Voluntary Life Insurance SUMMARY OF BENEFITS Sponsored by: Educational Service Center of Central Ohio Life Benefit Employee Spouse Dependent Amount Choice of $10,000 increments Not to exceed 5 times your annual salary Employees age 70 and older, maximum benefit is $50,000 Choice of $5,000 increments Employee must elect coverage for spouse to be eligible. Not to exceed 50% of employee elected amount. $250 Child: 14 days to 6 months $2,500, $5,000, $7,500 or $10,000 Child: 6 months to age 19 (to age 25 if full-time student) Newborn children to age 14 days are not eligible for a benefit Employee must elect coverage for dependents to be eligible. Minimum Amount $10,000 $5,000 $2,500 Maximum Amount $500,000 $25,000 $10,000 Guarantee Issue for Newly Eligible Employees Current Eligible Employees $150,000 $25,000 $10,000 You or your spouse may elect or increase insurance coverage up to 2 increments on a guaranteed acceptance basis during your company's defined annual open enrollment period, provided that you or your spouse have not been previously declined for coverage. Benefit Reduction Employee Spouse Benefits will reduce: 35% at age 65 35% at employee age 65 Additional Benefits See Definition: See Definition: See Definition: An additional 25% of original amount at age 70 An additional 15% of original amount at age 75 An additional 15% of original amount at age 80 Benefits terminate at retirement Accelerated Death Benefit Portability Conversion Benefits terminate at employee age 70 or retirement, whichever occurs first Eligibility Employee Spouse and Dependents All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again, or may be responsible for the cost of required examinations. Cannot be in a period of limited activity on the day coverage takes effect. (Please see other side) GLM-07020 Rev. 7/13 VLI Only_Increments_AOE
Employee Semi-Monthly Premium Life Premium for sample benefit amounts Employee and Spouse premiums are calculated separately. Refer to Program Specifications for your maximum benefit amounts. Benefits and premium amounts reflect age reductions. AGE Semi- Monthly Rate per $1,000 $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 <25 0.0300 $0.30 $0.60 $0.90 $1.20 $1.50 $1.80 $2.10 $2.40 $2.70 $3.00 25-29 0.0300 $0.30 $0.60 $0.90 $1.20 $1.50 $1.80 $2.10 $2.40 $2.70 $3.00 30-34 0.0400 $0.40 $0.80 $1.20 $1.60 $2.00 $2.40 $2.80 $3.20 $3.60 $4.00 35-39 0.0500 $0.50 $1.00 $1.50 $2.00 $2.50 $3.00 $3.50 $4.00 $4.50 $5.00 40-44 0.0700 $0.70 $1.40 $2.10 $2.80 $3.50 $4.20 $4.90 $5.60 $6.30 $7.00 45-49 0.0950 $0.95 $1.90 $2.85 $3.80 $4.75 $5.70 $6.65 $7.60 $8.55 $9.50 50-54 0.1300 $1.30 $2.60 $3.90 $5.20 $6.50 $7.80 $9.10 $10.40 $11.70 $13.00 55-59 0.2450 $2.45 $4.90 $7.35 $9.80 $12.25 $14.70 $17.15 $19.60 $22.05 $24.50 60-64 0.3750 $3.75 $7.50 $11.25 $15.00 $18.75 $22.50 $26.25 $30.00 $33.75 $37.50 65-69 0.7500 $6,500 $13,000 $19,500 $26,000 $32,500 $39,000 $45,500 $52,000 $58,500 $65,000 $4.88 $9.75 $14.63 $19.50 $24.38 $29.25 $34.13 $39.00 $43.88 $48.75 70-74 0.9050 $4,000 $8,000 $12,000 $16,000 $20,000 N/A N/A N/A N/A N/A $3.62 $7.24 $10.86 $14.48 $18.10 N/A N/A N/A N/A N/A 75-79 2.1500 $2,500 $5,000 $7,500 $10,000 $12,500 N/A N/A N/A N/A N/A $5.38 $10.75 $16.13 $21.50 $26.88 N/A N/A N/A N/A N/A 80+ 2.1500 $1,000 $2,000 $3,000 $4,000 $5,000 N/A N/A N/A N/A N/A $2.15 $4.30 $6.45 $8.60 $10.75 N/A N/A N/A N/A N/A This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. Example: Use this formula to calculate premium for benefit amounts over $100,000. Age Semi-Monthly Rate Per $1,000 X Benefit In $1,000 s = Semi-Monthly Cost Example: 35 0.0500 X 150 = $7.50 X = Dependent Children Semi-Monthly Rate Benefit $2,500 $5,000 $7,500 $10,000 Rate $0.27 $0.54 $0.81 $1.08 Premium covers all dependent children regardless of the number of children. GLM-07020 Rev. 7/13 VLI Only_Increments_AOE
Spouse Semi-Monthly Premium Life Premium for sample benefit amounts Employee and Spouse premiums are calculated separately. Spouse premiums will be calculated based on the Employee s age. Refer to Program Specifications for your maximum benefit amounts. Benefits and premium amounts reflect age reductions. AGE Semi- Monthly Rate per $1,000 $5,000 $10,000 $15,000 $20,000 $25,000 <25 0.0300 $0.15 $0.30 $0.45 $0.60 $0.75 25-29 0.0300 $0.15 $0.30 $0.45 $0.60 $0.75 30-34 0.0400 $0.20 $0.40 $0.60 $0.80 $1.00 35-39 0.0500 $0.25 $0.50 $0.75 $1.00 $1.25 40-44 0.0700 $0.35 $0.70 $1.05 $1.40 $1.75 45-49 0.0950 $0.48 $0.95 $1.43 $1.90 $2.38 50-54 0.1300 $0.65 $1.30 $1.95 $2.60 $3.25 55-59 0.2450 $1.23 $2.45 $3.68 $4.90 $6.13 60-64 0.3750 $1.88 $3.75 $5.63 $7.50 $9.38 65-69 0.7500 $3,250 $6,500 $9,750 $13,000 $16,250 $2.44 $4.88 $7.31 $9.75 $12.19 70+ N/A N/A N/A N/A N/A This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. Dependent Children Semi-Monthly Rate Benefit $2,500 $5,000 $7,500 $10,000 Rate $0.27 $0.54 $0.81 $1.08 Premium covers all dependent children regardless of the number of children. GLM-07020 Rev. 7/13 VLI Only_Increments_AOE
Definitions Accelerated Death Benefit Conversion Guarantee Issue Limited Activity Portability Term Life Exclusion: Suicide Additional Benefits LifeKeys SM TravelConnect SM Accelerated Death Benefit provides an option to withdraw a percentage of your life insurance coverage when diagnosed as terminally ill (as defined in the policy). The death benefit will be reduced by the amount withdrawn. To qualify, you have satisfied the Active Work rule and have been covered under this policy for the required amount of time as defined by the policy. Check with your tax advisor or attorney before exercising this option. If you terminate your employment or become ineligible for this coverage, you have the option to convert all or part of the amount of coverage in force to an individual life policy on the date of termination without Evidence of Insurability. Conversion election must be made within 31 days of your date of termination. For timely entrants enrolled within 31 days of becoming eligible, the Guarantee Issue amount is available without any Evidence of Insurability requirement. Evidence of Insurability will be required for any amounts above this, for late enrollees or increase in insurance, and it will be provided at your own expense. A period when a spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex. If coverage has been in force for at least 12 months, you may continue coverage for a specified period of time after your employment by paying the required premium. Portability is available if you cease employment for a reason other than total disability or retirement at Social Security Normal Retirement Age. A written application must be made within 31 days of your termination. Coverage provided to the designated beneficiary upon the death of the insured. Coverage is provided for the time period that you are eligible and premium is paid. There is no cash value associated with this product. Benefits will not be paid if the death results from suicide within 1 years after coverage is effective. May apply if employee contributes toward the premium. Online will & testament preparation service, identity theft resources and beneficiary assistance support for all employees and eligible dependents covered under the Group Term Life and/or AD&D policy. Travel assistance services for employees and eligible dependents traveling more than 100 miles from home. For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07020 Rev. 7/13 VLI Only_Increments_AOE
Voluntary Short-Term Disability Insurance SUMMARY OF BENEFITS Sponsored by: Educational Service Center of Central Ohio Short-term disability is intended to protect your income for a short duration in case you become ill or injured. All Full-Time Employees electing 31/31/9 elimination period STD Benefit Weekly Benefit 60% of weekly salary up to $1,500 per week Elimination Period (Accident/Illness) Benefits begin on: 31 st day/31 st day Maximum Duration 9 weeks Pre-Existing Condition Integration of Benefits Waiver of Premium You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 12 months. Your benefits may be reduced by benefits received from state disability or worker s compensation programs. The total of all benefits received from this policy, state disability plans, worker s compensation programs and your employer s sick pay plan may not exceed 100% of your income prior to disability. You will not be required to pay premium during any time of approved total or partial disability. Additional Benefits Enrolling for Coverage Survivor Income Benefit Rehabilitation Assistance Benefit Portability See the Schedule of Benefits on your Certificate for more information Eligibility: All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again until your annual open enrollment. GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Semi Monthly Premium Cost EXAMPLE John Doe, Age 35 List your weekly earnings $ $500 (*Maximum covered payroll is $2,500 Weekly) Multiply by the premium factor 0.002050 Your Estimated Semi-Monthly Premium $ $1.03 Attained Age Premium Factors <29 0.003100 30 34 0.002900 35 39 0.002050 40 44 0.001650 45 49 0.001750 50 54 0.002000 55 99 0.002050 *This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. (Please see other side) GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Understanding Your Benefits Total Disability Partial Disability Continuation of Disability Pre-Existing Condition Benefit Exclusions Benefit Reductions Coverage Termination Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation. Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation on a full-time basis. Partial Disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer as well as continue to receive benefits, which may enable you to receive 100% of your income during your time of disability. If you return to work full-time but become disabled from the same disability within 2 weeks of returning to work, you will begin receiving benefits again immediately. Any sickness or injury for which you have received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months following the coverage effective date, unless no treatment was received for the specified consecutive months after the coverage effective date. You will not receive benefits in the following circumstances: Your disability is the result of a self-inflicted injury. You are not under the regular care of a doctor when requesting disability benefits. Your disability is covered under a worker s compensation plan and/or is due to a job-related sickness or injury. Your benefits may be reduced if you are receiving benefits from any of the following sources: Any governmental retirement system earned as a result of working for the current policyholder; Any disability or retirement benefit received under a retirement plan; Any Social Security, or similar plan or act, benefits; Earnings the insured earns or receives from any form of employment; Disability income benefits received under state disability benefit laws. This coverage will terminate when you terminate employment with this policyholder, or at your retirement. For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Should there be a difference between this summary and the policy, the policy will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Voluntary Short-Term Disability Insurance SUMMARY OF BENEFITS Sponsored by: Educational Service Center of Central Ohio Short-term disability is intended to protect your income for a short duration in case you become ill or injured. All Full-Time Employees electing 15/15/11 elimination period STD Benefit Weekly Benefit Elimination Period (Accident/Illness) Maximum Duration Option 1: 60% of weekly salary up to $1,500 per week Benefits begin on: 15 th day/15 th day 11 weeks Pre-Existing Condition Integration of Benefits Waiver of Premium You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 12 months. Your benefits may be reduced by benefits received from state disability or worker s compensation programs. The total of all benefits received from this policy, state disability plans, worker s compensation programs and your employer s sick pay plan may not exceed 100% of your income prior to disability. You will not be required to pay premium during any time of approved total or partial disability. Additional Benefits Enrolling for Coverage Survivor Income Benefit Rehabilitation Assistance Benefit Portability See the Schedule of Benefits on your Certificate for more information Eligibility: All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again until your annual open enrollment. GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Semi Monthly Premium Cost EXAMPLE John Doe, Age 35 List your weekly earnings $ $500 (*Maximum covered payroll is $2,500 Weekly) Multiply by the premium factor 0.003500 Your Estimated Semi-Monthly Premium $ $1.75 Attained Age Premium Factors <29 0.005750 30 34 0.005200 35 39 0.003500 40 44 0.002600 45 49 0.002750 50 54 0.003200 55 99 0.003700 *This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. (Please see other side) GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Understanding Your Benefits Total Disability Partial Disability Continuation of Disability Pre-Existing Condition Benefit Exclusions Benefit Reductions Coverage Termination Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation. Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation on a full-time basis. Partial Disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer as well as continue to receive benefits, which may enable you to receive 100% of your income during your time of disability. If you return to work full-time but become disabled from the same disability within 2 weeks of returning to work, you will begin receiving benefits again immediately. Any sickness or injury for which you have received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months following the coverage effective date, unless no treatment was received for the specified consecutive months after the coverage effective date. You will not receive benefits in the following circumstances: Your disability is the result of a self-inflicted injury. You are not under the regular care of a doctor when requesting disability benefits. Your disability is covered under a worker s compensation plan and/or is due to a job-related sickness or injury. Your benefits may be reduced if you are receiving benefits from any of the following sources: Any governmental retirement system earned as a result of working for the current policyholder; Any disability or retirement benefit received under a retirement plan; Any Social Security, or similar plan or act, benefits; Earnings the insured earns or receives from any form of employment; Disability income benefits received under state disability benefit laws. This coverage will terminate when you terminate employment with this policyholder, or at your retirement. For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Should there be a difference between this summary and the policy, the policy will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07007 Rev. 7/13 STD_Vol_Specialty Worksite
Long-Term Disability Insurance SUMMARY OF BENEFITS Sponsored by: Educational Service Center of Central Ohio Long-term disability is intended to protect your income for a long duration after you have depleted short-term disability or any sick leave your company may offer. All Full-Time Employees electing Option 2 LTD Benefit Monthly Benefit Maximum Benefit Maximum Benefit Duration Own Occupation Period Elimination Period Employee Paid Plan 60% $8,500 2 years or age 70 24 Months 90 Days Pre-Existing Condition Waiver of Premium Benefit Limitations Enrolling for Coverage Eligibility: Semi-Monthly Premium Calculation List your monthly earnings (*Maximum covered payroll is $5,100 Monthly) Multiply by your premium factor You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 12 months. You will not be required to pay premium during any time of approved total or partial disability. Mental Illness: 24 months Substance Abuse: 24 months Specified Illness: No Limit All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again, or may be responsible for the cost of required examinations. $ Example: Sample Employee, Age 35 $2,500 0.000700 Your Estimated Semi- Monthly Premium** $ $1.75 **This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency Attained Age Premium Factors <30 0.000300 30 34 0.000550 35 39 0.000700 40 44 0.001000 45 49 0.001250 50 54 0.001700 55 59 0.002250 60+ 0.002600 GLM-07011 Rev. 7/13 LTD_
Understanding Your Benefits Elimination Period Own Occupation Total Disability Partial Disability Continuation of Disability Benefit Duration Reduction Pre-Existing Condition Benefit Exclusions Benefit Reductions Coverage Termination Additional Benefits The number of days you must be disabled prior to collecting disability benefits. The trade or profession you were employed in prior to your disability as defined by the US DOL Dictionary of Occupational Titles. Due to an injury or illness, you are unable to perform each of the main duties of your own occupation. Your own occupation is covered for a specific period of time. Following this, the definition of total disability becomes the inability to perform any occupation for which you are reasonably suited based on your experience, education, or training. Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation on a full-time basis. Partial Disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer and continue to receive benefits, which may enable you to receive 100% of your income during your time of disability. If you return to work full-time but become disabled from the same disability within 6 months of returning to work, you will begin receiving benefits again immediately with no new Elimination Period. Your benefit duration may be reduced if you become disabled after age 65. Any sickness or injury for which you received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months following the coverage effective date. You will not receive benefits in the following circumstances: Your disability is the result of a self-inflicted injury. You are not under the regular care of a doctor when requesting disability benefits. You were involved in a felony commission, act of war, or participation in a riot. You were residing outside of the United States or Canada for more than 12 consecutive months for purposes other than employment with your Employer. Your benefits may be reduced if you are receiving benefits from any of the following sources: Any compulsory benefit act or law (such as state disability plans); Any governmental retirement system earned as a result of working for the current policyholder; Any disability or retirement benefit received under a retirement plan; Any Social Security, or similar plan or act, benefits; Earnings from any form of employment; Workers compensation; Salary continuance or employer contributions to an employer sponsored retirement plan. Coverage will terminate when you terminate employment with this policyholder, or at your retirement. EmployeeConnect SM Survivor Income Benefit Progressive Income Benefit Family Care Expense See your Schedule of Benefits on your Certificate for more information For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Should there be a difference between this summary and the policy, the policy will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07011 Rev. 7/13 LTD_
Long-Term Disability Insurance SUMMARY OF BENEFITS Sponsored by: Educational Service Center of Central Ohio Long-term disability is intended to protect your income for a long duration after you have depleted short-term disability or any sick leave your company may offer. All Full-Time Employees electing Option 1 LTD Benefit Monthly Benefit Maximum Benefit Maximum Benefit Duration Own Occupation Period Elimination Period Employee Paid Plan 60% $8,500 Later of Age 65 or Social Security Normal Retirement Age 24 Months 90 Days Pre-Existing Condition Waiver of Premium Benefit Limitations Enrolling for Coverage Eligibility: You may not be eligible for benefits if you have received treatment for a condition within 3 months prior to your effective date under this policy until you have been covered under the policy for 12 months. You will not be required to pay premium during any time of approved total or partial disability. Mental Illness: 24 months Substance Abuse: 24 months Specified Illness: No Limit All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again, or may be responsible for the cost of required examinations. Monthly Premium Calculation List your monthly earnings (*Maximum covered payroll is $5,100 Monthly) Multiply by your premium factor $ Example: Sample Employee, Age 35 $2,500 0.001550 Your Estimated Monthly Premium** $ $3.88 Attained Age Premium Factors <30 0.000600 30 34 0.001150 35 39 0.001550 40 44 0.002500 45 49 0.003150 50 54 0.004150 55 59 0.004600 **This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency GLM-07011 Rev. 7/13 LTD_
Understanding Your Benefits Elimination Period Own Occupation Total Disability Partial Disability Continuation of Disability Benefit Duration Reduction Pre-Existing Condition Benefit Exclusions Benefit Reductions Coverage Termination Additional Benefits The number of days you must be disabled prior to collecting disability benefits. The trade or profession you were employed in prior to your disability as defined by the US DOL Dictionary of Occupational Titles. Due to an injury or illness, you are unable to perform each of the main duties of your own occupation. Your own occupation is covered for a specific period of time. Following this, the definition of total disability becomes the inability to perform any occupation for which you are reasonably suited based on your experience, education, or training. Due to an injury or illness, you are unable to perform each of the main duties of your regular occupation on a full-time basis. Partial Disability benefits may be payable if you are earning at least 20% of the income you earned prior to becoming disabled, but not more than 99%. Partial disability benefits allow you to work and earn income from your employer and continue to receive benefits, which may enable you to receive 100% of your income during your time of disability. If you return to work full-time but become disabled from the same disability within 6 months of returning to work, you will begin receiving benefits again immediately with no new Elimination Period. Your benefit duration may be reduced if you become disabled after age 65. Any sickness or injury for which you received medical treatment, consultation, care, or services (including diagnostic measures or the taking of prescribed medications) during the specified months prior to your coverage effective date. A disability arising from any such sickness or injury will be covered only if it begins after you have performed your regular occupation on a full-time basis for the specified months following the coverage effective date. You will not receive benefits in the following circumstances: Your disability is the result of a self-inflicted injury. You are not under the regular care of a doctor when requesting disability benefits. You were involved in a felony commission, act of war, or participation in a riot. You were residing outside of the United States or Canada for more than 12 consecutive months for purposes other than employment with your Employer. Your benefits may be reduced if you are receiving benefits from any of the following sources: Any compulsory benefit act or law (such as state disability plans); Any governmental retirement system earned as a result of working for the current policyholder; Any disability or retirement benefit received under a retirement plan; Any Social Security, or similar plan or act, benefits; Earnings from any form of employment; Workers compensation; Salary continuance or employer contributions to an employer sponsored retirement plan. Coverage will terminate when you terminate employment with this policyholder, or at your retirement. EmployeeConnect SM Survivor Income Benefit Progressive Income Benefit Family Care Expense See your Schedule of Benefits on your Certificate for more information For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater detail. Should there be a difference between this summary and the policy, the policy will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07011 Rev. 7/13 LTD_
Voluntary Accidental Death and Dismemberment Insurance SUMMARY OF BENEFITS AD&D Sponsored by: Educational Service Center of Central Ohio Benefit Employee Spouse Dependent Amount Choice of $10,000 increments. Not to exceed 5 times annual salary. Choice of $5,000 increments. Not to exceed 50% of employee's elected amount. Choice of $2,500 increments up to $10,000 for each child Minimum Amount $10,000 $5,000 $2,500 Maximum Amount $500,000 $250,000 $10,000 Benefit Reduction Benefits will reduce: Additional Benefits Employee 33% at age 70. An additional 33% of original amount at age 75 Benefits terminate at retirement. Safe Driver Education Spouse Training Felonious Assault Alternate Child Care Coma Common Disaster Exposure Disappearance Spouse Benefits terminate at spouse age 70 or employee retirement, whichever occurs first. Common Carrier Eligibility Employee Spouse and Dependents All employees in an eligible class. You are able to take advantage of this coverage now without a health examination. You may not be offered this opportunity again, or may be responsible for the cost of required examinations. Cannot be in a period of limited activity on the day coverage takes effect. (Please see other side) GLM-07018 Rev. 7/13 Stand Alone VADD
Employee Semi-Monthly Premium for Accidental Death and Dismemberment coverage Refer to Program Specifications for your maximum benefit amounts. EXAMPLE: Use this formula to calculate premium for your elected benefit amount. Use your benefit amount to calculate the cost. Semi-Monthly Rate per $1,000 Benefit in $1,000 s Employee 0.010 X = Semi-Monthly Cost Spouse 0.010 X = Example-Employee 0.010 X 150 = $1.50 Semi-Monthly Rate per $2,500 Benefit in $2,500 s Child 0.038 X = Semi-Monthly Cost Example-Child 0.038 X 4 = $0.15 *This is an estimate of premium cost. Actual deductions may vary slightly due to rounding and payroll frequency. Definitions AD&D Limited Activity Exclusion: Suicide Additional Benefits LifeKeys SM TravelConnect SM Accidental Death and Dismemberment (AD&D) insurance provides specified benefits for a covered accidental bodily injury that directly causes dismemberment (e.g., the loss of a hand, foot, or eye). In the event that death occurs from a covered accident, both the life and the AD&D benefit would be payable. This insurance is optional and can be purchased by you and your Spouse. A period when a Spouse or dependent is confined in a health care facility; or, whether confined or not, is unable to perform the regular and usual activities of a healthy person of the same age and sex. Benefits will not be paid if the death results from suicide within 2 years after coverage is effective. May apply if employee contributes toward the premium. Online will & testament preparation service, identity theft resources and beneficiary assistance support for all employees and eligible dependents covered under the Group Term Life and/or AD&D policy. Travel assistance services for employees and eligible dependents traveling more than 100 miles from home. For assistance or additional information Contact Lincoln Financial Group at (800) 423-2765 or log on to NOTE: This is not intended as a complete description of the insurance coverage offered. Controlling provisions are provided in the policy, and this summary does not modify those provisions or the insurance in any way. This is not a binding contract. A certificate of coverage will be made available to you that describes the benefits in greater details. Should there be a difference between this summary and the contract, the contract will govern. 2008 Lincoln National Corporation Group Insurance products are issued by The Lincoln National Life Insurance Company (Ft. Wayne, IN), which is not licensed and does not solicit business in New York. In New York, group insurance products are issued by Lincoln Life & Annuity Company of New York (Syracuse, NY). Both are Lincoln Financial Group companies. Product availability and/or features may vary by state. Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates. Each affiliate is solely responsible for its own financial and contractual obligations. GLM-07018 Rev. 7/13 Stand Alone VADD