM Ohio National s ContinuON Income Solutions SM offer a broad and diverse portfolio to cover the income protection needs of both individuals and small business owners. Flexible policy design, outstanding features and affordability make this one of the most comprehensive DI portfolios available today. s you use this Marketing Guide, you will see that Ohio National provides you with all the essentials for a solid and competitive portfolio. Here s an overview of what ContinuON Income Solutions SM offer: balanced, diverse portfolio. Ohio National has solutions for broad groups of markets individual employee, corporate executive, small business owner, professional, government worker and others. Flexibility. Ohio National s innovative, unbundled products give you maximum responsiveness in designing solutions for the particular needs and objectives of each client. They allow you to present competitive proposals across a wide range of cases. Top-of-the-market policy definitions. While disability income insurance is relatively simple in concept, it all comes down to policy language, which is complex. Our policy definitions offer distinct and identifiable advantages to your clients. Highly competitive features. With disability income insurance, features are as important as premiums. s is true of our policy definitions, our features likewise set Ohio National disability income insurance products apart. They give clients compelling, additional reasons to safeguard their income with Ohio National. Competitive pricing. Our focus on overall quality and commitment to low internal expenses translate into an extraordinarily price-competitive portfolio. Sound management and financial integrity. The foundation on which all these qualities rest is Ohio National s reputation and record for prudent management and financial strength and stability. The ability to earn an income is a valuable asset that can, and should, be well protected. We hope you ll find that Ohio National s ContinuON Income Solutions SM will play an important part in your clients overall financial plans. 4
Products & Features Non-Cancellable Products & Features Individual Non Cancellable DI vailable Classes: 5M,,, 5, 4, 3, This policy is designed to provide disability benefits to individuals working in professional, executive, white-collar and grey-collar technical occupations. Non Cancellable and Guaranteed Renewable to Expiration Date Classes: 5M,,, 5, 4, 3, We cannot cancel the policy as long as premiums are paid. We guarantee the premiums as stated in the policy, which can be renewed until the Expiration Date of the benefit period selected. We cannot add restrictions during that time. The policy may be renewed for the insured s lifetime so long as the policy was in force for the prior policy year, the insured is not receiving benefits, and the insured is regularly employed at least 30 hours a week and receiving wages. The premium rates after the Expiration Date will be based on our rates then in use for such ages. Premium Options: Level Premium, 5 Year Step-Rate Issue ages Level Premium Step-Rate premium 18 60 (nearest age) 22-40 (nearest age) Elimination periods 60, 90, 180, 365 enefit periods Two and five years (not available with Step-Rate option); to age 65, to age 67, to age 70 Minimum benefit $500 per month, including Social Insurance Supplement Rider Maximum benefit 5M,, 5, 4, 3 $15,000 per month, $10,000 per month includes Social Insurance Supplement Rider FL $10,000 for all classes Optional riders Residual Disability Income, automatic for 5M and ; optional for all other classes Social Insurance Supplement Cost of Living Increase Guarantee of Physical Insurability Catastrophic Disability enefit 5
Products & Features Non-Cancellable 5M, Total Disability or Totally Disabled (Pure Own Occupation) The insured has a total disability or is totally disabled if, due to a sickness or injury, in and of itself, the insured is not able to perform the material and substantial duties of his or her regular occupation. The insured is not totally disabled if he or she can: 1. perform any of the material and substantial duties of his or her regular occupation; and 2. be employed in, or can engage in, his or her regular occupation on a full-time or part-time basis. Your Regular Occupation The occupation (or occupations if more than one) in which the insured is regularly engaged at the time disability began. If his or her regular occupation at the time disability began is limited to a board-certified specialty within the scope of his or her degree or license, we will deem that specialty to be his or her regular occupation. If the insured is not working at the time disability began, regular occupation means any occupation he or she is able to do based on his or her education, training and experience. 5, 4,, 3,, Total Disability or Totally Disabled (Modified Own Occupation) The insured has a total disability or is totally disabled if, due to a sickness or injury, in and of itself, he or she is not able to perform the material and substantial duties of his or her regular occupation and is not working in any other occupation for wage or profit. The insured is not totally disabled if he or she can: 1. perform any of the material and substantial duties in his or her regular occupation; and 2. be employed in, or can engage in, his or her regular occupation on a full-time or part-time basis; or 3. work in any other occupation for wage or profit. Regular Care of a Physician In order to be eligible for monthly benefits or for us to waive premiums under this policy, the insured must be under the regular care and treatment of a physician that under prevailing medical standards, is appropriate for the condition causing the disability. The physician must be qualified by training or experience to treat the condition causing disability. If, in the opinion of that physician, and based on our medical review, continued medical treatment will not improve the insured s condition, we may waive this requirement. However, waiving this physician care requirement does not change or affect our rights under the proof of loss and authorizations, examinations and interviews provisions found in the policy. Waiver of Premium If the insured is disabled for at least 90 days or the elimination period, if shorter, we will waive payment of premiums that become due while he or she is disabled. Cosmetic or Transplant Surgery We will pay benefits if the insured is totally disabled due to cosmetic or transplant surgery. The transplant must occur more than six months after the issue date of the policy, and if so, the elimination period will be waived. Voluntary Suspension During Unemployment y written request to us, the insured may suspend the policy if he or she becomes unemployed and is receiving state or federal unemployment benefits. We will refund premiums paid for coverage beyond the date we get the insured s request to suspend the policy. While the policy is suspended, no premiums are due, and the insured has no coverage. The suspension will end the earlier of: 1. one year after the date the suspension began; or 2. the date we receive the insured s request to end the suspension. Your Regular Occupation The occupation (or occupations if more than one) in which the insured is regularly engaged at the time total disability began. If he or she is not working at the time total disability began, his or her regular occupation means any occupation he or she is able to do based on his or her education, training and experience. 6
Products & Features Non-Cancellable Recurrent Disability If total disability and/or residual disability (if the residual disability is either included or part of the policy or the Rider is attached) stops and then starts again within 365 days from the same or a related cause, the two periods of disability will count as one. The insured will not have to satisfy the elimination period again. Rehabilitation Ohio National may help pay for a rehabilitation program if we are paying benefits under the policy and approve the program. Elimination Period The elimination period is the period of time that the insured must be totally disabled or residually disabled before benefits begin. For a disability that results from normal pregnancy or childbirth, the elimination period must be satisfied by a disability for the longer of the number of days shown on: page 3 of the policy; or 90 days. Presumed Total Disability Total disability is presumed if, while the policy is inforce, the insured sustains the total loss of the use of both hands, or the use of both feet, or the use of one hand and one foot, or completely loses sight in both eyes or the hearing in both ears or speech. When total disability is presumed: 1. the elimination period will be waived; 2. base monthly benefits will be paid even if the insured still works; 3. base monthly benefits will not be made for more than the maximum benefit period shown on page 3 of the policy; and 4. the insured must meet the regular care of a physician requirement stated in the policy. Mental Disorders and Substance buse Limitation 5M,, benefits will not be paid for more than a cumulative total of 24 months (60 months: 5, 4, 3, ) during the life of the policy if the insured is disabled due to any mental disorder or substance abuse. This limitation does not include lzheimer s disease or if hospital confined. Exclusions No monthly benefits will be paid for a disability: 1. due to war or an act of war, declared or undeclared, or is related to military service when scheduled active duty is more than 30 consecutive days; or 2. while the insured is legally incarcerated or detained; or 3. due to a loss we have excluded by name or specific description in an exclusion Rider attached to the policy; or 4. due to the insured committing, or attempting to commit, a felony; or 5. in the event that the insured s material and substantial duties normally require that he or she be licensed with a federal, state, or industry regulatory body, during any period his or her license has been suspended or revoked, due to actual or alleged misconduct or malpractice; or 6. due to a loss caused by or contributed to, or which results from the insured being engaged in, an illegal occupation; or 7. caused by an intentionally self-inflicted injury. We will not pay monthly benefits for more than 12 months throughout the life of the policy for periods for which the insured is asserting a claim and residing outside of one of the 50 states, the District of Columbia or Puerto Rico. 7
Headline Products & Features Non-Cancellable Non-Cancellable Maximum enefit Period Variations enefit period Maximum benefit period Non-cancellable Conditionally renewable To ge 70 For total disability starting: efore age 68 To age 70 ge 68-74 2 Years ge 75+ 1 Year To ge 67 For total disability starting: efore age 65 To age 67 ge 65-74 2 Years ge 75+ 1 Year To ge 65 For total disability starting: efore age 63 To age 65 ge 63-74 2 Years ge 75+ 1 Year 5-Year For total disability starting: efore age 60 5 Years ge 60 but before age 63 To age 65 To age 70 To age 67 To age 65 To age 65 For lifetime, subject to premium changes, must work at least 30 hours a week and receive an income For lifetime, subject to premium changes, must work at least 30 hours a week and receive an income For lifetime, subject to premium changes, must work at least 30 hours a week and receive an income For lifetime, subject to premium changes, must work at least 30 hours a week and receive an income ge 63 74 2 Years ge 75+ 1 Year 2-Year For total disability starting: efore age 75 2 Years To age 65 For lifetime, subject to premium changes, must work at least 30 hours a week and receive an income ge 75+ 1 Year 8
Products & Features Guaranteed Renewable Individual Guaranteed Renewable DI vailable Classes:, This policy is designed to provide disability income payments to individuals working in occupations such as skilled technician, on site supervisor, manual laborer and certain unskilled trades. Guaranteed Renewable to age 65 or Earlier Retirement, Premiums Subject to Change by Class We cannot cancel the policy as long as premiums are paid. The policy can be renewed each year before the earlier of age 65 or the date the insured elects to receive Social Security or other retirement benefits. We can change the rates. Such a change will be based on the insured s age, risk class and sex as of the policy date. The insured may renew this policy up to and at age 75, so long as the policy was in force for the prior policy year, he or she is regularly employed at least 30 hours a week, and he or she is not receiving Social Security or other retirement benefits. vailability Issue ages Waiting periods enefit periods Minimum benefit Maximum benefit Optional riders 18 60 (nearest age) 30, 60, 90, 180 and 365 days One, two and five years $500 per month, including Social Insurance Supplement Rider $5,000 per month, including Social Insurance Supplement Rider $4,000 per month, including Social Insurance Supplement Rider Social Insurance Supplement (not available with one-year benefit period) Waiver of Waiting Period While Hospital Confined Guarantees are based upon the claims-paying ability of the issuer. Total Disability The insured is totally disabled or has a total disability if, due to injury or sickness, the insured is: unable to work at any job for which he or she is suited by education, training or experience; and under regular physician s care. Presumed Total Disability Total disability is presumed if injury or sickness causes the insured to lose the use of two or more hands or feet, or the loss of sight, hearing or speech. The loss must be complete and one from which the insured is not expected to recover. When total disability is presumed, the waiting period is waived and the benefit is paid even if the insured still works. Partial Disability The insured is partially disabled if he or she: can do some but not all of the duties of any job; or can do all of the duties of any job, but for less time than normally required for those tasks. If the insured returns to work immediately after receiving income for total disability under the policy and due to injury or sickness he or she remains partially disabled, we will pay benefits. The amount will be determined by deducting 50 percent of gross pay from the policy income benefit amount (see example below). We will require proof of gross pay. Example: Policy income amount $ 1,000 Gross pay $ 750 x.5 = $ 375 Partial disability benefit $ 625 Partial disability benefits will not be paid: at or after age 65 or earlier retire ment date; beyond the maximum benefit period; or when gross pay exceeds 125 percent of the policy income benefit amount. 9
Products & Features Guaranteed Renewable Waiver of Premium If the insured is totally or partially disabled for at least 90 days or the waiting period, if shorter, we will waive payment of premiums that become due while he or she is receiving total or partial income. Cosmetic or Transplant Surgery We will pay benefits if the insured is totally disabled due to cosmetic or transplant surgery. Rehabilitation Ohio National may help pay the costs of a rehabilitation program if we are paying total income under the policy and approve the program. Exclusions No benefit is paid if total disability is due to war or an act of war, declared or undeclared, or is related to military service when scheduled active duty is more than 30 consecutive days. No benefit is paid for any period the insured is incarcerated. 10
Products & Features Optional Riders Optional Riders ll riders may not be available in all states or for all occupational classes. See ON-Net to confirm availability. ll riders are available through age 60 except as noted. Residual Disability Rider Classes: 5, 4,, 3, (Included in ase Policy for 5M, ) The residual disability benefit amount is the monthly benefit amount for total disability multiplied by the ratio of the insured s loss of earnings during disability to his or her monthly earnings before disability. If such ratio of loss is more than 75 percent, then the residual disability benefit amount will be the same as the total disability benefit amount. For the first six months that the insured receives residual disability benefits, the amount will be at least 50 percent of the total disability benefit amount. Residual disability benefits will not be paid for more than the maximum benefit period stated in the policy. Residual Disability or Residually Disabled The insured is residually disabled if he or she, due to sickness or injury: 1. is not totally disabled; and 2. is working in any occupation*; and 3. has a loss of monthly earnings that is at least 20 percent of his or her monthly earnings before disability; and 4. has loss of monthly earnings solely the result, directly and apart from any other cause, of an injury or sickness; and 5. is able to perform one or more, but not all, of the material and substantial duties of any occupation* or is able to work in any occupation no more than 80 percent of the time he or she formerly spent before his or her current disability started; and 6. meets the regular care of a physician provision. *For 5M and, residual is included in the base policy and uses the pure own occ definition (see page 6). Monthly Earnings efore Disability Monthly earnings before disability means the greater of: 1. the insured s average earnings per month for the 12 months immediately before disability begins; or 2. the insured s average earnings per month for the 24 months immediately before disability begins. If money was being paid into a pension or profit-sharing plan, that amount will be added to the insured s monthly earnings before disability. Monthly Earnings Includes 1. all wages, salary, bonuses, commissions and fees; 2. any pension and profit-sharing contributions and deferred compensation; and 3. other amounts earned by the insured for services performed by him or her that are reported as earned income for personal income tax purposes, excluding extraordinary income. In addition, if the insured owns any part of a business in which he or she provides personal services, monthly earnings will also include his or her share of profits produced by or from the business. In calculating such profits, he or she may only include normal and usual business expenses. The following amounts are not included in monthly earnings: 1. any unearned income, such as interest, dividends, rent, royalties, or investment income or other income not derived from the insured s vocational activities; and 2. any income from annuities, sick pay or benefits received for disability under a formal wage or salary continuation plan. Monthly earnings will be determined using either the cash or accrual accounting method, whichever the insured chooses. ut, during the period of disability, the same method must be used to determine monthly earnings before disability and current monthly earnings. If the insured chooses the cash method, we will exclude any income received for services rendered prior to the start of his or her disability. 11
Products & Features Optional Riders Transition Return to Work enefit We will continue benefits after the insured s disability has ended and his or her current monthly income is less than 80 percent of monthly earnings before disability if he or she is at work full-time, and loss of income is due solely to the same injury or sickness that caused the disability for which he or she received benefits. Duration of benefit for classes 5M,,, 5, 4 the length of the ase enefit period. Duration of benefit for classes 3, 24 months. Inflation Indexing t the end of each year the insured remains disabled, his or her monthly earnings before disability will be increased equal to the CPI U. This new amount will be used in calculating the residual disability benefit. If the CPI U does not increase, neither will the monthly earnings before disability. Social Insurance Supplement (SIS) Rider ll Classes We will pay extra benefits while the insured is disabled. The amount of extra benefit for disability will be the extra benefit amount shown in the base policy, less any social benefit received in a month. Social income includes income provided by: the federal Social Security ct; Workers compensation, occupational disease, employer s liability, State Cash Sickness, or like law; the Railroad Retirement ct; Civil Service Retirement Program; and any like program covering federal, state or local government employees enefits may vary by state. New Jersey, Rhode Island and Puerto Rico require at least an 180 day elimination period on any SIS benefits. Cost of Living (COL) Rider Classes: 5M,,, 5, 4, 3, If the insured is totally disabled for more than 12 months, we will increase the benefit paid under the policy each year by three percent compounded. The increase also applies to the residual disability benefit when included in the base policy and to the Residual Disability Rider and/or Social Insurance Supplement Rider if attached to the base policy. Option to uy enefit Increase fter a disability during which benefits were increased by the Cost of Living Rider, the insured may increase the benefit on the base policy by an amount equal to the increase provided by this Rider, rounded to the nearest $100. To exercise this option, the insured must: be actively and gainfully employed on a full time basis; apply within 90 days after disability ends; and apply before age 60. Premiums for the benefit increase will be based on the insured s age as of the date he or she elects to increase the benefit. Catastrophic Disability enefit (CT) Rider Classes: 5M,,, 5, 4, 3, The Catastrophic Disability enefit Rider will provide the insured with additional monthly benefits while he or she is catastrophically disabled. Catastrophic disability and catastrophically disabled means that, due to an injury or sickness: a. the insured is unable to perform two or more ctivities of Daily Living (DL) without stand-by assistance due to loss of functional capacity; (bathing, continence, dressing, eating, toileting, transferring); or b. the insured requires substantial supervisions due to severe cognitive impairments. t the time of issue, the CT Rider is limited to the following: up to three times the base monthly benefit; maximum issue amount of $10,000; and total coverage cannot exceed 100 percent of the insured s monthly earned income Exclude the amount of the CT Rider when applying Ohio National issue and participation limits. lso exclude the amount of the CT Rider when applying medical and inspection limits. Increases to base coverage, including increases under the Guarantee of Physical Insurability Rider, cannot result in total coverage, including CT Rider coverage, exceeding 100 percent of the insured s monthly earned income. 12
Products & Features Optional Riders Guarantee of Physical Insurability (GPI) Rider Classes: 5M,,, 5, 4, 3, (Issued through age 50) The insured may exercise an increase amount on the first day of any policy year up to age 60 if he or she is not disabled. The increase amount may not cause the total benefit to exceed the amount of income for which the insured currently qualifies based on our then current issue and participation limits. The minimum increase is $100 per month. The maximum increase is one-half the base monthly benefit. The sum of all such increase amounts may not exceed the amount shown on page 3 of the base policy. The maximum amount of potential increase amounts that can be purchased at issue of the rider is three times the base monthly benefit. To exercise an option to increase coverage under this rider, the insured will not have to prove that he or she can be insured medically. This rider is not available on rated cases. Increases are to the base monthly benefit for the base policy only. If the CT Rider is attached to the base policy, increases under this rider cannot result in total coverage, including CT Rider coverage, exceeding 100 percent of the insured s monthly earned income. Special Increase mount The insured may not have a special increase amount that will give him or her more than our maximum disability income issue and participation limit in effect as of the date he or she applies for the special increase amount. The insured may request a special increase amount if either of the following applies. 1. The insured is no longer eligible to participate in his or her employer s group long term disability insurance plan because of a change in employment or the insured s employer discontinues or reduces group long term disability insurance and the insured is working and not eligible for group long term disability insurance in the next 24 months. The insured must apply for the special increase amount within 90 days of losing group long term disability insurance. or 2. The insured has at least a 50 percent increase in earnings since his or her last increase date. The increase in earnings must be permanent and sustainable. If the increase in earnings is the result of a one-time bonus, commission or extraordinary financial event, the insured will not qualify for a special increase amount. Optional Increase When Disabled On the first increase date after the first time the insured becomes disabled, he or she can buy one increase amount for the lesser of: $1,000; or the amount he or she qualifies for, if any, based on average annual income for the 12 months immedi ately prior to the time disabil ity began. n increased amount will not cover a disability that starts before the increase date on which it takes effect. Waiver of Waiting Period While Hospital Confined Rider Classes:, If the insured is hospital-confined during total disability, we will pay income during the waiting period for the number of days he or she is hospital-confined. This rider is not available on rated cases. 13
Products & Features usiness Overhead Expense (OE) usiness Overhead Expense (OE) Classes: 5M,,, 5, 4, 3,,, usiness Overhead Expense (OE) coverage is designed to reimburse small business owners (e.g., sole proprietors, partners, closely held corporations) not operated from the home for normal and customary expenses necessary to maintain the business as a going concern after a disability. Ohio National OE coverage is also designed for individuals who provide a personal service, such as doctors, dentists and CPs and whose business would be profoundly affected if the insured was unable to perform his or her duties. Employers who have staff who could do some or all of the insured s duties, including those who operate retail businesses, and/or other revenue-generating work are generally not eligible for OE coverage. In addition, those individuals who operate a business from their residence, including doctors and CPs, would typically not qualify for OE coverage other than under the most unusual circumstances. The owner(s) must devote full time service to the business, occupation or profession and be personally liable for expenses. If the business is incorporated, benefits from the policy must be assigned. If ownership is shared with others, only the insured s pro rata share of expenses will be covered. The owner must produce substantial income for the business such that his or her disability would cause great disruption or even failure of the business. Coverage will not be available if the prospect is overinsured for individual disability insurance coverage. enefits over $5,000 per month require documentation of actual expenses from actual business tax returns. If there is other OE coverage in force with another company, a usiness Expense Excess Coverage Endorsement will be necessary. Employees salaries for those employees not doing the same duties as the owner will be considered as a covered expense. Those doing the same duties as the owner will not be considered. Non Cancellable and Guaranteed Renewable to age 65 Classes: 5M,,, 5, 4, 3, We cannot cancel this policy as long as scheduled premiums are paid. The policyowner can renew it each year before age 65. We cannot raise the rates or add restrictions during that time. The policyowner may renew this policy one year at a time from age 65 up through age 75 so long as: the policy was in force the year be fore; and the insured is regularly employed at least 30 hours a week in the business. Guaranteed Renewable to age 65 Classes:, Premiums are subject to change by class. We cannot cancel this policy as long as premiums are paid. The policyowner can renew each year before age 65. We can change rates from time to time. Such a change will be based on the insured s age, risk class and gender as of the policy date. We will send notice of a change at least one month in advance, mailed to the last address on our records. The policyowner may renew this policy one year at a time from age 65 up through age 75 so long as: the policy was in force the year before; and the insured is regularly employed at least 30 hours a week in the business. vailability Size Issue ages Occupation classes Waiting periods usinesses with fewer than six owners/ principals and fewer than 20 employees 18 60 (nearest age) 5M,,, 5, 4, 3,,, 30, 60 and 90 days enefit periods 12, 18 and 24 months Maximum benefit 5M,,, 5, 4, 3 $30,000 per month $10,000 per month $4,000 per month $3,500 per month Minimum benefit $1,000 per month Optional riders Residual Disability (5M,,, 5, 4, 3, only) Partial Disability Substitute Salary Expense Six Month enefit Guarantee of Physical Insurability (5M,,, 5, 4, 3, only) Guarantees are based upon the claims-paying ability of the issuer. 14
Products & Features usiness Overhead Expense (OE) Maximum Monthly enefit Permits Carry Over of Excess Expenses The largest amount we will pay in a month is computed by multiplying the number of months for which benefits have been paid, plus one, times the maximum first-month total disability income, minus income paid. Definition of Total Disability The insured is considered totally disabled if: he or she cannot do the substantial and material duties of his or her business due to injury or sickness; and he or she is under a regular physician s care. For classes 5M,,, 5, 4, 3 and, the insured does not need to be under a physician s care on a regular basis to be considered totally disabled if he or she can show that further recovery is not expected. Nonmonthly Expenses If a covered business expense comes due while the insured is totally disabled and that relates to a period of more than one month, this covered business expense either: will be prorated throughout the time to which it applies; or will be fully paid that month, if the insured chooses this method before we pay a prorated portion of this covered business expense. However, we will not pay more than the maximum monthly benefit. The maximum benefit period for the new policy will be two years and the waiting period for the new policy cannot be less than the waiting period in the policy being converted. Waiver of Premium If the insured is totally disabled for at least 90 days or the waiting period, if shorter, we will waive payment of premiums that become due while totally disabled. Cosmetic or Transplant Surgery We will pay benefits if the insured is totally disabled due to cosmetic or transplant surgery. Presumed Total Disability Total disability is presumed if injury or sickness causes the insured to lose the use of two or more hands or feet, or to lose his or her sight, hearing or speech. The loss must be complete and one from that the insured is not expected to recover. When total disability is presumed: the waiting period is waived; and income is paid even if the insured still works. Exclusions No income is paid if total disability is due to war or an act of war, declared or undeclared, or is related to military service when scheduled active duty is more than 30 consecutive days. No income is paid for any period the insured is incarcerated. Conversion Privilege t any time prior to age 60, the policyowner may exchange this policy for an individual disability income insurance policy if: the policy is in force at that time; we receive a written request; and the insured is not disabled when the request is made. The maximum monthly benefit for such a disability income insurance policy will be the maximum first month total disability income for this policy. The amount of monthly benefit in the new policy, when added to all other such coverage with any company, cannot be more than our published issue and participation limits at that time. 15
Products & Features usiness Overhead Expense (OE) Optional Riders for usiness Overhead Expense ll optional Riders may not be available in all states or for all occupational classes. See ON-Net to confirm availability. ll riders are available through age 60 except as noted below. Guarantee of Physical Insurability Rider Classes: 5M,,, 5, 4, 3, (Issued through age 58) The insured may buy an additional amount of maximum first month total disability income on the first day of every second policy year. The insured will not have to prove he or she can be insured. Each additional amount must be: at least $200; but not more than 20 percent of the original maximum first month total disability income. The waiting period must be the same as in the policy. This benefit stops when: the insured reaches policy age 60; or when he or she has increased the origi nal maximum first month total disability income by 100 percent. Residual Disability Rider Classes: 5M,,, 5, 4, 3, When added to a policy, the Residual Disability Rider will provide income paid on an income replacement basis if the insured continues to work in his or her business or profession, as long as he or she: satisfies the waiting period (except for pregnancy, total disability is not required for residual benefits to be paid); can do some, but not all, of the substantial and material duties of the business or profession, or can do all such duties, but for less than the time normally required to do such duties; suffers a loss of gross monthly earnings before disability; and is under a regular physician s care unless further recovery is not expected. The income amount will be the lesser of: the maximum first month benefit times the ratio of the loss of gross monthly earnings during disability to the gross monthly earnings before disability, or the covered business expenses less the gross monthly earnings. However, for the first six months of covered loss, the income amount will not be less than 50 percent of the maximum first month benefit. fter a period for which we have paid income, the insured can return to work full-time, be released from a physician s care, and still be eligible for benefits up to six months based solely on a loss of gross monthly earnings of 20 percent or more. No loss of time or duties is required during this period. While disabled, any money received for work performed prior to the start of disability will not affect the benefit. Only the money actually received for work performed during a disability will affect the benefit. Gross monthly earnings before disability are measured as the average gross monthly earnings for the 12 months before the disability begins. Contributions to a pension, profit sharing, 401(k) or other qualified retirement plan are included in gross monthly earnings before disability. If loss of gross monthly earnings is 75 percent or more of the gross monthly earnings before disability, the original income benefit is payable. The minimum monthly income benefit payable for the first six months of residual disability is 50 percent of the original income benefit. 16
Products & Features usiness Overhead Expense (OE) Products & Features usiness uy-sell Partial Disability Rider ll Classes When added to the policy, the Partial Disability Rider will provide 50 percent of the original income benefit for up to six months, as long as the insured: satisfes the waiting period (except for pregnancy, total disability is not required for partial benefits to be paid); can do some, but not all, of the substantial and material duties of his or her business or profession, or can do all such duties, but for less than the time normally required to do such duties; and is under a regular physician s care, unless further recovery is not expected. The insured does not need to provide proof of covered business expenses, nor loss of gross monthly earnings, to collect this benefit. Six Month enefit Rider ll Classes n additional monthly overhead expense rider with a six month benefit is available up to an amount equal to one half the amount of base coverage. Substitute Salary Expense Rider ll Classes The Substitute Salary Expense Rider will provide a reimbursement for a salary expense incurred for a person hired to perform the substantial and material duties of the insured s business or profession and when a loss of gross monthly earnings is shown. The rider benefit is payable for a maximum of six months and for the lesser of 100 percent of the original income benefit or the actual loss of gross monthly earnings. In any month we pay less than 100 percent of the original income benefit, the difference will be carried forward beyond the six-month period until we have paid a total of six times the original income benefit. usiness uy-sell Classes: 5M,,, 5, 4, 3,,, Disability uy-sell coverage is designed to provide the funds to purchase an insured s ownership interest in a business in the event of long-term disability. Many firms have protection in the event of the death of an owner, but overlook the financial devastation that can occur as a result of disability. Flexible funding methods are available using lump-sum and/ or monthly installment payments, which help to provide the funds to effect an orderly transfer of ownership. Renewability The policy is renewable to the earliest of: age 65; the date the insured terminates full-time work with the business entity for any reason other than total disability; the date the buy-sell agreement is ended; the date the buy-sell benefit is paid; or the date one person owns more than 90 percent of the business entity. The buy-sell agreement must be in effect within one year from the policy date and before total disability begins. If not, the policy will be treated as having never been issued and all premiums paid will be refunded. enefits The amount of benefit paid will be the lowest of : the maximum aggregate benefit (combination of lumpsum and monthly installment benefit, if any); or the value of the insured s interest as of the date total disability begins; or 100 percent of the maximum aggregate benefit if total disability begins before age 60, 80 percent if total disability begins before age 61, 65 percent if total disability begins before age 62, 50 percent if total disability begins before age 63, 25 percent if total disability begins before age 64, or 10 percent if total disability begins before age 65. 17
Products & Features usiness uy-sell Definition of Total Disability The insured is considered totally disabled if : he or she cannot do the substantial and material duties of his or her occupation due to injury or sickness; he or she is under a regular physician s care; and he or she is not doing any work for the business entity. vailability Size Issue ages Occupation classes Waiting periods enefit periods Maximum benefit usinesses with at least two but no more than 10 working owners 18 59 (nearest age) (renewable to age 65; benefits reduce after age 60) 5M,,, 5, 4, 3,,, 12, 18 and 24 months Two, three or five years or lump-sum 5M,, 5, 4 $1,000,000;, 3 $500,000*;, & $400,000** (See page 28) Minimum benefit $50,000 lump-sum; $1,000 installment, subject to aggregate Riders Guarantee of Physical Insurability (5M,,, 5, 4, 3, only) Extended enefit *$1,000,000 if the majority of other applicants in the case are class 5M,, 5, 4 **For Class a) $1,000,000 if the majority of other applicants in the case are class 5M,, 5, 4 b) $500,000 if the majority of other applicants in the case are class, 3 Guarantees are based upon the claims-paying ability of the issuer. Conversion Privilege fter the uy-sell DI policy has been in force for two years, it may be exchanged for an individual disability income insurance policy, provided that all of the following conditions are met: the policy is terminated, either because the insured owns more than 90 percent of the business entity or the insured stops active full time work in the business entity; and the insured is under age 55; and the insured is not totally disabled and has not received buy-sell benefits under the policy. The new policy will: be owned by the insured; have a maximum total disability monthly benefit of $1,000, but not exceed our published issue and participation limits; have a maximum benefit period of two years and an elimination period of at least 90 days; and have the same rate class and exclusions as in the uy-sell policy. The premiums will be for the insured s attained age on the date of the conversion at our rates for the policy series in effect on the date of conversion. Evidence of the insured s good health will not be required. Legal and ccounting Fees enefit We will pay up to $2,000 for legal and/or accounting fees incurred in implementing the provisions of the existing buysell agreement upon submission of an approved claim. 18
Products & Features usiness uy-sell Transfer of Coverage fter the policy has been in force for two years, coverage on the same insured can be transferred to a new owner if all the following conditions are met: the new owner is not the insured; the insured is under age 59; the insured is not totally disabled and has not received buy-sell benefits under the policy; the insured ends active full time work with the business entity; the insured has begun active full-time work with another business entity in which he or she owns at least 10 percent, but not more than 90 percent of the new business entity; a buy-sell agreement is in effect on the new business entity within one year of the transfer; all underwriting conditions that apply to buy-sell coverage are met; and the transfer occurs within 90 days of termination of active full time work with the original business entity. Optional Riders for usiness uy-sell ll riders may not be available in all states or for all occupational classes. See ON-Net to confirm availability. ll riders are available through age 60 except as noted. Guarantee of Physical Insurability Rider* Classes: 5M,,, 5, 4, 3, (Issued through age 53) Each second anniversary prior to age 55, the insured may purchase up to 20 percent of the original maximum aggregate benefit. The maximum total increase amount that may be purchased is an amount equal to the original maximum aggregate benefit. *GPI not available in Puerto Rico. Extended enefit Rider ll Classes (Issued through age 59) If the Extended enefit Rider is purchased, the total benefit amount will continue for disabilities occurring after age 60. The new policy benefit will be based on the insured s share of the value of the new business entity, but not to exceed the maximum aggregate benefit of the original policy. Evidence of the insured s good health will not be required. Exclusions No buy-sell benefit is paid if total disability is due to war or act or accident of war, declared or undeclared. No income is paid for any period the insured is incarcerated. 19
Issue & Participation Limits Income Qualification Guide Issue & Participation Limits Income Qualification Guide Maximum Issue and Participation Limits ll Classes, Total Indemnity, ll Companies Including Social Insurance enefit nnual earned income asic DI coverage Employee pays premium SIS DI coverage Total DI coverage Total DI with IDI/LTD* asic DI coverage Employer pays premium SIS DI coverage Total DI coverage Total DI with IDI/LTD* $ 20,000 $ 550 $ 750 $1,300 $1,350 $ 590 $ 750 $ 1,340 $ 1,400 30,000 1,100 800 1,900 1,950 1,300 800 2,100 2,150 40,000 1,550 850 2,400 2,450 1,900 850 2,750 2,800 50,000 2,000 900 2,900 3,000 2,550 900 3,450 3,550 60,000 2,350 1,000 3,350 3,500 3,050 1,000 4,050 4,150 70,000 2,800 1,000 3,800 4,050 3,650 1,000 4,650 4,800 80,000 3,200 1,000 4,200 4,550 4,200 1,000 5,200 5,500 90,000 3,600 1,000 4,600 5,000 4,700 1,000 5,700 6,000 100,000 3,950 1,050 5,000 5,500 5,200 1,050 6,250 6,550 110,000 4,200 1,100 5,300 6,100 5,650 1,100 6,750 7,350 120,000 4,500 1,150 5,650 6,500 6,100 1,150 7,250 8,000 130,000 4,800 1,200 6,000 7,100 6,400 1,200 7,600 8,650 140,000 5,250 1,200 6,450 7,500 6,900 1,200 8,100 9,350 150,000 5,650 1,250 6,900 8,000 7,350 1,250 8,600 10,000 160,000 6,100 1,250 7,350 8,500 7,900 1,250 9,150 10,650 170,000 6,500 1,300 7,800 9,000 8,350 1,300 9,650 11,350 180,000 6,900 1,350 8,250 9,600 9,000 1,350 10,350 12,000 190,000 7,300 1,400 8,700 10,100 9,600 1,400 11,000 12,650 200,000 7,650 1,450 9,100 10,500 9,900 1,450 11,350 13,350 220,000 8,500 1,500 10,000 11,500 11,100 1,500 12,600 14,050 240,000 9,450 1,550 11,000 12,300 12,150 1,550 13,700 15,000 260,000 10,150 1,600 11,750 13,300 13,000 1,600 14,600 16,250 280,000 10,600 1,650 12,250 14,200 13,000 1,650 14,650 17,500 300,000 11,050 1,700 12,750 15,400 13,000 1,700 14,700 18,750 320,000 11,500 1,850 13,350 16,300 13,000 1,850 14,850 20,000 340,000 12,000 2,000 14,000 17,300 13,000 2,000 15,000 21,250 360,000 12,750 2,000 14,750 18,200 13,000 2,000 15,000 22,500 380,000 13,000 2,000 15,000 19,100 13,000 2,000 15,000 23,750 400,000 13,000 2,000 15,000 20,100 13,000 2,000 15,000 25,000 420,000 13,000 2,000 15,000 21,000 13,000 2,000 15,000 25,000 440,000 13,000 2,000 15,000 22,100 13,000 2,000 15,000 25,000 460,000 13,000 2,000 15,000 23,000 13,000 2,000 15,000 25,000 480,000 13,000 2,000 15,000 24,000 13,000 2,000 15,000 25,000 500,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 520,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 540,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 560,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 580,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 600,000 13,000 2,000 15,000 25,000 13,000 2,000 15,000 25,000 Issue limit for chiropractors (all states) is $5,000; participation limit is $6,500. *Issue limit in FL and occupations is $10,000; participation limit is $15,000 Principals of a Sole Proprietorship, Partnership, LLC or Sub-chapter S Corporation do not qualify for Employer Pays Premium issue and participation limits. These limits should only be used when the employer is paying the premium and none of the premium is included in the employee s taxable income in that year. 20
Issue & Participation Limits Income Qualification Guide Income Qualification Guide Notes 5M,,, 5, 4, 3 risks only, the total columns can be all asic coverage or a combination of asic and Social Insurance Supplement. If income is less than $20,000, individual consideration will be given on employer-paid cases (maximum limit of 66 2/3 percent of compensation). Generally, for applicants with a net worth exceeding $5,000,000, no coverage is available; however, individual consideration may be given with complete details. If unearned income exceeds 10 percent of earned income or $30,000, whichever is less annually, 50 percent of any excess will be deducted from the maximum issue and participation limits (see example below). Example: Earned income $ 240,000 Unearned income $ 89,000 $240,000 x 10% $ 24,000 $24,000 is less than $30,000 $89,000 $24,000 = $ 65,000 $65,000 / 2 = $ 32,500/12 = $2,708 Issue and participation at $240,000 = $ 11,000 $11,000 $2,708 = $ 8,292 limit The Five Rules Regarding Issue and Participation Limits 1. If the employee pays the group LTD and the individual plan premium, then subtract the group LTD amount from the limit under employee pays premium total DI with IDI/LTD column. (In FL and occupations, use the lesser of: the limit under employee pays premium total DI with IDI/LTD; or $15,000). 2. If the employer pays the group LTD, and the individual plan premium, then subtract the group LTD amount from the limit under employer pays premium total DI with IDI/LTD column. (In FL and occupations, use the lesser of the limit under employer pays premium total DI with IDI/LTD, or $15,000). 3. If the employer pays the group LTD, but the employee pays the individual plan premium, then subtract 80 percent of the group LTD amount from the limit under employee pays premium total DI with IDI/LTD column. (In FL and occupations, use the lesser of the limit under employee pays premium total DI with IDI/ LTD, or $15,000). 4. Professional association plans do not qualify as group LTD plans. 5. We will not issue more than the individual limit for a given income, regardless of the amount of group LTD. 100 percent offset for any military pensions. To be eligible for SIS benefits, the applicant must be paying FIC taxes or similar tax/contribution to their respective social insurance program. Principals of a sole proprietorship, partnership, LLC or Sub-chapter S Corporation do not qualify for employer pays premium limits. The Employee Pays Total DI with IDI/LTD and Employer Pays Total with IDI/LTD limits are designed to permit larger benefit amounts to employees covered under Group LTD plans. To prevent a double offset, only asic benefits will be issued to employees with Group LTD plans. The method of calculating issue and participation limits for employees covered under Group LTD plans depends upon whether these plans are paid by the employee or the employer. 21
Issue & Participation Limits Special Limits Special New Professionals/Student Issue and Participation Limits In an effort to recognize future earning potential, the company will issue the following amounts of long-term coverage, minus any group or individual disability income coverage in force or applied for. The amount may be all basic benefit, or a combination of asic and Social Insurance Supplement. These limits apply to either individual pay or employer pay situations. These limits apply to newly licensed individuals within their first year of starting in private practice. They do not apply to those with established practices over one year old and are not generating the income needed to qualify for these limits. We will consider, on a case-by-case basis, issuing benefits in excess of those stated above, subject to submission with the application of any employment contract in which specifics of the individual s compensation are provided. t the same time, complete documentation of any long-term disability income coverage in which the insured is participating or may become eligible to participate must be provided. Government Employees and Public School Teacher Limits Federal, state, county and municipal employees can be considered for coverage if: a. they are 5M,,, 5, 4, 3, risks; and b. they earn at least $20,000 annually. The maximum income and benefit insurable are $140,000 and $6,450 per month, respectively. Elected officials are not eligible for coverage. SIS benefits are offset for Social Security, Workers Compensation, State Cash Sickness, Railroad Retirement ct, Civil Service Retirement plans or other federal, state or local programs. Special Professional Issue and Participation Limits New in practice/residency Monthly benefit MD & DO new in private practice $ 6,000 MD & DO in residency $ 5,000 DDS, DDM new in private practice & Dentist $ 3,500 in residency Veterinarian, Pharmacist & Lawyer new in $ 3,000 private practice Pharmacists in residency $ 2,500 Optometrist, CP and Podiatrist new in $ 2,000 private practice Podiatrist in residency $1,000 Special Professional Issue and Participation Limits Students Government Employees and Public School Teacher Limits Monthly benefit MD & DO $ 2,500 4th year medical student Final year: Dental student Senior year: Veterinary student $ 2,000 MD & DO $ 1,500 3rd year medical student Senior year: Law student, Optometrist, Engineer, rchitect and Pharmacist M final year $ 1,000 Income asic SIS $ 30,000 $ 350 $ 1,550 $ 40,000 $ 650 $ 1,750 $ 50,000 $ 700 $ 2,200 $ 60,000 $ 750 $ 2,600 $ 70,000 $ 800 $ 3,000 $ 80,000 $ 900 $ 3,300 $ 90,000 $ 950 $ 3,650 $ 100,000 $ 1,100 $ 3,900 $ 110,000 $ 1,200 $ 4,100 $ 120,000 $ 1,350 $ 4,300 $ 130,000 $ 1,450 $ 4,550 $ 140,000 $ 1,600 $ 4,850 22
Underwriting Medical Underwriting Impaired Risks Proper evaluation of risks is fundamental to maintaining balance between customer needs, agent needs and company needs. Sound evaluation of impaired risks will help assure that we can meet our promises to pay claims now and in the future. The preferred methods of handling impaired risks involve: a. exclusions full; limited-period; qualified-condition; b. ratings; and c. longer elimination/waiting periods and/or shorter benefit periods. Some impairments can be handled only with exclusions, others with ratings (such as elevated blood pressure, overweight, etc.) and still others with a combination of all three methods. Examples of impairments that fall into each category are as follows: Exclusions Full Carpal tunnel syndrome Limited-Period sthma usually full asthma exclusion if severe; otherwise could offer not covered for asthma for first 90 days of each period of disability therefrom, if the policy elimination period is less than 90 days. Ratings One of the most often used charts involving ratings is build. The chart presented in this section provides some direction, though it is not a guarantee of final action. Other factors in combination with impairments could lead to more favorable or less favorable action. The underwriter will weigh all pertinent factors before arriving at any final decision. The Guarantee of Physical Insurability Rider and the Waiver of Waiting Period While Hospital Confined Rider are not available on rated cases. enefit Period Limits In addition to ratings, benefit periods and/or elimination periods may be adjusted. enefit Period 25 percent or less: long term benefits are usually available (to age 65, age 67 or age 70), but may be reduced at the discretion of underwriting. Over 25 percent to 50 percent: maximum benefit period is five years. Over 50 percent: maximum ben efit period is two years. Non-Tobacco Eligibility No use of any tobacco within the last 12 months. 23
Underwriting Medical uild Table Maximum Weight Height Standard premium 25% extra premium 50% extra premium 75% extra premium 1 4 8 136 150 165 179 9 142 155 172 185 10 147 161 178 192 11 152 167 184 199 5 0 158 173 191 206 1 163 179 197 213 2 169 185 204 220 3 174 191 211 228 4 180 197 218 235 5 186 204 225 243 6 192 210 232 251 7 198 217 239 258 8 204 224 247 266 9 210 231 254 274 10 217 237 262 283 11 223 244 269 291 6 0 229 252 277 299 1 236 259 285 308 2 243 266 293 317 3 249 273 301 325 4 256 281 310 334 5 263 289 318 343 6 270 296 326 352 7 277 304 335 362 8 285 312 344 371 9 292 320 353 380 1 If weight exceeds the 75% rating, the case will usually be declined. 24
Underwriting Headline Medical Medical and Inspection Requirements Individual Disability Income and usiness Overhead Expense (OE) ge Paramed exam lood/hos EKG Personal history interview Inspection 18-40 $3,000/mo. $2,000/mo. None $10,000 $10,001/mo. 41-50 $2,000/mo. $2,000/mo. $10,000/mo. $10,000 $10,001/mo. 51 and over $1,000/mo. $2,000/mo. $5,000/mo. $10,000 $10,001/mo. Personal History Interview 5M,,, 5, 4, 3, : $1,000/mo.;, : $500/mo. uy-sell ge Paramed exam lood profile & urine EKG 18-40 41-45 46-50 51-60 $4,000 monthly installments OR $200,000 lump sum $3,000 monthly installments OR $150,000 lump sum $2,000 monthly installments OR $100,000 lump sum $1,000 monthly installments OR $50,000 lump sum Inspection required for all ages with usiness eneficiary Report. $3,000 monthly installments OR $150,000 lump sum $3,000 monthly installments OR $150,000 lump sum $3,000 monthly installments OR $150,000 lump sum $3,000 monthly installments OR $150,000 lump sum None $6,000 monthly installments OR $400,000 lump sum $6,000 monthly installments OR $400,000 lump sum $6,000 monthly installments OR $400,000 lump sum Medical & Inspection Requirement Notes Disability Income, usiness Overhead Expense (OE) and Disability uy-sell amounts should be added together, if applied for at the same time, to determine requirements. The Social Insurance Supplement (SIS) and one-half of the Guaranteed Physical Insurability (GPI) Rider amounts, if applied for, are to be considered when determining requirements. The Catastrophic Disability enefit (CT) Rider is not considered when determining underwriting requirements. Health care workers and residents of Florida require a blood profile and urine sample for any amount. Underwriting requirements completed by another company can be used for up to six months provided the Ohio National application is fully completed (including page 6) and all other requirements are fulfilled. Underwriting reserves the right to request any requirement deemed necessary to underwrite the risk. 25
Underwriting Financial Financial Underwriting Financial documentation is required for all cases. Earned income will determine the maximum monthly benefit Ohio National will issue. This section explains how earned income is determined. Generally, earned income is reportable on IRS Form 1040, less tax deductible business expenses, if any. For employees with no ownership interest, examples of earned income include salary, regular bonuses, overtime and commissions. Perks, such as parking, car lease, subsidized lunches, etc., are NOT considered earned income. If a pension contribution is made on behalf of the employee, that contribution can t be counted as earned income. However, if the employee is able to defer earned income under a 401(k) plan, we may count these deferrals as earned income. These deferrals are limited to the actual contribution, but in no event more than IRS published maximums. Sole proprietors or partners typically take an advance against anticipated year end profits, called a draw. Earned income for a sole proprietor or partner is the insured s share of gross income minus cost of goods sold and all tax deductible business expenses. Contributions to a pension plan are made after distributable profits and, therefore, are not included as earned income (double counting). For employees of a corporation with ownership interest, earned income will include salary, regular bonuses, and commissions. Pension or profit sharing contributions can be counted as earned income because that money could have been received as salary and would be discontinued upon disability. In addition, the insured s share of before-tax corporate earnings can be considered income if the income is generated by the applicant s personal services; i.e. accountant, physician, etc. In addition to the following Financial Requirements, the underwriter may require tax forms, balance sheets, profit and loss statements or other accounting documentation if, in the opinion of the underwriter, verification is needed. Nonowner Employee Pages 1 and 2 of the most re cent IRS Form 1040 plus a copy of IRS Form W 2 if a joint return has been filed, and a copy of a pay stub with year to date earnings. Shareholder/Employee of a C Corporation Pages 1 and 2 of most recent IRS Form 1040 plus a copy of IRS Form W 2 and IRS Form 1120 if at least 10 percent ownership. Sole Proprietorship Pages 1 and 2 of the most recent IRS Form 1040 plus a copy of Schedule C. Partner Pages 1 and 2 of the most recent IRS Form 1040 plus either: Schedule E (plus any support ing statements), or Schedule K 1 with IRS Form 1065. Shareholder/Employee of an S Corporation Pages 1 and 2 of the most recent IRS Form 1040, plus a copy of IRS Form W-2, plus either: Schedule E (plus any support ing statements), or Schedule K 1 with IRS Form 1120S. Member of an LLC See appropriate guidelines for sole proprietorship/partner. Financial Questionnaire (Form 6497) Required where: unearned income exceeds $30,000; or net worth exceeds $5,000,000; or when coverage applied for and in force with all companies exceeds $10,000. Documentation of Expenses for usiness Overhead Expenses enefits over $5,000 per month require documentation of actual expenses from actual business tax returns. 26
Underwriting uy-sell uy-sell Underwriting No money should be collected with an application. ny money collected will be refunded. ll working owners of the business entity with 10 percent or more ownership share must be insured for Disability uy-sell coverage. We will participate in Disability uy-sell coverage with another insurer as long as the elimination periods for all coverages are the same. Coverage will not be available if the prospect is overinsured for individual disability income coverage. No uy-sell agreement needs to be submitted for underwriting review, but we reserve the right to request one. Please note: 1. uy-sell agreement must be in effect and certified to us by the first policy anniversary or the policy will terminate; and 2. uy-sell agreement must be in effect before disability begins and must be provided as part of the proof of loss. Each insured must own at least 5 percent of the business entity and no one person s interest can exceed 90 percent. Disability uy-sell is not available to business entities where the principals are related, such as parent/child or husband/wife. Generally, the business must have been in existence for three years and have a positive net worth of at least $50,000. If in doubt as to qualification, contact the Underwriting department at the home office. ll policies will be issued and must be paid for at the same time. If there are outstanding underwriting or delivery requirements that are not met on one or more of the lives to be insured, none of the policies will be issued or placed and paid for. Insurable Value Generally, we will insure 80 percent of the business value determined by using the valuation methods discussed below. We will consider insuring up to 100 percent of the value, if satisfactory and complete financial documentation is provided including all the following: balance sheets and profit and loss statements for the last three complete fiscal years; and if a professional corporation or a partnership, a copy of the tax returns for the past two years with all schedules; and a copy of the actual executed uy-sell agreement listing the purchase price, valuation method used and names of all owners and their interest specified. Valuation Methods Personal Service Professional Corporations: Sum of two times each principal s salary plus book value including accounts receivable; Professional Partnerships: Sum of two times net partnership distributive income plus book value including accounts receivable. Other Commercial usinesses Capitalization of earnings appropriate for the business as follows: Firms in existence three plus years, fluctuating earnings growth: five times the average of last two years earnings, plus book value. Firms in existence five plus years, moderate earnings growth: seven times the average of last two years earnings, plus book value. Firms in existence five plus years, significant earnings growth in each of last three years: 10 times the average of last three years earnings, plus book value. 27
Underwriting uy-sell Nonmedical Limits ge Installment Lump Sum 18 40 $ 4,000 $ 200,000 41 45 $ 3,000 $ 150,000 46 50 $ 2,000 $ 100,000 51 59 $ 1,000 $ 50,000 lood profile is required at all ages for amounts of $3,000/month or $150,000 lump sum and greater. Urine specimen required at $3,000/month or $150,000 lump sum and greater. 12 lead EKG required on all over age 50 cases where benefits exceed $6,000 per month or $400,000 lump sum. Financial Requirements For all businesses, a uy-sell questionnaire (Form 8660) and an inspection report with business beneficiary report is required. In addition: businesses valued at $250,000 to $500,000 require the most recent fiscal year balance sheet and profit and loss statement. businesses valued at $500,000 or above require a copy of the balance sheet and profit and loss statements for the past two fiscal years and the most recent business tax returns with all schedules. We reserve the right to require more detailed information. Disability uy-sell Issue and Participation Limits Occupation class Waiting period Lump-sum enefit period Monthly installment ggregate 5M,, 5, 4 365 Days $ 500,000 2 Yrs. 3 Yrs. 5 Yrs. 5M,, 5, 4 540 Days $ 600,000 2 Yrs. 3 Yrs. 5 Yrs. 5M,, 5, 4 730 Days $ 700,000 2 Yrs. 3 Yrs. 5 Yrs., 3 1 365 Days $300,000 2 Yrs. 3 Yrs. 5 Yrs., 3 1 540 Days $ 400,000 2 Yrs. 3 Yrs. 5 Yrs., 3 1 730 Days $ 500,000 2 Yrs. 3 Yrs. 5 Yrs. 1 2, & 365 Days $ 200,000 2 Yrs. 3 Yrs. 5 Yrs. 1 2, & 540 Days $ 300,000 2 Yrs. 3 Yrs. 5 Yrs. 1 2, & 730 Days $ 400,000 2 Yrs. 3 Yrs. 5 Yrs. $ 20,833 $ 13,889 $ 8,333 $ 31,250 $ 20,833 $ 12,500 $ 41,667 $ 27,778 $ 16,667 $ 12,500 $ 8,333 $ 5,000 $ 16,667 $ 11,111 $ 6,667 $ 20,833 $ 13,889 $ 8,333 $ 8,333 $ 5,555 $ 3,333 $ 12,500 $ 8,333 $ 5,000 $ 16,667 $ 11,111 $ 6,667 $ 500,000 $ 750,000 $ 1,000,000 $ 300,000 $ 400,000 $ 500,000 $ 200,000 $ 300,000 $ 400,000 1 Issue Limits are the same as Class 5M,, 5, 4 if the majority of applicants in the case are 5M,, 5, 4 2 Issue Limits are the same as Class, 3 if the majority of applicants in the case are, 3 28
Underwriting Submitting DI pplications Important Points When Submitting DI pplications pplications must be completed, answered accurately, signed, and dated by the applicant in the state of residency. You are required to be licensed and appointed by Ohio National in the state in which the application is completed. People who both live and work in New York, laska or Hawaii and residents of California are ineligible for coverage. Submit financial documentation with all applications Include all phone numbers where the applicant can be reached. In most cases, we ll request a phone history or an inspection report. Send a cover letter to address any special circumstances or considerations, including prior phone conversations with specific home office or field staff. Include a copy of the illustration with the application. The application must be completed to match the illustration. Educate your clients that underwriting disability income insurance is different from underwriting life insurance. condition that may not be life threatening may still result in total or residual disability. Do not reference attachments (e.g., see attached ) unless there is no appropriate space on the application for the information. ttachments to the application cannot become part of the policy if it is issued. ccurate and complete medical history is the responsibility of the agent at the point of sale. pplications must be taken in person, and each question must be asked of the applicant. ll questions requiring additional information must be answered with complete disclosure on the application. Policy changes must be delivered and paid for within two weeks. new application must be submitted to replace or supplement existing coverage. Standard replacement rules apply, if applicable. Policies issued prior to ContinuON Income Solutions SM cannot be increased except under GPI Riders. Please see page 46 for riders available after issue. Dating Rules Polices will be dated as follows: Full premium and non-risk amendment approval date. List billing common due date following approval date. No policy can be dated after the 28th of the month. ge-change backdating no more than 30 days from application date full back premium collected. COD business policy effective date will be based on signing of the field dating amendment. Delivery Period Sixty (60) days is allowed for regular policy delivery except where limited by the underwriter due to a delivery requirement (Warranty of Health). If additional delivery time is necessary, contact the Underwriting department. Not Taken/Redates/Reissues/Incompletes If a standard issue policy is returned to be marked not taken or for redating or reissue, a charge to the agent s account could be made. If non-risk outstanding requirements are not completed, and the policy has been reported as paid, a charge to the agent and general agent will be made due to the extra administrative cost necessary to secure the outstanding requirement by the home office. No alternate policies will be issued. Submitting Money Money received with an application must conform to the temporary insurance receipt. You can submit money of up to $5000 DI or OE monthly benefits. pplications for more than $5000 should be submitted COD. ll uy-sell applications must be submitted COD. No money will be accepted while an application is pending if it was originally submitted COD. ll money received will be refunded. Substandard risks should be submitted on a trial application basis. COD application with completed Part II and signed authorization should be used. Risk mendment Disability income insurance cases will not be processed until all signed risk amendments are received in the home office. 29
Underwriting Headline Employment Working Out of the Home: While generally not insurable, we will consider those applicants who have a segregated work location at their home used exclusively for work activity and who have a stable work history, can document income over the last three years, and who must spend at least 25 percent of their time away from their home to accomplish their work. Professionals, such as CPs or Doctors, can be written since their practices require them to see patients or clients. Coverage may be subject to certain restrictions. Individuals working from home, whose income is reported on a W-2, who are employed by an outside business and who have no ownership in the business, will have no restrictions as to disability income coverage. Our normal underwriting guidelines for income and occupation apply. Part-time Work Part-time employees are not insurable. The applicant must work a minimum of 30 hours in one job to be considered for disability income coverage. If the applicant works more than one job, the classification for the most hazardous job must be used. Seasonal Employment Only full-time, year-round occupations are insurable. Occupations such as snow plowing, life guarding, etc. are not insurable. Changes in Occupation If an insured changes to an occupation with a better risk classification, we may adjust the policy classification and rates after he or she has been employed for one year. Changes should be requested via a policy change form. 30
General Information Discounts General Information List ill Discounts There are two distinct discounts available depending on the number of lives on the List ill. Discounts Number of insureds* Discount 3-6 10% 7+ 15% *Number of insureds may vary by state. Once a case has been issued with these discounts, they remain permanent. If a person leaves the List ill, the premium will not change. In addition, if the number of lives drops below seven or three, respectively, the premium will not change. Some state may require a larger number of lives in order to qualify for the List ill discount. Unisex rates are to be used for all polices issued with a List ill Discount. List illing bill is sent to the employer 15 days before the due date. If payment is not received by 30 days past due, a lapse occurs. Please see page 46 for reinstatement requirements. List ill Requirements ll policies must have a common due date (e.g., first day of the month) Policies will be held until the home office has approved the minimum required number of lives. The case will not be reported as paid until money and all requirements for the minimum required number of lives have been received in the home office. Rates for list bill participants over age 60 are available from the home office; maximum benefit is $5,000 per month, with a two-year benefit period. Multilife (ssociation) Discount Program (Classes: 5M,,, 5, 4, 3, Individual DI Policy) Ten or more members of any trade or professional association, a labor union, or any other association that has been in active existence for at least two years when the association or union has a constitution or bylaws and is formed in good faith for purposes other than that of obtaining insurance. Prior home office approval must be obtained before an ssociation Discount can be offered. The premium structure will be sex-distinct rates with a 15 percent Multilife (ssociation) Discount. Reduced compensation will apply to all Multilife (ssociation) Discount policies. Size Discount (ll Classes, ll Individual DI Policies) size discount of $4 per $100 of monthly benefit is applied to each unit of base monthly benefit in excess of $2,000. Third-Party dministrators We do not encourage the use of TPs to handle premium billing. However, if that is a case requirement, we will require complete financial information, an inspection report and a usiness History and Condition Report on the TP. We will require that the TP sign a performance agreement before solicitation can begin. Modal Factors Semi-annual.5125* Quarterly.2625* Monthly bank draft.0865** Monthly list bill.0900** *$25 minimum premium. **$10 minimum premium. 31
General Information usinessowner Matrix usinessowner Matrix* ge Years owning current business Net earned income Number of full-time employees 18-30 0 0 to 2 0 $0-40,000 0 0-3 0 31-40 +1 3rd Year +1 $40,001-70,000 +1 4-5 +1 41-50 +2 4th or 5th Year +2 $70,001-99,999 +2 6-7 +2 51 + +1 5 Years+ +3 $100,000+ +3 8+ +3.. C. D. 6 or less = No change in occupation class Totals from column ++C+D = 7 or more = Raise one occupation class *Must own 20% or more of the business usinessowners usinessowners present unique opportunities in deciding on the proper classification. Most owners of small businesses are actively involved in all phases of their business and wear many hats in the course of a day. The traditional classification system does not account for the difference between the highly motivated, successful long-term owner and the start-up businessowner, whose odds of failing are very high. Successful, stable businessowners exhibit a strong work ethic, and their claims experience and persistency are generally better than those of employees or new businessowners. The usinessowner Matrix, therefore, is used with businessowners who own 20 percent or more of the business interest. It measures those factors identified as having an influence on the quality of the risk. It quantifies those factors by raising the traditional chart occupational class. Using the usinessowner Matrix To use the Matrix, first determine the appropriate class by using the traditional occupational classification chart. Second, determine the adjustment factor for each category (age, years owning, income, and number of full-time employees). Third, determine the total adjustment factor. nd finally, adjust the occupational class as indicated. No upgrades are permitted within Class 5M,, and 5. usinessowner Matrix is included in the disability income software. sample form is shown at top of page. Years Owning Current usiness Years owning current business could include consecutive years owning the same type of business, but does not include years of experience in the industry or years as owner of another business. usinessowner llowance businessowner who has been at least a 20 percent businessowner of a profitable business for at least the last two years is eligible for an additional 20 percent of monthly benefit amount, up to $1,000. Ineligible for Consideration Certain occupations are excluded from consideration under the usinessowner Matrix: thlete/club Pro arber/eautician Chiropractor Cosmetologist Director (theatrical, any medium) Farmer/Rancher Florist Hairdresser/Hairstylist Hypnotherapist Producer (theatrical, any medium) Real Estate gent 32
Risk Classifications Guidelines Guidelines Risk classification determines the premium charged, type of policy, riders available and the overall limits. Therefore, it is necessary that proper information be obtained from the prospect to accurately determine the risk class. Job Duties Versus Job Title Duties, not title, determine the proper risk class. Manual duties, multiple jobs, frequent travel and any unusual hazards, such as location of job site (offshore, mine) or types of material handled (explosives), all have an impact and should be explained thoroughly on the application. Factors ffecting Class In addition to the duties, other factors that affect class include: claims experience; unstable or declining industry; competition; health risks; moral hazards; and income. Income documentation will be required on all risks, except those who qualify under the Special New Professionals/ Student Issue and Participation Limits. Final determination of all classes rests with the home office underwriter. The following is a brief description of the five classes we offer, except those who meet special professional student limits. General Occupation Class Descriptions The Occupational Classifications fall into nine classes. The M classes are for individuals in the health care industry. These professionals include, but are not limited to Pharmacist, Certified Registered Nurse nesthetist, Dentist, Physician, Psychologist, Psychiatry, Nurse. The classes include non-medical Professionals, Executives, Technical and Clerical Workers in addition to light manual labor and more hazardous occupations involving manual duties. 5M This class includes select medical occupations with noninvasive duties such as Cardiology, General Practice, Pediatrics and Radiology. (Refer to ON-Net for M Recognized Medical Specialties.) This class includes select medical occupations with invasive duties such as Endodontist, Neurology, Orthodontist, Surgeon, and Vascular Medicine. (Refer to ON-Net for M Recognized Medical Specialties.) This class includes General Dentist, nesthesiology, Surgical ssistant, Critical Care Medicine, Podiatrist, and Certified Registered Nurse nesthetist. (Refer to ON-Net for M Recognized Medical Specialties.) 5 This class includes non-medical professional and executive occupations with the most favorable experience, where most work is performed in an office setting with minimal travel, and no direct supervision of persons with manual duties. Salary from $100,000 or more a year for the last two years. It includes CP, ttorney, ctuary, Engineer, and most PhDs. 33
Headline Risk Classifications Guidelines 4 This class includes other non-medical professional and executive occupations, which have exhibited favorable experience. Salary ranging from $40,000 to $60,000 a year for the last two years. Some occupations in this class require a higher salary depending on job functions. This class includes Computer Systems nalyst/programmer, Consultant, Manufacturer Representative, Small nimal Veterinarian and Teacher/Guidance Counselor. 3 This class includes some types of sales duties and semiprofessional, technical and managerial occupations. In many cases, they are office duties only occupations such as uyer, Claims djuster, Dietician, and Optician. This class includes most technical, nonhazardous occupations involving special skills such as clerical, technical, scientific or supervisor (no manual work). It includes Chiropractor, Dental ssistant, Photographer, Surveyor. The Managerial Duties Endorsement Classes: 5, 4, 3, This endorsement may be used by the underwriting department to upgrade a lower non-medical occupation to a higher non-medical occupation. This endorsement would allow for better pricing and possibly enhanced Riders. Manual duties must comprise no more than 25 percent of the total business activities. It would change the definition of occupation in the contract to cover only Managerial duties and not Manual duties. The following definitions explain which is entailed in each. Managerial duties means the sedentary, administrative functions of your regular occupation. Managerial duties does not mean Manual duties. Manual duties means duties that require physical activity. Physical activity includes, but is not limited to, operating machinery, driving a vehicle, climbing, bending, stooping, kneeling, lifting, crouching, crawling, pushing and pulling. Generally involves people who perform light manual labor or supervisors who may do manual labor on occasion. Examples: Mechanic, Machine Operator, Diamond Cutter, Electrician. Generally involves the most hazardous occupations involving manual labor and/or where the accident hazard is great. Examples: utcher, Tree Surgeon, Welder, ricklayer. Not Insurable Examples: ir Traffic Controller, Commodity roker, Law Enforcement Officer, Pilot, and Unskilled Worker. 34
Occupational Listing Occupational Listing u Occupation Listing bstractor ccount Executive see roker ccountant CP College degree in accounting salary, or net income $60,000 each of the last 2 years Others (including auditor, bookkeeper, payroll clerk-salary or net income > $20,000) Others, income $20,000 ctor or ctress ctuary FS or S, > 3 years experience Without designation, > 3 years experience Others cupuncturist, Certified dministrator see Executive dvertising see Sales gent see Insurance or roker as applicable gronomist see Scientist ir Conditioning/Heating Estimator Installer/Repairer ir Traffic Controller ircraft Crew Member llergist musement Park Worker nesthesiologist nesthetist nnouncer, Radio/TV nthropologist see Scientist ppraiser Commercial properties, income $60,000 each of the last 2 years Residential properties, income $60,000 each of the last 2 years Income < $60,000 3 5 4 3 5 4 3 5M 3 3 rcheologist see Scientist rchitect College or professional degree with 90% office and consulting duties (not Landscape) College or professional degree with < 90% office and consulting duties (not Landscape) Landscape rchitect see Landscape rmed Forces rmored Car Driver rt Director rtist (Commercial, Graphic, Illustrators) Working full time away from residence, not freelance Make-up (not freelance) Freelance ssembler Light Industry stronomer see Scientist thlete* Club Pro/Resident teaching only Others thletic Director 2 Schools and colleges no coaching duties Others see Teacher ttorney uctioneer udiologist uditor see ccountant uthor uto Dealer Net income $75,000 each of the last 2 years; new vehicles; no direct sales Net income $50,000 each of the last 2 years; new vehicles; no direct sales: New vehicle sales Used vehicle sales 5 4 3 3 4 5 3 4 3 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 35
Occupational Listing Listing Ch acteriologist see Scientist aggage Handler aker & Confectioner Owner/Manager no manual duties Manual Duties ank/savings & Loans Officer income $60,000 Officer income $40,000 Manager/Teller income $25,000 Manager/Teller income < $25,000 arber/eautician* artender ellman/ellhop iochemist see Scientist iologist see Scientist lacksmith/farrier oilermaker ondsman No firearms ailbondsmen/others ookbinder ooking gent ookkeeper see ccountant otanist see Scientist ricklayer roker (ccount Executive, Financial Consultant, Securities Sales, Security Specialist, Mortgage & Stock roker) Income $150,000 each of the last 3 years, 4 years in the business & not managing own account; Income $75,000 each of the last 3 years, 3 years in the business & not managing own account Income < $75,000 each of the last 3 years, or < 3 years in the business; not managing own account Commodity roker uilding & Wrecking Worker us Driver 5 4 3 3 4 3 utcher In Slaughterhouse uyer C Cabinet Maker Cable Worker Cafeteria Worker Camera Operator Cardiac Electrophysiologist Cardiologist Non-invasive Cardiovascular Surgeon Carpenter Carpet and Rug Owner/Supervisor no manual duties Installer/Cleaner/Dryer Cartographer Cashier Casino Worker Caterer Owner/Manager no cooking or serving duties Cooking or serving duties Cement/Concrete Worker Census Taker Certified Registered Nurse nesthetist Chauffeur full time only Chef/Cook Income $60,000; Master Chef over 3 Years, Over 4 cooks Hospital/Restaurant/School Diner/Fast-Food Restaurant Domestic Services Chemical Worker Chemist see Scientist Child Care Owner/Manager not in home ssistant; full time not at home Chimney Worker/Sweep Chiropodist see Podiatrist Chiropractor 1, * 4 5M 3 3 36 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines
Occupational Listing Occupational Listing Cl De Claims djuster Cleaner full time only Clergy Ordained, full time, include ½ housing allowance in salary, > 4 full time employees Income $25,000; ordained, full time, include ½ housing allowance in salary Income < $25,000; ordained full time include ½ housing allowance in salary Traveling Minister/Evangelist works as independent contractor Clerk Cold Storage Worker Collection gent office duties only Colorectal Surgeon Commodity roker Computer CIO (Chief Information Officer), > 25 employees, not self-employed, not working from home Income $60,000; Systems/Software/Design Engineer, Systems nalyst, Programmer college degree Income < $60,000 or no college degree Maintenance/Technician/Operator Conductor Orchestra Construction see specific duties Construction Laborer Consultant 3 Income $100,000 each of the last 2 years, 5 years experience, not working from home Income $60,000 each of the last 2 years, not working from home Others with income < $60,000 Contractor t building or construction sites 10% of time On-Site Duties Cook see Chef Copywriter 3 4 3 5 4 3 3 5 4 3 3 Correspondent Not Foreign Cosmetologist* Counselor In Clinic, MSW Not in Clinic or not MSW Courier/Parcel Service Worker office sales only Manual duties Court Reporter Crane Operator Dock/Wharf Crematory ttendant Criminologist Critical Care Medicine Curator D Dairy Skilled Worker Cold Room Worker Day Care see Child Care Day Trader Delivery Driver see Driver Dental Endodontist Oral & Maxillofacial Surgeon Orthodontist Periodontist Prosthodontist General Practicing Dentist Lab Owner ssistant/hygienist/labtech Dental ssistant/hygienist/lab.tech Dental Lab Owner Dermatologist Detective 3 3 4 3 3 5M Coroners 2 MD Other than MD *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 37
Occupational Listing Listing Di E Dialysis Technician see Medical Technician Diamond Cutter/Polisher/Setter Diecaster/Diemaker Dietician Registered Professional no cooking Cooking Director* Theatrical, any medium Dispatcher Office duties only DO and MD not classified elsewhere by specialty Dock Master Dock Worker Dog Catcher Dog Groomer Doorman/Doorkeeper Draftsperson Drag Line Operator Driver Delivery (newspaper & full time) Limo (working full time) rmored us Delivery (uto/van/light truck) mbulance/taxi Long-Haul/Heavy/Overnight Dry Cleaning Owner, Manager office & supervising duties only Clerk counter duties only Manual duties Dry Wall Installer E Ear, Nose & Throat (ENT) MD Economist PhD, 90% office duties Masters degree, 90% office duties Editor Elected Official/Politician Electrician Electrologist 3 3 4 5 4 3 Electrophysiologist Elevator Inspector uilder/installer/repairer Emergency Room Physician Employment gent Endocrinologist Endodontist Engineer Engineering degree, registered professionals 90% office and consulting duties Engineering degree, < 90% office and consulting duties Other Railroad Engraver Entertainer Entomologist see Scientist Epidemiologist Estimator Not at building or construction sites Occasionally at building or construction site Executive Income $100,000 each of the last 2 years (with most from salary as opposed to variable sources), dministrator/officer/director, over 3 years, limited travel, 10 full time employees, no manual labor Income $60,000 each of the last 2 years (with most salary as opposed to variable sources) 5 full time employees, no manual labor Income < $60,000, no manual labor Explosives Worker Exporter/Importer No manual duties Exterminator/Fumigator Supervising only Others 3 5M 5 3 3 5 4 3 38 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines
Occupational Listing Occupational Listing F Hor Factory Worker Foreman/Manager/Supervisor Supervisory duties only F Foreman/Manager/Supervisor/Skilled Worker with manual duties Heavy Industry Unskilled worker Family Practice Physician 5M Farm Implements Office/Sales duties only Shop Employee Farmer/Rancher* Film Splicer Financial nalyst Income $75,000 each of the last 2 years; non-stocks and Securities, Certified, minimum 5 years experience 4 Income $50,000 each of the last 2 years; non-stocks and Securities, Certified, minimum 3 years experience 3 Financial Planner see Insurance gent/financial Planner Firefighter Fisherman Flight ttendant Floor Finisher Floor Trader Florist* Store duties only 3 Delivery duties Food Processor Foreman Supervising only Manual duties Forester/Forest Ranger Freight Handler Supervising duties only Funeral Director Not embalming 3 Embalming Furrier G Game Warden Garment Worker Skilled Others Gastroenterologist General Practice Physician General Surgeon Geneticist see Scientist Genetics Physician Geologist see Scientist Glazier Golfer see thlete Government Employee 2 No or occupation classes, no elected officials (see appropriate Occ Class) Groundskeeper Guard Unarmed rmed; Prison/Penal Institution Gunsmith Gynecologist H Hairdresser/Hair Stylist* Harbor Master Harbor Pilot Health Spa Worker Heating see ir Conditioning Heavy Equipment Operator Hedge Fund Manager Hematologist MD Hepatologist MD Hired Hand Home Health Care id Homeopath see Naturopath Horticulturist 5M 5M 5M 5M 3 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 39
Occupational Listing Listing Hos Log Hospital dministrator see Executive Hospitalist MD Host/Hostess First-Class Restaurant Others Housekeeper full time only Hypnotherapist* Illustrator not freelance Immunologist Ph.D. No lab work Others Inhalation Therapist Inspector Supervising only Working Instructor see Teacher Sports I 5M 3 3 Martial rts/skiing/yoga Insurance gent/financial Planner Income $60,000 each of the last 2 years; 5 years in business 4 Income $40,000 each of the last 2 years; 3 years in business 3 Others Insurance Rater/Underwriter 4 Interior Designer/Decorator Income $60,000 each of the last 2 years; office and consulting duties only; with a degree 4 Income $40,000 each of the last 2 years; office and consulting duties only; no degree 3 Other than office duties Internal Medicine MD 5M Inventor Investigator Investment anker (Underwrite IPO s, Securities, Mergers & cquisitions, etc) Income $100,000 each of the last 3 years 5 Income $60,000 each of the last 2 years 4 Income < $60,000 3 J Janitor Jewelry Retail Stores Owner and Manager; no repairing Retail Stores Clerk; no repairing Doing repairs Jockey Journalist No Freelance Junk Dealer Justice of the Peace Full time employment only K Kennel Owner/Worker Office duties only no manual labor Others Kitchen Worker L Lab Technician see Medical Technician Labor Union Official office duties only Other skilled trades Other unskilled trades Laborer Light Manual Skilled Landscape rchitect, office duties only, (achelor s degree) Manager, office duties only Others light manual labor/supervisor Others use heavy equipment Laundry Worker Law Enforcement Officer Lawyer Librarian Limousine Driver see Driver Lobbyist Locksmith Logging/Lumber Owner (not in woods) see Executive Manual duties 4 3 3 3 5 3 40 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines
Occupational Listing Occupational Listing Lon N Long Haul Driver Longshoreman M Machine Operator Skilled Worker, light machinery Heavy Machinery Maid Mail Room Worker, Not Postal Service Maitre D First-Class Restaurant Manager (if not covered under office worker) Supervising only Working Manicurist Manufacturer s Representative Income $60,000; each of the last 3 years; 25% outside of home 4 Income $40,000; each of the last 3 years; 25% outside of home 3 Mason Masseur State licensed; associated with medical facility; not working from home Others MD and DO not classified elsewhere by specialty Mechanic Medical Doctor (MD) Not otherwise classified by Specialty Medical Microbiologist see Scientist Medical Technician/Medical ssistant With S/ college degree 3 Others Messenger Unarmed Others Metallurgist see Scientist Meteorologist see Scientist Meter Reader Microbiologist see Scientist Midwife Licensed/Certified Military Mine Worker Mineralogist see Scientist Minister see Clergy Model Monument Shop Worker, Stone Mortgage roker see roker Mortgage Loan Closer Motor Vehicle Dealer see uto Dealer Mover Musical Instrument Maker Musician Sole occupation; working full time and not freelance N Naturopath/Homeopath Income $100,000 each of the last 2 years; with degree; and a state license Others, state licensed Nephrologist Neurologist Neurosurgeon Night Club Worker Nuclear Energy Worker Nuclear Medicine Physician Nuclear Medicine Technician see Medical Technician Numismatist Nurse Registered (supervisor duties only/instructor/ office duties only) Registered Doctor s office Registered Others Licensed Practical (LPN)/Vocational (LVN) Private Duty/Visiting ide includes CN Nurse Practitioner Nurses ide 3 3 5M 5M 3 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 41
Occupational Listing Listing O Pri O Obstetrician Occupational Therapist Office Worker Income $60,000; Manager, Clerical, dministrative ssistant-office duties only; 5 years experience 4 Income $40,000; Manager, Clerical, and dministrative ssistant; office duties only; 3 years experience 3 Income < $40,000; Manager, Clerical, and dministrative ssistant; office duties only; < 3 year experience Offshore and Oil Field Worker Oncologist Ophthalmologist Optician Selling/Fitting Only 3 Others Optometrist No selling duties 5 Selling duties 4 Oral & Maxillofacial Surgeon Orderly Orthodontist Orthopedic Surgeon Osteopath (DO) Not otherwise classified by specialty Otolaryngologist (ENT) P Painter Paralegal 4 Paramedical Examiner R.N. with office duties only Others Park Superintendent/Tour Director Parking ttendant Passenger gent/clerk Operations/Reservation/Tickets Pathologist 5M Pawn roker Payroll Clerk see ccountant Pediatrician Perfusionist Periodontist Personnel gency Owner/Proprietor/Recruiter Pharmacist Registered Photographer Commercial set/studio only On-Site not freelance Freelance Physiatrist Physical Therapist Physician s ssistant/nurse Practitioner Physicist see Scientist Piano/Organ Repairer/Tuner Picture Framer Pilot Pipe Fitter Plasterer Plastic Surgeon Plumber Podiatrist Porter Postal Service Worker Principal 2 see School Superintendent Printer 5M 5M 3 42 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines
Occupational Listing Occupational Listing Pro Sa Proctologist Producer Oil/Gas Production Office and dministrative duties only 3 Theatrical* any medium On location/self employed Professor/Teacher see Teacher Program Director 3 Programmer see Computer Projectionist In Studio Others Promoter Proofreader Prosthetic Limb Dealer Not making or repairing 3 Making or repairing Prosthodontist Psychiatrist MD Psychoanalyst Psychologist.P. with PhD.P. with Master s degree Psychotherapist Public Relations gent 3 Publisher 4 Pulmonologist Purchasing gent 4 R Racing ll Sports Radiation Therapist Radiologist 5M Railroad Worker Real Estate gent* Net income $100,000 each of the last 3 years; > 3 years experience, working full time 4 Net income $60,000; > 3 years experience, working full time 3 Others, working full time Real Estate Developer Receptionist Recording Engineer Referee Registered Nurse see Nurse Rehabilitation Therapist Repairing/Servicing/Installing Clock/Jewelry/Office Machines/Precision Instruments/Watch Others Pipeline/Sign/Sprinkler/uto ody Reporter Not Freelance; no flying Freelance or flying Resident MD/DO use Specialty Respiratory Therapist Restaurant Owner/Manager Income $40,000 each of the last 2 years; not tending bar 3 Income < $40,000 each of the last 2 years; not tending bar Occasionally tending bar Rheumatologist 5M Rigger River Pilot Rodeo Rider Roofer S Sales (not classified elsewhere) Income $60,000 each of the last 2 years; no door-to-door, 5 years experience, no delivery 4 Income $40,000; no door-to-door, 3 years experience, no delivery 3 Income < $40,000; no door-to-door, 3 years experience, no delivery 1 year experience, Route Sales, Installing/Servicing Door-to-door *No business owner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 43
Occupational Listing Listing Sc Tec School Superintendent and Principal 2 Masters/PhD; not teaching Scientist (including: gronomist, nthropologist, rchaeologist, stronomer, acteriologist, iochemist, iologist, otanist, Chemist, Entomologist, Geneticist, Geologist, Metallurgist, Meteorologist, Microbiologist, Mineralogist, Physicist, Seismologist, Sociologist, Topographer, Toxicologist, Zoologist): Income $60,000 each of the last 2 years; PhD; 90% office duties; not working with hazardous material Income $40,000 each of the last 2 years; Masters degree 90% office duties; not working with hazardous material College Degree < 90% office duties, no field duties; not working with hazardous materials College Degree, field duties, no hazardous duties Seamstress Seismograph Party Chief Crew Seismologist see Scientist Ship Crew Shipping/Receiving Clerk Not handling goods Handling goods Shoe Maker/Repairer Skilled Shoe Shiner Slaughterhouse Worker Social and Welfare Worker 2 PhD, 90% office duties MSW degree, 90% office duties Others Sociologist see Scientist Sound Engineer/Mixer Speech Therapist Sprayer Stable Worker Stagehand Station Manager TV/Radio office duties only 5 5 4 3 4 3 3 3 Station Master Stationary Engineer Mill/Transportation Lumberyard/Oil & Natural Gas Statistician Steamfitter Steeplejack Stock Clerk Not handling heavy goods Handling heavy goods Stockyard Worker Street Cleaner Superintendent uilding/plant, five employees School see School Superintendent Hospital see Executive Supervisor if not shown elsewhere No manual duties Working Surgical ssistant Surveyor Swimming Pool Service Worker System nalyst/system Engineer/Programmer see Computer T Tailor/Seamstress Talent Scout Taxicab Driver Taxidermist Teacher 2 (90 days min. waiting period) Income $60,000 for each of last 2 years; college or university with PhD Income $40,000 for each of the last 2 years; college or university with Master Degree Income < $40,000; Special Ed./Teacher of handicapped; Classroom only (any level) Coach/Dance/Driving/Music/Trade School/ Sports/Vocation Reform School Technician see Medical Technician 3 4 5 4 3 44 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines
Occupational Listing Occupational Listing Occupational Listing Tex Z Textile Worker Therapist Respiratory Speech Inhalation Occupational Physical Psychotherapist Radiation Rehabilitation Hypnotherapist Thoracic Surgeon Ticket gent Office duties only Tilesetter/Tile Layer Title Examiner Tour Director U.S. / Canada/ Puerto Rico Foreign Travel 4 Toxicologist see Scientist Traffic Manager Trainer thletic Dog, horse, no riding Other animals Translator/ Interpreter Travel gency Owner/gent office duties only Tree Sprayer/Surgeon/Trimmer Truck Driver see Driver Umpire Upholsterer Urban Planner Urologist U 3 HO 4 3 3 V Valet Varnisher Vascular Surgeon Vending Machine Collector/Filler/Installer/Repairer/Service Venture Capitalist Veterinarian Small animals only Others W Waiter/Waitress full time Warehouse Worker Checker/Crater/Packer Watchman Welder Window Dresser/Trimmer Screen/Storm, Maker/Installer Cleaner Writer Full time salary not working from home Others X-Ray Technician see Medical Technician Yard Worker Z Zoo Director office and administrative duties only Keeper ttendant/feeder Zoologist see Scientist X Y 4 3 3 *No businessowner matrix 1 Limit DI to $5000 2 See Government Guidelines for I&P 3 Consultants working from home should refer to our working at home guidelines 4 Home Office 45
Miscellaneous Forms Needed, Optional Rider vailability, bbreviations What Form is Needed When? Transaction Form Questions Required note to answer Exercise Guarantee Physical Insurability 3022 all new page 3 will be sent to be included with the original policy. Change Occupational Class 3023 1.3 2.1-3 The insured must be at new occupation for a minimum of 12 months. 3.all Reinstatement 3023 1.11 2.all 3.all Policy may be reinstated ONLY within six months from date of lapse. ll back premium must be collected. Conversions 3023 1.6 Other changes resulting in an increase in risk submitted with conversions require 3023-DI, parts 2 and 3. Include supplements Form 6705 (OE) and Form 8660 (uy-sell) if OE or uy-sell policy. Optional Rider vailability The following chart summarizes the riders and benefits available at and after issue. ll optional Riders may not be available in all states or for all occupational classes. Riders added after issue must be exercised at policy anniversary. See ON-Net to confirm availability. Riders vailable Plan t Issue t/fter Issue Individual 5/4//3/ GPI/CT RDR/SIS/COL Individual 5M/ GPI/CT SIS/COL Individual / WWP SIS usiness OE 6 mo. benefit/gpi PDR/SSE/RDR 5M///5/4/3/ usiness OE / 6 mo. benefit PDR/SSE usiness uy-sell GPI/E bbreviations CT COL GPI RDR SIS MDE WWP PDR SSE E Catastrophic Disability enefit Rider Cost of Living Disability Income Increase Guarantee of Physical Insurability Residual Disability Rider Social Insurance Supplement Managerial Duties Endorsement Waiver of Waiting Period While Hospital Confined ( & only) Partial Disability Rider (OE) Substitute Salary Expense (OE) Extended enefit (uy-sell) 46
The Ohio National Life Insurance Company Ohio National Life ssurance Corporation One Financial Way Cincinnati, Ohio 45242 Post Office ox 237 Cincinnati, Ohio 45201-0237 Telephone: 513.794.6100 www.ohionational.com Form 8722 Rev. 9-11 2011 Ohio National Financial Services, Inc. Tracing its corporate origins to 1909, Ohio National today markets a variety of insurance and financial products in 47 states (all except laska, Hawaii and New York), the District of Columbia and Puerto Rico, with subsidiary operations in Santiago, Chile. We are committed to building long-term relationships with our customers and to providing them with solutions as their needs change over time. Note: This brochure provides a general (not comprehensive) description of disability income insurance policies issued by Ohio National Life ssurance Corporation. It is not part of the policy. For more detailed information, please see brochures on specific coverages or refer to a complete proposal containing a description of particular benefits, limitations and exclusions. Product, product features and rider availability vary by state. Guarantees are based upon the claims-paying ability of the issuer. Disability income insurance is not available in C. Issuers not licensed to conduct business and products not distributed in K, HI or NY. for representative use ONLY. NOT FOR USE WITH the General PULIC.