HomeMy WebLinkAbout2005 08 22 Regular Item 503- Award UNUM Provident right to offer Voluntary Workplace Benefits to City employees
City of Winter Springs
Commission Meeting August 22,2005
Regular Agenda Item 503 UNUM Provident
Page] of2
COMMISSION AGENDA
ITEM 503
Consent
Informational
Public Hearing
Regular X
August 22. 2005
Regular Meeting
Mgr.
/iJ~
V / Dept.
Authorization
REQUEST: The City Manager requesting the City Commission to award UNUM
Provident the rights to offer Voluntary Workplace Benefits to City employees.
PURPOSE: This agenda item is needed to have the City Commission approve the selection of
Unum Provident as the carrier of choice for offering V oluntary Workplace Benefits.
CONSIDERATIONS:
The City has historically allowed as many as 14 insurance carriers to offer City employees
insurance on City time, and through payroll deduction.
In 2002, I had a study performed which documented the abuse of that practice. Subsequent
action limited the companies to one company, AFLAC, and the number of offerings that could
be offered to term life, short term disability, cancer and accident insurance.
A recent review of work place offerings indicated that overly aggressive marketing was again
resulting in excessive coverage and unapproved product offering indicating a need to re-evaluate
the Volunteer Workplace Benefit program.
RFP's were distributed to carriers offering similar policies. Four carriers responded with
proposals. After reviewing the information, Unum Provident was chosen for the following
reasons:
1. Similarity to current plan
2. Non-commissioned enrollers (to avoid temptation of over-selling; non-aggressive)
3. Guarantee-issue products (not currently offered)
4. Assurance of offering only City Manager-approved products
5. Enroller attendance at all new employee orientation meetings
City of Winter Springs
Commission Meeting August 22, 2005
Regular Agenda Item 503 UNUM Provident
Page 2 of2
6. Timely product offerings for new employees
7. Copies of all new employee applications will be provided to City Human Resource
Department
8. Improved communication with Human Resource Department
In summary, Unum Provident was determined to be the best overall provider of Workplace
V oluntary employee benefits.
AL TERNA TIVES:
Two alternative packages are recommended for consideration as follows.
A. Three product packages consisting of term life, specified illness with cancer rider and
short-term disability.
B. Four product package consisting of term life, specified illness with cancer rider, short-
term disability and accident.
Staff believes accident insurance is excessive and duplicative coverage. However, the accident
policy is being recommended for consideration since there are currently 141 employees enrolled
in this plan. The question is does the City want to endorse excessive coverage through payroll
deductions just because a number of employees already have it?
RECOMMENDATION:
It is recommended that the City Commission award the right to offer Volunteer Workplace
Employee Benefits through payroll deductions to UNUM Provident to provide one of the
following benefit packages.
A. Three Product Package:
1) Term Life
2) Specified Illness with cancer rider.
3) Short Term Disability
B. Four Product Package:
1) Term Life
2) Specified Illness with Cancer rider.
3) Short Term Disability
4) Accident
ATTACHMENT:
Spreadsheet comparing Unum Provident and Aflac.
COMMISSION ACTION:
Specified Critical Illness 1 Cancer (PCR 8/16/2005)
Page 1 of 3
UnumProvident Voluntary Workplace Benefits
Specified Critical Illness I Cancer Product Comparison Report
Created 8/16/2005
UnumProvident Aflac
Specified Critical Illness (2001) Cancer Indemnity & Dread Disease A-
75300/75200/75100
Plan Design
Contract Individual Contract Individual
Covered Conditions Heart Attack - 100% Cancer (LeveI1/Level 2/Level 3)
Stoke - 100% - The First Occurrence benefit: $1,500/ $2,000/$5,000.
Major Organ Transplant - 100% Covered children: $2,250/$3,000/$7,500. Payable once
Permanent Paralysis - 100% per covered person.
End Stage Renal (kidney) Failure - 100% - The Wellness Benefit: $40/$75/ $75 per calendar year for
Coronary Artery by-pass surgery - 25% certain cancer screening tests. No lifetime maximum.
- Hospital Confinement Benefit: First 30 days; $200/ $300/
$300 per day. 31+ day: $400/$600/$600. No lifetime
maximum.
- Medical Imaging: $100/$150/$200 for CT scans, MRI's,
bone scans, MUGA scans, PET scans or transrectal
ultrasounds. No lifetime maximum.
- Radiation and Chemotherapy Benefit: $200/$300/$300
per day. No lifetime maximum.
- Experimental Treatment Benefit: $200/$300/$300 per day
for alternative treatments approved by the National Cancer
Institute. No lifetime maximum.
- Immunotherapy Benefit: $300/ $400/$500 for each
calendar month as part of treatment. Lifetime maximum:
$1,500/$2,000/$2,500.
- Anti-nausea Benefit: $100/$125/$150 for each calendar
month for which anti-nausea drugs are prescribed while
receiving radiation or chemo. No lifetime max.
- Nursing Services Benefit: $100/$125/$150 per day for full
time private nursing care required by the attending
physician while confined in a hospital and during the time
the hospital confinement benefit is payable. No lifetime
maximum.
- Surgical/Anesthesia Benefit: Based on schedule of
benefits from $95 to $3,000/$5,000/$5,000. The maximum
for anyone operation is $3,750/$6,250/$6,250. There is no
lifetime limit on the number of operations. The anesthesia
benefit is 25% of the amount shown in the schedule of
operations.
- Outpatient Surgical Benefit: $200/$300/$300 when an
operating room charge is incurred for outpatient surgeries.
No lifetime maximum.
- Skin Cancer Surgery Benefit: Based on schedule of
benefits from $100 to $600 skin cancer related surgical
operations. No lifetime maximum.
- Prosthesis Benefit: $2,500/$3,000/$3,000 or for
prosthetic devices requiring surgical implantation. Lifetime
maximum of $5,000. If surgical implantation is not
necessary; $200/$225/$250 or with lifetime maximums of
$400/$450/$500.
- Reconstructive Surgery Benefit: Based on policy
schedule from $700 to $3,000 for reconstructive surgery.
No lifetime maximum.
- In-Hospital Blood and Plasma Benefit pays actual
charges up to 50 x/ 1 00x/150x or the number of days of
covered hospital confinement. No lifetime maximum.
- Outpatient Blood and Plasma Benefit pays the actual
charges up to $200/$250/$250 each day the insured
receives a transfusion as an outpatient and a charge is
incurred. No lifetime maximum.
- Second Surgical Opinion: $200/$250/$300 concerning
surgery for a diagnosed cancer.
- National Cancer Institute Evaluation -Consultation Benefit
of $500 with $250 for transportation assistance if the NCI-
associated center is more than 50 miles from home.
Payable once per covered person.
- Ambulance Benefit: $200 for ground, $1000 for air by a
licensed ambulance service to or from the hospital/home.
No lifetime maximum.
- Transportation Benefit pays $0.40/$0.50/$0.50 cents per
mile to a treatment facility more than 50 miles from home,
with a maximum of 1, 200/$1,500/$1,500 $ per trip. No
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Specified Critical Illness 1 Cancer (PCR 8/16/2005) Page 2 of 3
lifetime maximum.
_ Lodging Benefit pays an indemnity of $50/$60/$60 per
day for an insured or anyone adult family member when
cancer treatment is being received more than 50 miles
from home. Calendar year maximum of 90 days per
covered person.
_ Bone Marrow Transplant Benefit: $10,000 for such
transplant. $10,000 is the lifetime maximum.
_ Stem Cell Transplant Benefit: $2,500/ $5,000/$5,000 for
such transplant. These are also the lifetime maximums per
plan.
Benefit Amounts
Minimum Face Amount $5,000 The policy design offers three tiers of benefits for the
conditions covered.
Maximum Face Amount $50,000 ($30,000 for Spouse) The policy design offers three tiers of benefits for the
conditions covered.
Partial Benefits 25% Coronary artery bypass surgery Not applicable - most benefits are indemnity-based, only
25% Carcinoma in situ requiring that a charge be incurred for the covered
50% benefit reduction at age 70 condition. Services that are covered for the charge
incurred are noted above.
Employee Eligibility
Issue Ages Employee 16-69 18-70 on payroll and 18-64 nonpayroll (18-64 for all in
Spouse 16-64 some states)
Children Newborn - 24
Actively at Work Actively at work means that on the day the employee Information not provided.
applies for coverage, he/she is working at one of the
company's business locations, or is working at a location
where he/she is required to represent the company.
Minimum of 20 hours per week.
Underwriting
Modified Issue Modified Issue is available for face amounts up to $30,000. Payroll Plans
Simplified Issue Simplified Issue is available for amounts over $30,000. Direct Bill and Association plans
Application 3 yes/no Medical Questions for Modified Underwriting (up Payroll: 5 Yes/No questions; any Yes answers detail must
to $30k) be provided
6 yes/no Medical Questions, HtlWt question and List of
Medications & Health Conditions for SI underwriting Non-Payroll: 8 Yes/No questions; any Yes answers detail
must be provided and 2 additional questions for the
specified-disease rider.
Definitions
Effective Date Coverage effective the date the application is signed. The effective date of the policy will be the date shown in
the Policy Schedule, not the date the application is signed
Waiting Period No Waiting period for Illness under the base policy. 30 day waiting period for all benefits
30 Day Waiting period for Cancer and Health Screening
Riders.
Benefit Reduction The face amount for the employee and spouse benefits Not applicable
reduce by 50% on the first policy anniversary after the
insured's 70th birthday, or five years after the policy date,
whichever is later.
Additional Features
Portable Coverage is portable - employees can keep their coverage Yes, coverage is portable
if they change jobs or retire.
Guarantee Renewable Policy is guaranteed renewable as long as premiums are This policy is guaranteed-renewable for life.
paid and full benefits have not been paid.
Riders and
Spouse Rider Spouse coverage is available in face amounts of $5,000 - No, but if a divorce takes place, the spouse may apply for
$30,000.* their own coverage without evidence of insurability.
Spouse issue ages: 16-64
'Spousal increase eff 11-1-03. $25K max in TX.
Child Rider Available to children: newborn to 24 years. No, but if dependency is terminated they may apply for
Available face amounts of $2,500 and $5,000. their own policy without evidence of insurability.
Cancer and Carcinoma in Cancer & Carcinoma In Situ Rider 100% cancer/25% Not applicable
Situ carcinoma in situ.
Health Screening Benefit Pays $50 per calendar year per insured for 20 covered Cancer screening tests are Included in base policy.
Rider health screening test.
Insureds are eligible for benefits 30 days after the effective
date of coverage.
Positioning Points
Product Points \_ UnumProvident offers the flexibility of a lump sum I Brand Recognition
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Page 3 of3
benefit. A large lump sum benefit allows the insured to use Although the policy has a 'first occurrence' benefit,
benefits to meet the insured's personal needs. With additional benefits allow the policy to remain in force after
today's technology, many have shorter hospital stays and one or more benefits have been paid.
treatment is provided outside of being hospital confined. A
lump sum benefit will provide coverage even if hospital The 32 conditions in the Specified Disease rider are not
confinement is not required. the usual stroke / heart attack / renal failure but rather
_ UnumProvident's effective date of coverage is the date conditions or diseases such as tuberculosis, botulism,
the employee signs the application. West Nile virus, malaria, polio, yellow fever, etc.
_ UnumProvident's app has 3 health questions required to
issue coverage
_ 30 day waiting period on Cancer and HSB riders only
_ UnumProvident offers a Cancer and Carcinoma Rider.
_ UnumProvident has a portability provision in the event
you leave or retire from your current place of employment.
_ UnumProvident does not have a pre-existing provision.
Weaknesses:
- Spouse max issue age of 64
- Benefit reduction at age 70
Premium
Design Unisex, Tobacco/Non-Tobacco Payroll policies are based only on individual, one-parent
family or two parent family.
Non-payroll (direct and association plans) are age-banded
by issue age (age last birthday) from 18-49; 50-59; and 60-
64.
Age bands 16-29,30-39,40-49,50-59,60-69 18-70
Premiums do not increase with age.
Premium Comparison
Face Amount-Enhanced $25,000 Benefit Amount 3-Tiered series; rates are the 2nd tier - policy form A-
Plan 75200
Premiums Weekly Premiums Weekly
Age 25 $2.20 Individual 18-70: $6.21
Age 35 $4.05 One-parent family 18-70: $7.59
Age 45 $8.25 Two-parent family 18-70: $10.50
Age 55 $14.72
Age 65 $23.60
Plan / Tobacco Distinct / Base plan with Cancer Rider / Non Tobacco / Weekly Uni-tobacco / Weekly Rates
Monthly Premiums
Health Screening Benefit Rider - Weekly Premium $.40
For internal UnumProvident educational and informational use only. This represents a comparison of selected policy provisions and does not represent an insurance
contract While every effort is made to ensure that competitor information is current and complete, the comparison information is generic in nature and not able to refiect all
state-specific provisions or contract/pricing changes. Please consult the specimen policies for full information
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Term Life (PCR 8/16/2005)
Page 1 of 3
UnumProvident Voluntary Workplace Benefits
Term Life Product Comparison Report
Created 8/16/2005
UnumProvident AFLAC
Level Term Life Life Assurance (10YRT)
Plan Design
Contract Type Individual Certificate
10-year level/10-year level/Yearly Renewable
Policy Minimums $10,000 face amount $12,500 face amount.
Policy Maximums $150,000 face amount $100,000 face amount.
Policy Fee $52.00 annually Information is not available.
Age Definition Age last birthday Information is not available.
Employee Eligibility
Issue Ages 15 - 70 18-65
Family Options
Spouse Coverage Issue ages 15-55, Face amounts between $10,000 and Spouse Term Rider, see details below.
$50,000, Policy is portable and may be converted to cash
value policy.
20-year spouse term rider is also available, details below.
Child Coverage Child Term Rider, details below. Child Term Rider, see details below.
Underwriting
Account Eligibility 100+ eligible employees. 10 standalone adult applications Information is not available.
at the employer level are required to set up a billing
account for the case.
Guaranteed Issue Employee: Up to $100,000, Must be actively at work at Not available.
application.
Spouse: Up to $25,000, Must be able to perform normal
activities.
Available if a minimum of 15% participation of the total
eligible employee population is achieved.
Modified Guaranteed Issue Employee: Up to $100,000, Must be actively at work and Not available.
answer two health questions.
Spouse: Up to $50,000, Must be able to perform normal
activities and answer two health questions.
No participation requirements.
Simplified Issue Employee: SI Level 1 Up to $150,000. Must be actively at Up to $100,000, Must answer six health questions for face
work and answer seven health questions. amounts under $50,000, and four additional health
questions if face amount is above $50,000.
Risk Class Employee: Tobacco and Non-tobacco Employee and Spouse: Tobacco or Non-tobacco.
Spouse: Uni-tobacco
Riders
Spouse Term Spouse coverage up to $25,000 in level term life for 20 Issue ages 15-65 and underwritten the same as base
years. policy. Up to $50,000 is available.
Additional Term Not offered. Rider not offered.
Child Term Issue ages 14 days through 24 years, Face amounts Issue ages 14 days to age 17 and underwritten the same
between $1,000 to $10,000, May be converted to cash as base policy. Up to $15,000 is available.
value policy at age 25.
LBOR/ABOR Employee and spouse, Pays up to 75% of the death Accelerated Death Benefit: 50% of original amount of
benefit, to a maximum of $150,000, 12 month life insurance payable for a Terminal Period Condition.
expectancy.
Accidental Death Benefit Employee, ages 15-65; and spouses, ages 15-55. Doubles face amount of policy in the event of accidental
Additional benefit equal to the face amount of the base death.
policy, up to a maximum of $150,000, should the insured
die before age 70 as a result of an accident, Pays double
for Public Conveyance accidents, and 25% extra if wearing
a seatbelt.
Waiver Employee, ages 15-55, Waives the policy premium during Primary insured. Premiums waived if insured becomes
disability if the insured employee becomes disabled prior totally disabled under the terms of the policy.
to age 65 and remains disabled beyond the six-month
period.
Issue Age 25
$10,000 $1.36 Minimum face amount available is $12,500.
$25,000 $1.90 $2.02
$50,000 $2.80 $2.88
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Term Life (PCR 8/16/2005) Page 2 of 3
$75,000 1$3.70 1$3.81
$100,000 $4.60 $4.62
Issue Age 35
$10,000 $1.39 Minimum face amount available is $12,500.
$25,000 $1.97 $2.08
$50,000 $2.93 $3.00
$75,000 $3.89 $3.98
$100,000 $4.85 $4.85
Issue Age 45
$10,000 $1.94 Minimum face amount available is $12,500.
$25,000 $3.35 $3.00
$50,000 $5.70 $4.96
$75,000 $804 $7.10
$100,000 $10.39 $9.23
Issue Age 55
$10,000 $3.41 Minimum face amount available is $12,500.
$25,000 $7.02 $5.77
$50,000 $13.04 $11.42
$75,000 $19.06 Coverage not available at this age.
$100,000 $25.08 Coverage not available at this age.
Issue Age 25
$10,000 $1.60 Minimum face amount available is $12,500.
$25,000 $2.48 $2.60
$50,000 $3.97 $4.15
$75,000 $5.45 $5.71
$100,000 $6.93 $7.62
Issue Age 35
$10,000 $1.72 Minimum face amount available is $12,500.
$25,000 $2.80 $2.83
$50,000 $4.60 $4.62
$75,000 $6.40 $6.75
$100,000 $8.20 $8.77
Issue Age 45
$10,000 $2.90 Minimum face amount available is $12,500.
$25,000 $5.75 $4.85
$50,000 $10.50 $8.88
$75,000 $15.25 $13.33
$100,000 $20.00 $17.77
Issue Age 55
$10,000 $5.81 Minimum face amount available is $12,500.
$25,000 $13.02 $9.75
$50,000 $25.04 $19.50
$75,000 $37.06 Coverage not available at this age.
$100,000 $49.08 Coverage not available at this age.
Positioning Points
Strengths 1) Great name recognition.
2) Spouse rider up to $50,000.
3) Child rider up to $15,000.
AFLAC Incorporated (NYSE: AFL) is an international
holding company. A Fortune 500(R) company, AFLAC
insures more than 40 million people worldwide. It is a
leading writer of insurance products marketed at the
worksite in the United States, offering policies to
employees at more than 278,900 payroll accounts. The
company insures one out of four Japanese households
and is the largest life insurer in Japan in terms of individual
policies in force. In January 2003, AFLAC was the number
one insurance company in Fortune magazine's list of "The
100 Best Companies to Work for" and was included in the
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Term Life (PCR 8/16/2005)
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overall listing for the fifth consecutive year. In March 2003,
Fortune also included AFLAC in its annual listing of
"America's Most Admired Companies." And in July 2003,
Fortune named AFLAC to its list of "America's 50 Best
Companies for Minorities." AFLAC's Internet address is
aflac.com
Weaknesses 1) No spouse stand alone policy available.
2) Plan requires 7 health questions for coverage to
$50,000 and 11 health questions for coverage up to
$100,000.
3) Employees over age 50 only qualify for $50,000.
4) Available face amounts are low.
5) Plan is 5 year age banded.
AFLAC's term plan is 5 year age banded.
For internal UnumProvident educational and informational use only. This represents a comparison of selected policy provisions and does not represent an insurance
contract. While every effort is made to ensure that competitor information is current and complete, the comparison information is generic in nature and not able to reflect all
state-specific provisions or contracVpricing changes. Please consult the specimen policies for full information.
file://C:\Documents and Settings\jpalladino\Local Settings\Temporary Internet Files\OLKllD\Ter...
8/18/2005
Accident (PCR 8/17/2005)
Page 1 of6
UnumProvident Voluntary Workplace Benefits
Accident Product Comparison Report
Created 8/17/2005
UnumProvident AFLAC Personal Accident AFLAC Personal Accident AFLAC Personal Accident
Accident Insurance Expense Plus Expense Plus Expense Plus
Policy Series 33000 Policy Series 34100 Policy Series 34200
Plan Design
Contract Individual Individual, Income Individual Individual
replacement plan
Plan Type Plan 1 - on and off-job On/Off Job Coverage Accident On / Off Job On / Off Job
accident coverage
Plan2 - off-job accident
coverage
Plan 3 - on and off job
accident w/o CAT, AD&D
and lower hospital benefits
Benefit Amounts
Accident Followup $50 for one visit $25 for 6 visits AFLAC will pay $25 for one $35 for one treatment per
Treatment treatment per day for up to a day for up to a maximum of
maximum of 6 treatments 6 treatments per covered
per covered accident, per accident, per covered
covered person. person.
Accidental Death Named Ins. $25k Named Ins. $25k, $100 k Common Carrier: Named Common Carrier: $150,000
Spouse: $10k CC Insured and Spouse: for insured and spouse;
Child: $5k, Spouse: $10k, $50K CC $100,000; child: $15,000 $25,000 child
Benefit amount doubles if Child: $5k, 15k CC Other accidents: Insured Other accidents: $40,000
accident occurs on a (CC: Common Carrier) and Spouse: $25,000; child: insured and spouse;
common carrier. $7,500 $12,500 child
Plan 1 & 2 only
Accidental Dismemberment $15,000 Loss of both hands, Varied for EE, SP and CH - Both arms and both legs: Both arms and both legs:
feet, the sight of both eyes, EE $1,250, Sp $500, Ch Insured / Spouse: $25,000; Insured / Spouse: $40,000;
or any combination of two or $250 child: $7,500 child: $12,500
more losses. Single loss: EE $6,250, Sp - Two eyes, two feet, two Two eyes, two feet, two
$2,500, Ch $1,250 hands, two arms or two legs: hands, two arms or two legs:
$7,500 Loss of one hand, Double loss: EE $25,00, SP Insured / Spouse: $25,000; Insured / Spouse: $40,000;
foot, or sight in one eye. $10,000, Ch $5,000 child $7,500 child $12,500
- One eye, one foot, one One eye, one foot, one
$1,500 Loss of two or more hand, one arm, one leg: hand, one arm, one leg:
fingers, toes, or any Insured / Spouse: $6,250; Insured / Spouse: $10,000;
combination more than two. child: $1,875 child: $3,750
- One or more fingers or One or more fingers or toes:
$750 Loss of one finger or toes: Insured / Spouse: Insured / Spouse: $2,000;
toe. $1,250; Child: $600 Child: $625
- Loss of use does not Loss of use does not
constitute dismemberment, constitute dismemberment,
except for eye injuries except for eye injuries
resulting in permanent loss resulting in permanent loss
of vision such that central of vision such that central
visual acuity cannot be visual acuity cannot be
corrected to better than corrected to better than
20/20. 20/20.
Ambulance $100 $100 $150 for ground ambulance $200 for ground ambulance
Air $500 Air Ambulance - $500 transportation or $1,000 for transportation or $1,500 for
air ambulance air ambulance
transportation. transportation.
Appliance $100 $100 $125 if a person requires, as $125 if a person requires, as
advised by a physician, the advised by a physician, the
use of a medical appliance use of a medical appliance
as an aid in personal as an aid in personal
locomotion resulting from locomotion.
injuries sustained in a
covered accident. .
Blood/ Plasma & Platelets $300 $100 Pays an indemnity of $100 if $200 If a covered person
a covered person requires requires blood / plasma
blood/plasma and / or and/or platelets for the
platelets. treatment of injuries
sustained in a covered
accident.
Burn Flat amount for 2nd degree; Levels for 2nd Degree Burns treated by a Physician Burns treated by a Physician
$750 at least 36% of body $100-less than 10% within 72 hours after a within 72 hours after a
3rd degree $200-to 25% covered accident: Benefits covered accident: benefits
9-34 Sq inch - $1,500 $500-to 35% based on degree and size of range from $125to $12,500
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35+ Sq inches - $10,000 $1,000, over 35% the burn and range from depending on the degree
Skin Grafts - 25% of burn 3rd Degree $100 to $10,000. and size of the burn. If a
benefit Up to 35 Sq.inch $7,000 If a covered person receives covered person receives
(sized based) one or more skin grafts for a one or more skin grafts for a
35Sq.inch+ - $10,000 covered burn, AFLAC will covered burn, AFLAC will
Skin Grafts - 25% of burn pay a total of 50% of the pay a total of 50% of the
benefit burn benefit paid for the burn benefit paid for the
burn involved. burn involved.
Care None None $25 for one treatment per $35 for one treatment per
day for up to a maximum of day for up to a maximum of
6 treatments per covered 6 treatments per covered
accident, per covered accident, per covered
person person.
Catastrophic Accident Names insured - $100,000 None See Accidental Death I See Accidental Death and
(<65 years) Accidental Dismemberment Dismemberment
Spouse or Child - $50,000
(<65 years)
Age 65-69, Amount reduced
by 50%
Age 70+, Amount reduced
by 75%
pays for loss of use of sight,
hearing, speech, arms or
legs. 1 yr elimination
Coma None $10,000 after 30 days Coma duration of at least 7 Duration of at least 7 days:
days and requiring $12,500
intubation for respiratory
assistance: $10,000
Concussion $100 with CT scan $200 (EEG abnormalities) $50.00 $50
Dislocations Closed - up to $2,000 Closed - up to $500 AFLAC will pay for no more AFLAC will pay for no more
Open - up to $4,000 than 2 dislocations per than 2 dislocations per
Reduction without covered accident, per covered accident, per
anesthesia 25% covered person: Benefits covered person: Benefits
depend on open or closed range from $65 to $2,500
reduction and the part of the depending on if the repair is
body. If a dislocation is open or closed and the part
reduced with local or no of the body. If a dislocation
anesthesia by a Physician, is reduced with local or no
AFLAC will pay 25% of the anesthesia by a Physician,
amount shown for closed AFLAC will pay 25% of the
Reduction Dislocation. amount shown for closed
Reduction Dislocation.
Doctor's Office $50 initial visit See Emergency Treatment See Accident-Follow Up See Accident-Follow Up
Treatment Treatment
Emergency Room Level Benefit Varied benefit $120 for the insured I $120 for the insured I
Treatment EE, SP, Child $150 includes EE/Sp $120, Child $70 spouse and $70 for children spouse and $70 for children
x-rays includes x-rays, doctor's for injuries sustained in a for injuries sustained in a
office, or hospital emergency covered accident. This covered accident. This
room treatment. benefit is payable for X-rays, benefit is payable for X-rays,
treatment by a physician or treatment by a physician or
treatment received in an treatment received in an
emergency room. emergency room.
Emergency Dental Work $50 (w/extractions) & $150 $50 (wi extraction) & Broken Teeth repaired with Broken Teeth repaired with
(wi crown) $150 (w/crown) crowns $150 crowns: $200
Broken Teeth resulting in Broken Teeth resulting in
extractions $ 50 extractions: $65
AFLAC will pay for no more
AFLAC will pay for no more than one dental benefit per
than one dental benefit per covered accident, per
covered accident, per covered person.
covered person.
Eye Injury $200 - surgery $250 - surgery Surgical repair: $300 Surgical repair $300
$200 - removal of foreign $50 - removal of foreign Removal of a foreign body Removal of a foreign body
body body by a Physician: $65 by a Physician: $65
Fractures Up to $5,000 - Open Up to $2,000 - Open AFLAC will pay 25% of the AFLAC will pay 25% of the
Up to $2,500 - Closed Up to $1,000 - Closed amount for closed reduction amount for closed reduction
Chips 25% of closed amount Chips 25% of closed amount for chip fractures and other for chip fractures and other
fractures not reduced by fractures not reduced by
open or closed reduction. open or closed reduction.
Benefits range from $150 to Benefits range from $150 to
$2,000 for fracture $2,000 for fracture
treatment, open or closed. treatment, open or closed.
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Hospital Admission $750 per admission per $1,000 once per year per Pays an indemnity of $1 ,000 $1,000 when a covered
covered person covered person when a covered person is person is confined to a
confined to a hospital hospital ($2,000 if admitted
($1,500 if admitted directly directly to ICU) for at least
to ICU) for at least 24 hours 24 hours for injuries
for injuries sustained in a sustained in a covered
covered accident. accident.
Hospital Confinement $200/day, up to 365 days $200/day, up to 365 days Pays an indemnity of $200 $250 for each day for which
for each day of hospital a covered person is charged
confinement for which a for a room and confined to a
covered person is charged hospital for at least 18 hours
for a room when a covered for treatment of injuries
person is confined to a sustained in a covered
hospital for at least 18 hours accident. Payable up to 365
for treatment of injuries days.
sustained in a covered
accident. Payable up to 365
days.
Hospital Intensive Care Unit $400/day up to 15 days $400/day up to 15 days AFLAC will pay an additional $400 each day a covered
$400 each day a covered person is confined and
person is confined and charged for a room in an
charged for a room in an intensive care unit and
intensive care unit and receiving the Hospital
receiving the Hospital Confinement Benefit.
Confinement Benefit. Payable up to 15 days per
Payable up to 15 days per covered accident, per
covered accident, per covered person.
covered person.
Knee Cartilage - Torn $500, $100 exploratory $500 $500 $625
Laceration $25 - $400 $25 - $400 Lacerations requiring Lacerations requiring
sutures must be repaired sutures must be repaired
within 72 hours after the within 72 hours after the
accident and repaired under accident and repaired under
the attendance of a the attendance of a
Physician: Benefits range Physician: Benefits range
from $25 to $400 depending from $35 to $500 depending
on size. on size.
Lodging $100 I night up to 30 days $100/night, up to 30 days Lodging: pays an indemnity Lodging: pays an indemnity
of $100 per night for one of $125 per night for one
motel I hotel room for a motel I hotel room for a
member(s) of the immediate member(s) of the immediate
family. The hospital and family. The hospital and
motel I hotel must be more motel I hotel must be more
than 100 miles from the than 100 miles from the
residence of the covered residence of the covered
person. Payable up to 30 person. Payable up to 30
days per covered accident. days per covered accident.
Paralysis None. See CAT Accident Quadriplegia: $10,000; Quadriplegia: $12,500
Paraplegia: $ 5,000 Paraplegia: $ 6,250
The duration of the Paralysis The duration of the Paralysis
must be a minimum of 30 must be a minimum of 30
days. This benefit will be days. This benefit will be
payable once per covered payable once per covered
person. person.
Physical Therapy $25 for 6 treatments $25 for 6 treatments $25 per treatment, one $35 per treatment, one
treatment per day for a treatment per day for a
maximum of 10 treatments maximum of 10 treatments
per covered accident, per per covered accident, per
covered person. covered person.
Prosthetic Device I Artifical $500 for one Prosthetic $500 Payable once per $750 Payable once per
Limb Device I Artifical Limb covered accident per covered accident per
$1,000 for more than one covered person. This benefit covered person. This benefit
Device or Limb does not apply to hearing does not apply to hearing
aids, wigs or dental aids aids, wigs or dental aids
such as false teeth. such as false teeth.
Ruptured Disc $400 $500 $500 $625
Surgery Benefit, (open $1,000 excluding hernias $1,000 includes hernia $1,000 Open abdominal (including
abdominal, thoracic) $100 exploratory $250 exploratory exploratory laparotomy),
cranial, hernia or thoracic
surgery: $1,250
Miscellaneous surgery
requiring general anesthesia
that is not covered by any
other specific-sum injury
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benefit (only one
miscellaneous surgery
benefit is payable per 24-
hour period even though
more than one surgical
procedure may be
performed): $300
Tendon/Ligament and Repair of one Tendon, Repair T/L - $500 Tendons or Ligaments, Torn Tendons or Ligaments, Torn
Rotator Cuff Ligament or Rotator Cuff - Repair R/C - $250 one, $500 Rotator Cuffs, or Torn Knee Rotator Cuffs, or Torn Knee
$400 1+ Cartilage: $500 Cartilage: $625
Repair more than one - $250 Arthroscopic Arthroscopy without surgical Arthroscopy without surgical
$600, repair $250 repair: $300
Exploratory arthroscopic
with no repair - $100
Transportation $300 over 100 miles (up to 3 $300, over 100 mile, 3 trips Pays an amount of $400 per $600 per round trip if a
trips) round trip if a covered covered person requires
person requires special special treatment and
treatment and confinement confinement in a hospital for
in a hospital for injuries injuries sustained in a
sustained in a covered covered accident. Payable
accident. Payable for up to 3 for up to 3 trips per calendar
trips per calendar year per year per covered person.
covered person. Hospital Hospital must be more than
must be more than 100 100 miles from home or the
miles from home or the covered accident.
covered accident.
X-ray or Major Diagnostic Included in Emergency Included in Emergency $150 for CT scan, MRI or $200 if a covered person
Tests Treatment Treatment EEG. The exam must be requires one of the following
performed in a hospital, a exams for injuries sustained
physician's office, or an in a covered accident: CT
ambulatory surgical center, scan, MRI or EEG. The
and a charge must be exam must be performed in
incurred. This benefit is a hospital, a physician's
limited to one payment per office, or an ambulatory
calendar year per covered surgical center, and a
person. charge must be incurred.
This benefit is limited to one
payment per calendar year
per covered person.
Monthly Income Rider Available Rider available Rider available
Replacement Benefit
Elimination Periods N/A 0, 7 day N/A N/A
Available
Benefit Periods Available N/A 6, 12 month N/A N/A
Employee Eligibility
Actively at Work Required Required Required
Issue Ages Base Plans 1,2 & 3 Not addressed 18 to 64 18-64
0-80 Employee & Spouse
0-24 Children
Accident Only &
AccidenUSickness Disability
Rider
17-67 Employee & Spouse
Sickness Hospital
Confinement Rider
14 days-67 Employee &
Spouse
14 days-24 Children
Underwriting
Guaranteed Issue Plan 1,2 & 3 and the Not available Not available
Accident Only Disability
Income Rider are
guaranteed issue.
Simplified Issue AccidenU Sickness Disability Detailed information not
Income Rider and the provided.
Sickness Hospital Health questions are
Confinement Rider required for riders.
Definitions
Accident I I Not addressed. I Defined as Accidental Death I Defined as Accidental Death
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Accident (PCR 8/17/2005) Page 5 of 6
or Dismemberment: caused or Dismemberment: caused
by an accident that occurs by an accident that occurs
on or after the effective date on or after the effective date
of coverage and while of coverage and while
coverage is in force, coverage is in force,
independent of disease, independent of disease,
bodily infirmity or any other bodily infirmity or any other
cause. See Limitations and cause. See Limitations and
Exclusions for items not Exclusions for items not
covered by this policy. covered by this policy.
Riders
Disability Income Riders Off the Job Accident only Off-Job only Accident Off-the-job and On-the-job Off-the-job and On-the-job
DisabilityRider: Employee or Disability Rider riders are available with riders are available with
Spouse EE only $700 - $2,000 per Elimination Periods of 0 or 7 Elimination Periods of 0 or 7
Employee $400 - $1,500 per month days and benefit periods of days and benefit periods of
month 6 or 12 months. 6 or 12 months.
Spouse - $500 per month Sickness & Off Job Accident
zero day EP, 6 or 12 month Disability Rider
BP EE only $400 - $2,000 per
month
Sickness & Off Job Accident
Disability Rider: Employee On Job Accident Only
or Spouse Disability Rider
Employee $400 - $1,500 per EE only $400 - $1,000 per
month month
Spouse - $500 per month
on, 0/14, 7/7, 14/14 EP's, 6
or 12 month BP
On Job Accident Only
Disability Rider: will file but
not release.
Sickness Hospital Rider $100 per day up to 30 days Not Addressed
per year. (ee premium-
$3.51/month)
Reduced Child benefit
$75/day, up to 30 days
Health Questions required
for Employee and Spouse.
No Health Questions
required for Children.
Wellness Rider Not available Included in base plan Included in base policy: Included in base policy:
coverage. Wellness Benefit: pays $60 Wellness Benefit: pays $60
$601 one time per year, 12 for routine examinations or for routine examinations or
month waiting period other preventive testing after other preventive testing after
the policy has been in force the policy has been in force
for 12 months. Payable once for 12 months. Payable once
per policy year for treatment per policy year for treatment
received during that year. received during that year.
Spouse Accident Disability Benefit Not Available Spouse Off-the-Job Spouse Off-the-Job
Disability Rider available Disability Rider available
with a 6 month benefit with a 6 month benefit
period, zero day EP period, zero day EP
Premium
Classification Monthly Premiums Base plan - Unisex, Uni- Base plan - Unisex, Uni- Base plan - Unisex, Uni-
tobacco, Uni-age tobacco, Un i-age tobacco, Uni-age
Occupation Distinct - Class Occupation Distinct - Class Occupation Distinct - Class
A, B, C, D, Composite A,B,C,D A,B,C,D,E
Premium Comparison
Occ Classification Composite Rates 24 Hour Plan 1 $700 Off Job Base plan - Unisex, Uni- Base plan - Unisex, Uni-
Acc. Disability Rider tobacco, Uni-age tobacco, Uni-age
Occupation Distinct - Class Occupation Distinct - Class
A,B,C,D A,B,C,D,E
Plan Type 1 Rider Base Plan 1 - on/off job Base Policy Only Rates per Base Policy Only Rates per
coverage month month
$700 off Job Disability Rider
Sickness Hospital
Confinement Rider
Individual Premiums Base Plan - $16.38 Class B - $17.50 1 $7.70 Class A: $15.90 monthly Class A: $19.40 monthly
Disability Rider - $8.19 Class C - $23.901 $9.10 Class B: $19.80 monthly Class B: $24.10 monthly
SHCR - $3.51 Class C: $23.90 monthly Class C: $28.70 monthly
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Premium Mode I (EPI BP)
monthly I (0112)
monthly 1(0/14/12)
Class DIE: $28.40 monthly
Monthly
Class DIE: $34.10 monthly
Monthly
For internal UnumProvident educational and informational use only. This represents a comparison of selected policy provisions and does not represent an insurance
contract. While every effort is made to ensure that competitor information is current and complete, the comparison information is generic in nature and not able to reflect all
state-specific provisions or contract/pricing changes. Please consult the specimen policies for full information
file://C:\Documents and Settings\jpalladino\Local Settings\Temporary Internet Files\OLKllD\Acci... 8/18/2005
Short Term Disability (PCR 8/17/2005)
Page 1 of2
UnumProvident Voluntary Workplace Benefits
Short Term Disability Product Comparison Report
Created 8/17/2005
unumprovident Aflac
Short Term Disability (2005) Personal Short Term Disability 57200157400
Plan Design
Contract Individual (ISTD-05) Individual A-57200IA-57400
Plan Type Non Occupation 24 Hour sickness or off-the-job injury
Select
24 Hour
Elimination Periods 017,7/7,0114,14114,0/30,30130,60/60,90/90,180/180 0/7,0/14,7/14,0/30,30130,60/60,90190, 180/180
Benefit Periods 3,6, 12,24,60 months 57200: 6, 12,24 months
57400: 3 ,6, 12,24 months
Benefit Amounts
Monthly Minimum $400 57200: $400
57400: $500
Monthly Maximum Salary Coverage of up to 60%. Benefit amounts up to 57200 $3,000
$5,000 in $100 increments. 57400: $5,000
Employee Eligibility
Issue Ages 17-69 18-64
Actively at Work Must be actively at work on a full time basis (20 hr/week) Working a full time job (30 hours or more)
Salary Requirements Yes Yes
Underwriting
Guaranteed Issue - Based on participation of 20% Not Available
- 50% of salary up to $5,000
_ Insured must answer Mllevel underwriting, If 20%
participation is achieved, GI will be available on a
retroactive basis.
Modified Issue -All employees must answer questions Available for face amounts of $500 to $2,000.
- 3 Health questions 14 questions with 4 additional if 4 questions are answered
yes.
Simplified Issue Benefit amounts greater than 50% of income 22 Health Questions may be required based on answers to
4 yes/no Health Questions. Give details if answers are specific questions.
"yes",
Risk Classes Industry Rate Classification A, B, C risk classes
AAA, AA, A B - See Rate manual
Definitions
Definition of Disability _ Own Occupation (first 24months) and not engaged in any If working full time unable to work in your full time job and
other occupation earn atleats 80% of earnings in any job considered
_ Any Occupation (after 24 months) if applicable disabled. 2 of 5 ADL (continence, transferring, dressing,
toileting, eating) loss required if working less than full time.
Disability must begin within 90 days of lasttreatmenl.
Pre-existing Provision 12/12 12/12 Pre-existing conditions will not be covered unless it
begins more than 12 months after the effective date of
coverage. A sickness not covered until 30 days after policy
is in force.
Recurrent Disability 6 months, same disability 180 days, same disability
Pregnancy No benefits will be paid for losses caused by or occur as a Pregnancy covered to same extent as sickness. Excluded
result of giving birth within the first 9 months of the policy if delivery is within the first 10 months of the effective date.
Effective Date. BP for cesarean delivery is 8 weeks less EP or 6 weeks for
Medical complications of a pregnancy will be covered if the non-cesarean delivery.
medical complication otherwise meets the definition of a
covered Sickness.
Pregnancy is considered as any other covered Sickness
nine months after the Policy Effective Date, subject to the
elimination period and pre-existing conditions clauses.
Mental Disorders _ Mental Illness without demonstrable organic disease is Not covered
excluded.
_ Mental Illness Rider - covers disability due to mental
illness. Must be elected at the account level. All insureds
will receive this rider. Additional Premium
Exclusions _ We will not pay benefits for losses that are caused by or * Giving birth within the first 10 months of the effective date
occur as the result of: of this policy as a result of a normal pregnancy
-War or act of war, whether declared or undeclared; Complications will be covered to the same extent as a
-Riding in or driving any motor-driven vehicle in a race, sickness
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Short Term Disability (PCR 8/17/2005)
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stunt show or speed test; 'Being intoxicated or under the influence of any controlled
-Operating, learning to operate, serving as a crewmember substance, unless administered on the advice of a
of or jumping or falling from any aircraft, including those physician;
which are not motor-driven. This does not include flying as 'Participating in any activity or event, including the
a fare paying passenger; operation of a vehickle, while under the influence of a
-Engaging in hang-gliding, bungee jumping, parachuting, controlled substance or while intoxicated.
sail gliding, parasailing or parakiting or any similar 'Mountaineering using ropes and or other equipment,
activities; parachuting or hang gliding;
-Participating or attempting to participate in an illegal 'Participating in, an illegal activity that is defined as a
activity andlor being incarcerated in a penal institution; felony
-Committing or trying to commit suicide or injuring yourself 'Intentionally self-inflicting a bodily injury or attempting
intentionally, whether you are sane or not; suicide, while sane or insane.
-Addiction to alcohol or drugs, except for drugs taken as 'Having cosmetic surgery or other elective procedures that
prescribed by your Physician; are not medically necessary or having dental treatment
-Having a Pre-Existing Condition as described and limited except as a result of an injury.
in this policy; 'Being exposed to war or any act of war
-Practicing for or participating in any semi-professional or 'Participating in any form of flight aviation other than as a
professional competitive athletic contest for which you fare-paying passenger in a fully-liscensedl passenger-
receive any type of compensation or remuneration; carriying aircraft.
-Having a psychiatric or psychological condition including 'Participating in any sport or sporting activity for wage,
but not limited to affective disorders, neuroses, anxiety, compensation or profit or racing any type of vehicle in an
stress and adjustment reactions. However, Alzheimer's organized event.
disease and other organic senile dementias are covered 'Being totally disabled while outside the territorial limits of
under this policy; the US.
-Having a work-related Injury, unless an On-Job Total ' Psychotic disorders, bipolar disorder, delusional
Disability benefit is shown on the Policy Schedule; disorders, somatoform disorders, eating disorder
-Giving birth within the first nine months after the Coverage
Effective Date as the result of a normal pregnancy,
including Cesarean. Complications of a pregnancy will be
covered to the same extent as any other Covered
Sickness
Additional Features
Coverage Effective Effective the first day of the month in which payroll The Effective date of the policy and riders will be the date
deductions begin. shown in the Policy Schedule, not the date the application
is signed.
Guarantee Renewable Guaranteed Renewable to age 72. Guaranteed Renewable to Age 70.
Portable Yes Fully Portable
Riders
Waiver of Premium Premiums are waived after 90 days of total disability (or Not Addressed
after the elimination period if longer than 90 days).
Premiums are waived up to the maximum benefit period.
Other Rider On-Job Injury Rider - account level
Premiums
Design Unisex Unisex
Unitobacco Unitobacco
Level premium Level premium
Age banded Age banded
Age Bands 17 -49, 50-69 18-49
50-64
Rates
Monthly Premium for a AAA/AA/A/B B Rates (Accounting Firms, Governmental Accounts,
$1,000 Benefit Industry Rate Classification Health Services-Hospitals, textile Mills, etc.)
57400
Elimination 1 Benefit Period 30/30112 30/30/12
35 $19.11/$21.71/$25.53/$29.34 $25.00
45 $19.11/$21.71/$25.53/$29.34 $25.00
55 $26.831 $30.34 1 $35.711 $41.04 $36.00
60 $26.831 $30.34 1 $35.711 $41.04 $36.00
For internal UnumProvident educational and informational use only. This represents a comparison of selected policy provisions and does not represent an insurance
contract. VVhile every effort is made to ensure that competitor information is current and complete, the comparison information is generic in nature and not able to refiect all
state-specific provisions or contract/pricing changes. Please consult the specimen policies for full information.
file:/ /C: \Documents and Settings\jpalladino \Local Settings\ Temporary Internet Files\O LK 11 D\Shor... 8/18/2005