Group Life & Disability Trust Products For small group employers Provided by Mosaic Group and USAble Life

Mosaic GroupSM1

is an authorized agency of:

Life+ Payable upon death, regardless of cause.+ If an insured becomes totally disabled prior to age 60, and

remains totally disabled without interruption for at least 6 months, he or she may apply for a waiver of premium.

+ Full conversion privilege without medical evidence upon termination of employment.

+ Lifebenefitswillreduceby35%oftheoriginalamountat age65,andby50%oftheoriginalamountatage70.

+ Evidence of Insurability satisfactory to USAble Life is required foralllateentrants,includingtheirentirebenefitamount.Fornew enrollees, satisfactory evidence of insurability is only required for life amounts in excess of thefollowingbenefitlevels:

+ Thelifeinsurancebenefitforclasseswith$15,000ormorewillincludeanAcceleratedDeathBenefitatnoadditionalcost.Askyourgrouprepresentativefordetailsaboutthisbenefit.

Dependent Life + Available in conjunction with employee group life insurance.

Once elected, the plan automatically covers additional dependents as they become eligible.

+ Providesalifeinsurancebenefitfortheinsured’sspouse andeligiblechildren(unmarriedchildrenfrombirthto19yearsor 26 years and dependent upon the insured for support).

+ Dependentsmaynotbehospitalconfinedwhen coverage begins.

+ Fullconversionavailableuponterminationofemployee’sinsurance or when dependent reaches the limiting age.

Short-Term Disability (STD)+ Benefitsarepayablefirstdayforaccidentsandeighthday forsicknessorpregnancy.

+ Choiceoftwobenefitdurations:13or26weeks.+ Weeklybenefitissubjecttoamaximumof662/3%ofweeklyincome(excludingbonuses,overtimeoranyextracompensation)andmaynotexceed$500.

+ NoSTDbenefitsarepayablefordisabilitiesforwhichanemployeeiseligibleforbenefitsunderWorker’s Compensationoranysimilarlaw.

Accidental Death & Dismemberment (AD&D)+ 24-hourcoverage,onandoffthejob.+ Principalsumequalsthelifeinsurancebenefitandissubject tothesamereductionschedule.

+ Principalsumispayableforlossoflifeoranytwomembers:hands,feetoreyes;andonehalftheprincipalsumpayable forlossofanyonemember.

AD&D limitationsBenefitsshallnotbepayableforanylossresultingfrom:self-destructionoranyattemptthreat;travelorflightin,ordescentfromanykindofaircraft,unlesstheinsuredisafare-payingpassengerofacommercialairlinewithoutanydutiesinconnectionwithsuchtravel,flightordescent;anyinsurrectionorfromwaroranactofwar,whetherdeclaredorundeclared;serviceinthemilitary(land,seaorair)forcesofanycountry,combinationofcountriesorinternationalorganizationatwar;participationinorattempttocommitanassaultoffelony; takinganydrug,exceptasprescribedbyaphysician,orthevoluntarytakingofpoisonorinhalingofgas;bodilyormentalinfirmityordisease;ptomaines,orbacterialinfectionother thaninfectionsoccurringinconsequenceofanyaccidental injurytothebody.

Mosaic Group is a full-service insurance agency that partners with multiple insurance carriers to offer you flexible choices, better benefit programs and competitive rates. More than 6,9691 companies across North Carolina count on us to provide benefits to complement their employer-sponsored health plans. Let us know how we can help you customize a plan that’s right for your company.

General Provisions for Group Life & Disability Trust Products + Products underwritten by USAble Life, recognized as among the 50 top-performing insurance

companies in the nation.2

+ Late applications for contributory coverage are subject to satisfactory Evidence of Insurability.

+ Coverage is subject to the Actively at Work and Evidence of Insurability requirements of the policy. Employees who are not Actively at Work on their effective date of coverage will not be insured until the day they return to work. Amounts of insurance for which Evidence of Insurability is required will be effective on the first of the month following the approval date.

+ If benefits are selected by occupational class, there must be at least one eligible employee in each class; and no class may have a benefit greater than two times the amount for the next lower class.

+ All benefits terminate at retirement.

Give your employees the protection they need

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WHOIT’SFOR

Eligibility requirements for small-group employers

North Carolina employer groups must have 1 to 9 eligible employees to be eligible for coverage.

Full-time employees, partners and officers (working 30 hours a week) at work on the effective date of the plan may be covered on that date.

At least 75% of the eligible employees must enroll if contributory; all employees must enroll if non-contributory.

The employer must contribute at least 25% of the cost of the benefit plan.

Group size Guarantee issue

One life $15,000

2-9 lives $35,000

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NOTE: Products underwritten by USAble Life.1 Mosaic Group internal data, December 2016 2 Ward Group, a McLagan/Aon Hewitt Company, www.wardinc.com/wards50/life-health.php (Accessed March 2017)

3 Blue 20/20 is available only to groups of 51+ members.

BLUE CROSS®, BLUE SHIELD®, the cross and shield symbols and service marks are marks of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. All USAble marks indicated are owned by USAble Life. All SM1 marks are owned by Blue Cross and Blue Shield of North Carolina (BCBSNC). BCBSNC is an independent licensee of the Blue Cross and Blue Shield Association. U9150, 4/17

Long-Term Disability (LTD) for 2 to 9 employees+ Maximum monthly benefit – 60% of basic monthly earnings to $6,000 a month;

insured earnings to $120,000 a year. (Basic monthly earnings does not include bonuses, overtime or extra compensation other than commissions. Commissions will be averaged over the 12-month period prior to the date disability began.)

+ Progressive partial disability benefit – Provides an opportunity through a combination of earnings and benefits to receive up to 100% of pre-disability income. Naturally, the LTD Benefit is limited to the plan’s maximum. To be eligible for progressive partial disability benefits, a claimant must be earning less than 80% of his pre-disability earnings.

+ Elimination periods – Choose either 90 or 180 days.

+ Benefits payable for 5 years (if group has 2 to 4 covered employees) or to age 65 (if group has 5 to 9 covered employees) with reducing benefit duration in compliance with Age Discrimination in Employment Act (ADEA).

+ Definition of disability – For the first 24 months of disability, the employee is considered totally disabled if he or she is unable to perform the material duties of his or her regular occupation. After 24 months, the employee is considered disabled if he or she is unable to perform the material duties of any gainful occupation for which he or she is reasonably fitted by training, education and experience.

+ Full family integration – Benefits paid under this plan will be reduced by disability benefits received from worker’s compensation, Social Security, other group disability income plans, and any other income benefits as defined in the master policy.

LTD limitations & exclusions+ 12/6/24 pre-existing condition exclusion – Benefits will not be paid for disabilities

resulting from conditions for which an insured received treatment 12 months prior to the effective date. This exclusion no longer applies to a disability which begins more than 24 months after the insured’s effective date. This exclusion no longer applies if an insured has been treatment free for 6 months after the effective date.

+ 24-month mental illness and substance abuse limitation – Benefits for a disability resulting from mental illness or substance abuse are payable as any sickness for 24 months, and beyond the 24 months if institutionalized.

+ General exclusions – No benefits are payable for disabilities resulting from war or acts of war, intentionally self-inflicted injuries, or active participation in a riot.

LTD underwriting guidelines• Certain industries are not eligible for this

LTD program. • Employees working less than 30 hours per

week are not eligible.• Groups with more than 50% of the insured’s

over age 50 are not eligible.• Groups which have been engaged in business

less than 2 years are not eligible.• No evidence of insurability is required, except

for late entrants on contributory plans.• Participation requirement: 75% for

contributory groups and 100% for non-contributory groups.

• Groups in which more than 50% of the employees are members of the same immediate family are not eligible unless the family members have been actively at work for two years prior to the effective date.

• LTD must be sold in combination with Life and AD&D benefits.

• Minimum employer contribution is 25% of premium.

To learn more about how Mosaic Group can help complete your employee benefits package, contact us at 1-888-723-4476.

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HELP?

Mosaic Group also offers Blue Cross and Blue Shield of North Carolina products including all Dental Blue® products and Blue 20/20SM, 3.

Mosaic GroupSM1

is an authorized agency of: