for associations, affinity groups, employers, and individuals · 2014. 2. 13. · • provide an...

Administered by:

Member Benefits Program

Offered through:

Toll Free 1-877-925-1840

For Associations, Affinity Groups, Employers, and Individuals


Call 888-SBUA-INS (888-728-2467) Managed by ETMG, LLC License #1544170 2 of 2

May 16, 2011 11:45 AM

About ETMG, LLC 3

About Small Business United 4

Enrollment & Servicing Technology Platform 5

Member Benefits 6

Client Testimonials 7

SBU Group Indemnity Plans - Employer Sponsored 9

SBU Group Indemnity Plans - Voluntary 13

SBU2 HealthValu Plans 17

SBU2 HealthSelect Plans 23

SBU2 CriticalMed Plans 28

Major Medical Plans - Groups of 10+ 31

Prudential Life & Disability Insurance 33

Ameritas Group Dental 37

EyeMed Vision Benefits 39

SBU Multiple Employer 401(k) Plan 41

Individual(k) Retirement Plan 48

Long Term Care Insurance 50

Medicare Supplemental & Medicare Advantage Plans 52

Contact Information

Albert PomalesBenefit Specialist LeadETMG, LLC

6300 Bridgepoint ParkwayBuilding One, Suite 480Austin, TX 78730

512.279.5600 main512.279.5605 direct512.682.8795 fax888.US1.ETMG toll [email protected]

Jeff BurnsChief Operations OfficerETMG, LLC



Kevin WolterBenefit SpecialistETMG, LLC



Curt EstesBusiness DevelopmentETMG, LLC



Phil HutsonBenefit SpecialistETMG, LLC



Kayde CampbellBenefit SpecialistETMG, LLC





May 16, 2011 11:45 AM

The Executive Team

What is ETMG and what is its role?

• A for-profit Texas limited liability company in situs in Austin, TX.• Managing General Agency & General Agency• Third Party Administrator TDI COA #14869• Premium Collection Agency • Develops and markets employee benefit programs and insurance management solutions

for employees of small businesses. • Target market is trade associations, 1099 affiliated contractor groups, interest groups, professional

employer organizations (PEOs), unions, and organizations comprised of or serving small businesses. • SBU is the initial association client of ETMG. • Dedicated to making available, on a large scale, welfare programs for its clients and their members.

About ETMG, LLC

TOM NEWBY President, Co-Founder

Sales and Product Development. Awarded Forbes Magazine Top 10 Health Insurance Brokerages (out of of 25,000) two consecutive years with his previous successful brokerage Global Benefit Solutions.

MARK ADAMS CEO, Executive Chairman & Co-Founder

Corporate Governance, strategic direction, and Investor Relations. Built numerous successful businesses into multi-million dollar ventures. Awarded Ernst and Young’s prestigious “Entrepreneur of the Year Award”.

JOHN CONSTANTINE Vice Chairman & Co-Founder

Corporate Governance, strategic direction, and Investor Relations. Successful Entrepreneur and managing partner of several Texas Surgical Centers. Mr. John Constantine has over 20 years experience in the healthcare field, including business management, investments, marketing and public relations.

JEFF BURNS Chief Operating Officer

Ongoing leadership and implementation of the companies’ strategic business plan, including infrastructure development, operations, management, and optimization of technical and administrative processes. Previous Co-founder of a $40M Austin-based technology start-up with over 20 years experience in technology and management.

OLIVER SANDLIN Corporate Legal Counsel

ETMG Corporate governance, licensing, and regulatory compliance. Principal Sandlin Law Firm, Austin, Texas.



May 16, 2011 11:45 AM

About Small Business United

Small Business United (SBU) is a non-profit association headquartered in Austin, Texas. SBU pools its members’ purchasing power to offer them discounts on office supplies, access to legal and HR networks at a reduced rate, and group-rated health insurance through ETMG, LLC. SBU knows that each association has different needs, and we work hard to tailor our solutions and offerings to your situation.

SBU and ETMG, LLC don’t just offer great benefits to your association members. Up to 10% of the revenue generated by ETMG, LLC and SBU programs and products is payable to the sponsoring association.

What is SBU and what is its role?



May 16, 2011 11:45 AM

Enrollment & Servicing Technology Platform

Enrollment Solution Flexibility• Any benefit – core and/or worksite, administrative• Any method – laptop, call center, Internet, combo• Any time frame – annual, perpetual, subscription• Efficiency – interview timer, 24/7 supervision• Topaz signatures or PIN Voice• HIPAA compliant

Member Calls into Call CenterLicensed Call Center Representative asks several defining questions to guide them & select the appropriate plan.

No Pre-existing conditions

Not currently insured

|

Provided multiple options from multiple carriers

|

Review options:- Desired premium

- Deductible- PPO, HMO, or HSA

Looking to lower cost Has health insurance

|Increase deductible

Add Limited Benefit Plan Lower monthly payment

|Monthly Payment

Current ded. ($1000) $500Increase ded. ($3000) $242 Add LBP $138 NEW TOTAL $380

Looking to lower cost Has health insurance

| |Risk pool

Enroll in PPOHigher deductible

Add Limited Benefit Plan

| |Monthly Payment

PPO ded. ($2500) $598

Monthly Payment

PPO ded. ($5000) $454 Add LBP $138 NEW TOTAL $592

ETMG In-House Call Center Services• Provide an Agency toll-free number for association member use in enrollment and servicing questions• Provide Tier 1 support for general servicing, support, and all monthly premium billing questions. Refer all provider specific servicing

and/or billing questions to the carrier support line as a Tier 2 support request.• Provide marketing with the assistance of Association to include html email marketing, Agency website page hosting specific to

Association products, outbound telephone marketing, fax broadcast marketing, association periodical marketing, and direct mail solicitation, as may be agreed upon by the parties.

• Annual Enrollment Assistance – Provide direction and information to employees regarding enrollment process.• Actual Enrollment by phone, laptop, web-based application, or other medium• Benefit Eligibility Verification – Resolution of inquiries regarding basic eligibility and coverage.• Benefits Enrollment (New Hire) – provide enrollment for new association members and document steps that a new member must

follow when electing for benefits.• Benefits Issue Resolution – Provide information, follow up and resolution on benefits related issues.• Benefits Termination – Provide information and follow up regarding benefit coverage and system updating related to terminations.• Billing Process – Coordination, administration, implementation, and audit of individual ACH billing for monthly premiums of enrolled

association members.• Provide Audit Reports of enrolled and billed members to Association or Association designee as periodically required to maintain

membership and enrollment reconciliation. Provide audit statements of Association Royalty Fees paid and tie back to Agency revenue generated by the program.

• Claims Exception Coordination – Document inquiries regarding possible claim appeals and forward to the client for review.• COBRA Coordination – Coordination of COBRA requests with third party administrator or carrier.• Current Benefit Election Review – Provide current election information to Association members.• Death Claim Process – Issue resolution and follow up regarding death claims.• Electronic Eligibility Process – Document how eligibility information is sent electronically.• Family Status Change Process – Coordinate family status change requests and forms.• Long Term Disability Process – Provide information regarding long-term disability coverage and benefits.• Supplemental/Voluntary Process - Provide information on voluntary/supplemental products, coverage, and benefits and offer

enrollment for these products.• Long Term Care Process – Provide information regarding long-term care coverage and benefits and offer enrollment as this program

becomes available and is introduced to the Association.• All insurance products offered by Agency to Association Members will insured by A- (as determined by AM Best) or better.

Where do you live?

Do you take any medication on a regular basis?

What is your desired premium range, deductible, HSA, etc.?

Do you have any current health concerns/issues?

Human Resource Solutions• Eliminate Paperwork Problems• Complete all forms online• Automated forms can be

printed from the Web



May 16, 2011 11:45 AM

Member Benefits

By joining Small Business United and leveraging the strength of our association’s combined purchasing volume, your small business, association, or individual members are able to obtain discounts on products and services available only to large corporations. A monthly $4.17 membership fee & $6.00 processing fee apply.

SBU’s HRAnswerLink was developed specifically for small to mid-sized businesses to provide a Human Resource (HR) service delivered via a customized website, email, and phone communications. SBU’s HR Support Center - $9.95 per month

• Access state and federal laws that pertain to your business• Customize an employee handbook, forms, policies, & letters

HR On-Demand Upgrade - $34.95 per Month

• Unlimited HR consultations & advice by telephone or email• Unlimited HR document customization

HRAnswerLink

Online HR Support 24x7!

Background Checks, Health & Safety Training, Business Training, Labor Law Posters, Salary Reports, and more!

Access a nationwide network of pre-qualified attorneys offering free or discounted legal care. Plan Attorney Benefits:

• Unlimited initial phone consultations for new legal matters.• Review 5 ten page business documents each month. • Calls made on behalf of your business (2 per month).

Follow up calls - Hourly rate of $125.• Letters written on behalf of your business (3 per month).

Follow up letters - Hourly rate of $125.• Initial collection letters (10 per month).

Additional/Follow-up letters - Hourly rate of $125 or contingency fee %• 30 Minute one-on-one consultations for each new legal matter.

Additional time - Hourly rate of $125.• Registered Agent in all states you are incorporated or do business in.

Legal Plan

Guaranteed Low Hourly Rates - Plan attorneys charge $125.00 per hour, or give members a 40% discount off their usual and customary hourly rate.

Retainers - Example: 10 hrs. x $125.00 = $1,250.00 retainer fee Any unused portion of the retainer will be returned.

Contingency Fee Discounts - This fee is expressed as a percentage of the amount collected or awarded. In collection matters, your attorney will accept 18% if the case is settled before formal court proceedings begin. After proceedings begin, the fee is 27%. On all other contingency matters there is a 10% discount on the lower of either the state maximum or the attorney’s standard rate.

SBU Legal Plan Membership - $24.95 per month

Discount Printer/Copier Parts and SuppliesSBU has partnered with one of the nation’s largest suppliers of office machine parts and consumables to bring its members excellent discounts on ink & toner for nearly every office printing and copy machine made by every major manufacturer—and then some. SBU offers 20%-40% off the list price for toner and inkjet supplies, and we stock materials for these manufacturers:

Receive free UPS Ground shipping on orders of $75 or more!

AB DickApple ComputerBrotherCanonCitizenCompaqCopystarDanka InfotecDanka Office Imaging KodakDellDexDigital Equipment CorporationDuploEpsonFrancotyp-PostaliaFujitsuGenicomGestetner

Graphic EnterprisesHaslerHitachiHPIBMIkonImagistics (Pitney Bowes)JetfaxKodakKonica MinoltaKyocera Mita LanierLexmarkMonroeMuratecNashuatecNECNeopost

OceOkidataOlympiaOmnifaxOutput TechnologiesPanasonic Rex RotaryRicohRisoRoyal CopystarSamsungSanyoSavinSharp Standard DuplicatingTeco Information SystemTektronixToshibaXerox

SBU has partnered with OfficeMax to offer members-only deep discounts and access to over 12,000 products through the Instant Purchasing Account (IPA). Your IPA provides savings on office supplies, technology, furniture and more.

• No order charge for purchases over $50 • Orders can be shipped to a residence

OfficeMax

SMALL BUSINESS UNITEDASSOCIATION

MEMBER DISCOUNT CARD8888-001-0560-0022-07



May 16, 2011 11:45 AM

Client Testimonials

Client Testimonials

“ETMG is always available and willing to help on insurance issues as they come up. Not only did they put together various options for coverage that would cover almost all needs of our individual employees, but they take care of all the details when a new member comes on or an employee leaves. We don’t have the expertise they have, so it is comforting to have that support there when you need it.”

-Brian PlaterVP Finance and Business Operations

Fifth Generation, Inc.

“I cannot tell you how much your help meant… We are working on re-launching a 300+ agent office as Keller Williams Realty, and health benefits was a real turning point in many of the associates’ decisions to join the brokerage. I appreciate your willingness to give me your office number, cell phone number and even letting me know when you were leaving the office for the evening. You rock. What you do makes a huge difference for our people, and we are so grateful.”

-Ellen M. MarksDirector of Marketing & Communications

Keller Williams Realty International

“Let’s get real honest. Insurance in general is a painful topic. It’s difficult to understand and navigate, is constantly changing, often contradicts itself and of course costs squeamish amounts of money. Many businesses wake up one day to realize not only are they throwing profit out the window, but they’re even doing that part all wrong. That was us until we partnered up with ETMG. When we went to market looking for a whole new look to our benefits package ETMG was among 5 groups we met with. They were the only management group that offered real solutions for a non-traditional group like Technology Navigators. They provide us with great service and even better products. We have more employees now with the security of having insurance than ever AND get this, it costs less! If that’s not enough of a reason to give them a call, I don’t know what is. ETMG takes the pain of out of Insurance and we’re happy to be a client.”

-Jamie BihlTechnology Navigators

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU Group Indemnity Plans Employer Sponsored



May 16, 2011 11:45 AM

PLAN 1 PLAN 2 PLAN 3

Office Visits - Physician/Licensed Practitioner Pays amount shown for sickness or injury visits to a doctor or licensed practitioner; also includes one wellness visit. May be used for services provided in a hospital emergency room or urgent care center.

$80 Per Visit - 6 Visit(s) $100 Per Visit - 8 Visit(s) $100 Per Visit - 8 Visit(s)

Daily In-Hospital Pays amount shown for hospitalization in a licensed facility as a result of an accident or sickness. Also covers Mental and Nervous and Alcohol and Substance Abuse treatment at 50% of the Daily In-Hospital benefit. (Total number of In-Hospital days and Intensive Care Unit days combined is limited to 30 days.)

$500 Per Day - 30 Days $1,000 Per Day - 30 Days $2,000 Per Day - 60 Days

Additional Daily Benefit for First Day of HospitalConfinementPays an amount equal to one day of the Daily In-Hospital benefit for the first day of confinement.

$500 First Day 1 Admission

$1,000 First Day 1 Admission


SurgeryPays amount shown for surgical procedures at a licensed hospital, outpatient facility or physician’s office as shown on the Schedule of Surgical Benefits.

$2,500 Per Surgery Based on Schedule 1 Surgery

$2,500 Per Surgery Based on Schedule

2 Surgery(ies)

$2,500 Per Surgery Based on Schedule

5 Surgery(ies)

AnesthesiaPays amount shown for anesthesia services provided during a surgical procedure at a licensed hospital, outpatient facility or physician’s office.

20% of Scheduled Surgical Benefit



Outpatient Diagnostic TestingPays amount shown per day for laboratory, imaging and testing services for accident or illness diagnosis in an outpatient setting.

$300 Per Day - 1 Day $300 Per Day - 3 Day $500 Per Day - 3 Day

Provider Network DiscountsCovered persons will receive contracted discounts from the usual and customary fees from network physicians, hospitals, outpatient diagnostic imaging and laboratory providers. Service is provided by MultiPlan. Information on participating providers can be obtained by going to www.hmcareadvantage.com and clicking on Member Information or by calling 800.672.2140.

Included Included Included

Hospital Emergency RoomPays amount shown for a non-work related injury or illness visit to an emergency room of a hospital or licensed facility. Limit one illness visit per calendar year. Additional illness visits paid at Office Visits benefit amount.

$300 Per Visit - 1 Visit $500 Per Visit - 1 Visit $500 Per Visit - 3 Visit(s)

Inpatient Visits - PhysicianPays amount shown for one physician visit per day while confined to a hospital for a covered sickness or accident.


Daily Intensive Care UnitPays amount shown for inpatient hospital intensive care services, including intensive care (ICU), coronary care (CCU), neonatal intensive care (NICU) and pediatric intensive care (PICU). (Total number of In-Hospital days and Intensive Care Unit days combined is limited to amount of Daily In-Hospital days.)

$1,000 Per Day Replaces Standard In-

Hospital Days


Hospital Days


Hospital Days

Outpatient Hospital Services (Includes Surgery Centers)Pays amount shown per treatment day for therapies and treatments performed on an outpatient basis.

$300 Per Treatment Day - 1 Day

$500 Per Treatment Day - 2 Day(s)


Wellness Screening TestPays amount shown for mammography, colonoscopy, flexible sigmoidoscopy or bone densitometry.

$75 Per Test - 1 Test $150 Per Test - 1 Test $150 Per Test - 1 Test

Wellness ServicePays amount shown for Pap test, PSA or immunization. $75 Per Service - 1 Service $75 Per Service - 1 Service $75 Per Service - 1 Service

Home Health CarePays amount shown for home visits for nursing care, home health aid service, physical, speech and occupational therapies, nutritional counseling and medical social services when prescribed by the covered person’s physician.

N/A $50 Per Visit - 5 Visit $50 Per Visit - 20 Visit

Ambulance ServicesPays amount shown for ground or air transportation by a licensed ambulance service. N/A $300 Per Trip - 3 Trip(s) $300 Per Trip - 3 Trip(s)

Outpatient Prescription Drug Insurance (2)

Provides prescription drug insurance with discounts and co-pays. Discounts apply before and after maximum is reached. Dependent-only coverage is not available. Outpatient Prescription Drug Insurance is underwritten by Fidelity Security Life Insurance Company. For a list of participating pharmacies or more information regarding prescription drugs covered under this plan, go to www.hmcareadvantage.com and click on MemberInformation or call 800.997.3784.

$15 CoPay Generic Formulary

$15 CoPay Generic Oral Formulary Contraceptives

Brand Name Not Covered $750 Max. Benefit



Brand Name Not Covered $1,000 Max. Benefit



$50 CoPay Brand Name Formulary

$1,000 Max. BenefitThis benefit summary provides a very brief description of the important features of your coverage. This is not the insurance contract, but only a summary of coverage. Only the Group Policy or Participation Certificate and the Certificate of Insurance contain the actual provisions, including exclusions and limitations, which control the terms of your coverage. This means that the Group Policy or Participation Certificate and the Certificate of Insurance set forth in detail the rights and obligations of both you, the Group Policyholder or Participating Employer and HM Life Insurance Company. Therefore, if you become insured, it is important that you READ YOUR CERTIFICATE CAREFULLY.

SBU Group Indemnity Plans - Employer Sponsored

HM CARE ADVANTAGE A LIMITED BENEFIT MEDICAL PLAN

HM Care Advantage [01/18/2011]

The long-awaited SBU Group Indemnity Plan is approved and available in the following states:TX, AZ, CA, CO, CT, DE, DC, GA, HI, IL, IN, IA, KS, LA, MI, NE, OH, PA, RI, TN, WA, and WV.This benefit summary is designed to provide an overview of the different plan options that are available and the cost for each of the plans. Benefits shown are per calendar year per covered person. The calendar year is the employer-defined benefit cycle. HM Care Advantage pays a fixed amount for medical services. Employees are responsible for additional balances not covered by insurance. Employees and spouses ages 18 to 69 years may enroll for coverage. Benefits terminate at age 70.



May 16, 2011 11:45 AM


Additional benefits included with your HM Care Advantage plan…For additional information, go to www.hmcareadvantage.com and click on Member Information, or call the numbers below.

Pharmacy Discount Card*Provides discounts for brand and generic drugs with no limits on the number of prescriptions filled. Service is provided by Caremark, Inc. To obtain a list of participating pharmacies, go to the HM Care Advantage Web site or call 877.321.2652.

Health Information On-CallAccess to a toll-free telephone line to talk with health coaches who provide information and support for health-related concerns. This service is available 24/7, 365 days a year. Service is provided by Health Dialog Services Corporation.

Vision Discount*Covered persons must use a participating network vision provider to receive this benefit which includes a covered eye exam and reduced cost for other services such as frames, spectacle lenses, contact lenses and laser vision care. Service is provided by Davis Vision. To obtain the name of a Davis Vision provider near you, go to the HM Care Advantage Web site or call 800.999.5431.

Complementary Wellness Discount ProgramDiscounts on health-related products and services, including fitness center memberships, chiropractic care, acupuncture, vitamins, massage therapy and more. Service is provided by Healthways WholeHealth Networks, Inc. To find participating service providers and retail outlets, go to the HM Care Advantage Web site.

Health Information On-LineInternet site providing lifestyle improvement programs, health information and resources on a range of topics, including tobacco cessation, nutrition, weight management, stress management, chronic conditions, back pain, insomnia, depression, diabetes and other general health topics. Service is provided by HealthMedia® Inc.

*Replaced by insured prescription drug and/or vision coverage when insured coverage is offered.

HM Care Advantage is an HM Life Insurance Company product administered by Key Benefit Administrators (KBA). The medical portion of the product provides group limited medical indemnity benefits; it does not provide major medical or comprehensive medical insurance. Based on the plan selected, Medical and Vision coverages are underwritten by HM Life Insurance Company, Pittsburgh, PA, under policy form series HL902, HM905 or similar. For other insured products when available: Dental and Outpatient Prescription Drug coverages are underwritten by Fidelity Security Life Insurance Company, Kansas City, MO, under policy form series M-9037 and M-9031/M-9022. In certain states, Dental is underwritten by Renaissance Life & Health Insurance Company of America, Greenwood, IN, under policy form series DT-300A or DT-310A. Administrative and/or customer support services when available are provided: for Health Information On-Call – Health Dialog Services Corporation; for ComplementaryWellness Discount Program – Healthways WholeHealth Networks, Inc; for Health Information On-Line – HealthMedia® Inc.; for Pharmacy Discount Card – Caremark, Inc; for Vision – Davis Vision; for Provider Network Discounts – MultiPlan . Other administrative and/or customer support services may be provided by HM Life Insurance Company and HM Benefits Administrators. Certain exclusions and limitations may apply. See your certificate or other evidence of coverage for details. Coverage or service requested or the use of a specific association, franchise, trust or union may not be available in all states.

MONTHLY PREMIUM PLAN 1 PLAN 2 PLAN 3

Employee $142.34 $246.97 $399.23

Employee + Spouse $266.40 $467.52 $760.18

Employee + Child(ren) $272.27 $476.63 $774.00

Family $396.17 697.02 $1,134.79

Spouse Only $131.82 $229.97 $372.79

Spouse + Child(ren) Only $252.08 $443.47 $721.96

Child(ren) Only $129.97 $223.21 $358.88



The SBU Group Indemnity Plan is approved and available in the following states:TX, AZ, CA, CO, CT, DE, DC, GA, HI, IL, IN, IA, KS, LA, MI, NE, OH, PA, RI, TN, WA, and WV.



May 16, 2011 11:45 AM


HM Care Advantage [01/18/2011]HM Care Advantage [01/18/2011] SBU Group Indemnity Plans – Page 6 of 6MTG-1743 (07/06/10)

HM CARE ADVANTAGE–MEDICAL EXCLUSIONS & LIMITATIONS

The following will not be Covered Expenses underthis Indemnity Medical Benefit unless specificallyprovided elsewhere in the Policy:

Treatment that is solely for the purpose of rest careor treatment while confined in a skilled nursing facility,custodial care, and any associated transportation;

Cosmetic surgery or care, or treatment solely forcosmetic purposes, or complication thereof. Thisexclusion does not apply to: cosmetic surgeryresulting from an accident, if initial treatment of theCovered Person is begun within 12 months of thedate of the Accident; reconstruction incidental to orfollowing surgery resulting from a covered Accidentor Sickness or from trauma, infection or otherdiseases of the involved part; correction of acongenital defect or anomaly that results in afunctional defect of a covered dependent child; withrespect to a mastectomy: all stages of reconstructionof the breast on which the mastectomy has beenperformed; surgery and reconstruction of the otherbreast to produce a symmetrical appearance; andtreatment of physical complications for all stages ofthe mastectomy, including lymph edema;

Examinations needed for employment, obtaininginsurance or travel;

Voluntary abortion, unless: the life of the mother wouldbe endangered if the fetus were carried to term; ormedical complications have arisen from an abortion;

Sex change procedures;

Experimental health care services or unless suchservices are: prescribed or recommended asAppropriate Treatment by the Covered Person'sPhysician; approved, on a basis other than limitedor experimental, by the American MedicalAssociation or the appropriate medical specialtysociety for such treatments;

Reversal of elective sterilizations for males or females;

Diagnosis and treatment of infertility in connectionwith the reversal of elective sterilizations;

Diagnosis and treatment of infertility in connectionwith: in vitro fertilization, gamete intra-fallopian tubetransfers or zygote intra-fallopian tube transfers;cloning; or medical or surgical services deemed tobe experimental;

Treatment of exogenous obesity, gastric bypasssurgery or weight control unless Medically Necessary;

Routine eye examinations or fitting of glasses orcontact lenses;

Hearing examinations or fitting of hearing aids;

Dental examinations or dental care other thanexpenses resulting from a Covered Accident;

Smoking cessation unless Medically Necessary;

Skilled Rehabilitation Services once a maintenancelevel has been established or no further progresscan be attained;

Suicide or any attempt thereat, while sane or insane,or any intentionally self-inflicted injury or sickness,unless as a result of a medical condition or an act ofdomestic violence;

Participation in a riot, civil commotion, civildisobedience, insurrection or unlawful assembly,unless a loss that occurs while a Covered Person isacting in a lawful manner within the scope ofauthority;

Committing, attempting to commit, or taking part in afelony or assault;

Participation in a contest of speed in power drivenvehicles, parachuting, parasailing, bungee jumping,mountain climbing, spelunking or hang gliding;

Air travel, except: as a fare-paying passenger on acommercial airline on a regularly scheduled route;a charter flight operated by a scheduled airline; oras a passenger for transportation only and not as apilot or crew member;

The Covered Person being legally intoxicated asdetermined according to the laws of the jurisdictionin which a Covered Accident occurred;

Any treatment for an accident or sickness resultingfrom the use of a controlled substance by aCovered Person that is not provided by or at thedirection of a Physician;

An act of war, whether declared or undeclared, orwhile performing police duty as member of anymilitary or naval organization. This exclusionincludes a Covered Accident occurring or Sicknesscontracted while in the service of any military, navalor air force of any country engaged in war; (theCompany will refund the pro rata unearnedpremium for any such period the Covered Person isnot covered);

An accident or sickness arising out of and in thecourse of any occupation for compensation, wageor profit or expenses which are payable underWorkers’ Compensation, Occupational Disease orsimilar law, whether or not application for suchbenefits has been made;

Any treatment received or expenses incurredduring a period of time that insurance for aCovered Person is not in force;

Any treatment received or expenses incurred afterthe Participation Certificate has terminated;

Any service, supply or treatment that is notprovided by or at the direction of a Physician, or isinconsistent with standards of medical practice forthe applicable condition;

Treatment of any accident or sickness outside theUnited States or Canada;

Services, supplies or treatment not consideredMedically Necessary even if ordered by a Physician;

Transportation except as provided for inAmbulance Services;

Benefits for services or treatment rendered by anyperson who is: employed or retained by thePolicyholder; living in the Covered Person'shousehold; a parent, sibling, spouse or child of aCovered Employee or of His spouse; or a CoveredPerson treating himself.

Depending on plan design, the treatment of: Mentalillness; function of organic nervous disorder,regardless of cause; alcohol abuse; or drug use,unless such drugs were taken on the advice of aPhysician and taken as prescribed;

Not available in all states. Some provisions,benefits, exclusions or limitations listed herein mayvary by state.

HM CARE ADVANTAGE –OUTPATIENT PRESCRIPTION DRUGEXCLUSIONS & LIMITATIONS

Benefits are not payable for the following items:All over-the-counter products and medicationsunless shown under the definition of PrescriptionDrug. This includes, but is not limited to,electrolyte replacement, infant formulas,miscellaneous nutritional supplements and allother over-the-counter products and medications.

Blood glucose meters; insulin injecting devices.

Depo-Provera; levonorgestrel; condoms,contraceptive sponges, and spermicides; sexualdysfunction drugs.

Biologicals (including allergy tests); bloodproducts; growth hormones; hemophiliac factors;MS injectables; immunizations; all otherinjectables unless shown under the definition ofPrescription Drug.

Aerochamber, Aerochamber with Mask; PeakFlow Meter; all other medical supplies anddurable medical equipment unless shown underthe definition of Prescription Drug.

Liquid nutritional supplements; pediatric LegendDrug vitamins; prenatal Legend Drug vitamins;prescribed versions of Vitamins A, D, K, B12, FolicAcid and Niacin - used in treatment versus as adietary supplement; all other Legend Drugvitamins and nutritional supplements.

Anorexiants; any cosmetic drugs including, butnot limited to, Renova, skin pigmentation preps;any drugs or products used for the treatment ofbaldness; topical dental fluorides.

Refills in excess of that specified by theprescribing Physician; or refills dispensed afterone year from the original date of the prescription.

All newly marketed pharmaceuticals or currentlymarketed pharmaceuticals with a new FDAapproved indication for a period of one year fromsuch FDA approval for its intended indication.

Any drug labeled “Caution - limited by FederalLaw for Investigational Use” or experimentaldrugs.

Any drug that the FDA has determined to becontraindicated for the specific treatment.

Drugs needed due to conditions caused, directlyor indirectly, by an Insured Person taking part in ariot or other civil disorder; or the Insured Persontaking part in the commission of a felony.

Drugs needed due to conditions caused, directlyor indirectly, by declared or undeclared war or anact of war; or drugs dispensed to an InsuredPerson while on active duty in any armed force.

Any expenses related to the administration of anydrug.

Needles or syringes unless shown under thedefinition of Prescription Drug.

Drugs or medicines taken while in or administeredby a hospital or any other health care facility oroffice.

Drugs covered under Workers' Compensation,Medicare, Medicaid or other Governmental program.

Drugs, medicines or products, which are notMedically Necessary.

Brand Name Prescription Drugs (except for Tier III).

Diaphragms; erectile dysfunction Legend drugs,unless specifically listed in the definition ofPrescription Drug; Infertility Legend drugs.

Epi-Pen, Epi-Pen Jr., Ana-Kit, Ana-Guard;Glucagon-auto injection; Imitrex-auto injection.

Smoking deterrents, Legend or over-the-counter.

Dispensing Limits and Authorized Refills: Retail:the lesser of a 30-day supply or specified unit doses.

Not available in all states. Some provisions,benefits, exclusions or limitations listed hereinmay vary by state.

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU Group Indemnity Plans Voluntary



May 16, 2011 11:45 AM

PLAN 1 PLAN 2 PLAN 3

Office Visits - Physician/Licensed Practitioner Pays amount shown for sickness or injury visits to a doctor or licensed practitioner; also includes one wellness visit. May be used for services provided in a hospital emergency room or urgent care center.


Daily In-Hospital Pays amount shown for hospitalization in a licensed facility as a result of an accident or sickness. Also covers Mental and Nervous and Alcohol and Substance Abuse treatment at 50% of the Daily In-Hospital benefit. (Total number of In-Hospital days and Intensive Care Unit days combined is limited to 30 days.)

$500 Per Day - 30 Days $1,000 Per Day - 30 Days $2,000 Per Day - 60 Days

Additional Daily Benefit for First Day of Hospital ConfinementPays an amount equal to one day of the Daily In-Hospital benefit for the first day of confinement.

$500 First Day 1 Admission



SurgeryPays amount shown for surgical procedures at a licensed hospital, outpatient facility or physician’s office as shown on the Schedule of Surgical Benefits.

$2,500 Per Surgery Based on Schedule 1 Surgery

$2,500 Per Surgery Based on Schedule 2

Surgery(ies)

$2,500 Per Surgery Based on Schedule 5

Surgery(ies)

AnesthesiaPays amount shown for anesthesia services provided during a surgical procedure at a licensed hospital, outpatient facility or physician’s office.




Outpatient Diagnostic TestingPays amount shown per day for laboratory, imaging and testing services for accident or illness diagnosis in an outpatient setting.

$300 Per Day - 1 Day $300 Per Day - 3 Day $500 Per Day - 3 Day

Provider Network DiscountsCovered persons will receive contracted discounts from the usual and customary fees from network physicians, hospitals, outpatient diagnostic imaging and laboratory providers. Service is provided by MultiPlan. Information on participating providers can be obtained by going to www.hmcareadvantage.com and clicking on Member Information or by calling 800.672.2140.

Included Included Included

Hospital Emergency RoomPays amount shown for a non-work related injury or illness visit to an emergency room of a hospital or licensed facility. Limit one illness visit per calendar year. Additional illness visits paid at Office Visits benefit amount.

$300 Per Visit - 1 Visit $500 Per Visit - 1 Visit $500 Per Visit - 3 Visit(s)

Inpatient Visits - PhysicianPays amount shown for one physician visit per day while confined to a hospital for a covered sickness or accident.


Daily Intensive Care UnitPays amount shown for inpatient hospital intensive care services, including intensive care (ICU), coronary care (CCU), neonatal intensive care (NICU) and pediatric intensive care (PICU). (Total number of In-Hospital days and Intensive Care Unit days combined is limited to amount of Daily In-Hospital days.)


Hospital Days


Hospital Days


Hospital Days

Outpatient Hospital Services (Includes Surgery Centers)Pays amount shown per treatment day for therapies and treatments performed on an outpatient basis.

$300 Per Treatment Day - 1 Day



Wellness Screening TestPays amount shown for mammography, colonoscopy, flexible sigmoidoscopy or bone densitometry.

$75 Per Test - 1 Test $150 Per Test - 1 Test $150 Per Test - 1 Test

Wellness ServicePays amount shown for Pap test, PSA or immunization. $75 Per Service - 1 Service $75 Per Service - 1 Service $75 Per Service - 1 Service

Home Health CarePays amount shown for home visits for nursing care, home health aid service, physical, speech and occupational therapies, nutritional counseling and medical social services when prescribed by the covered person’s physician.

N/A $50 Per Visit - 5 Visit $50 Per Visit - 20 Visit

Ambulance ServicesPays amount shown for ground or air transportation by a licensed ambulance service. N/A $300 Per Trip - 3 Trip(s) $300 Per Trip - 3 Trip(s)

Outpatient Prescription Drug Insurance (2)

Provides prescription drug insurance with discounts and co-pays. Discounts apply before and after maximum is reached. Dependent-only coverage is not available. Outpatient Prescription Drug Insurance is underwritten by Fidelity Security Life Insurance Company. For a list of participating pharmacies or more information regarding prescription drugs covered under this plan, go to www.hmcareadvantage.com and click on MemberInformation or call 800.997.3784.

$15 CoPay Generic Formulary $15 CoPay Generic

Oral Formulary Contraceptives

Brand Name Not Covered $750 Max. Benefit



Brand Name Not Covered $1,000 Max. Benefit



$50 CoPay Brand Name Formulary

$1,000 Max. BenefitThis benefit summary provides a very brief description of the important features of your coverage. This is not the insurance contract, but only a summary of coverage. Only the Group Policy or Participation Certificate and the Certificate of Insurance contain the actual provisions, including exclusions and limitations, which control the terms of your coverage. This means that the Group Policy or Participation Certificate and the Certificate of Insurance set forth in detail the rights and obligations of both you, the Group Policyholder or Participating Employer and HM Life Insurance Company. Therefore, if you become insured, it is important that you READ YOUR CERTIFICATE CAREFULLY.

SBU Group Indemnity Plans - Voluntary



The long-awaited SBU Group Indemnity Plan is approved and available in the following states:TX, AZ, CA, CO, CT, DE, DC, GA, HI, IL, IN, IA, KS, LA, MI, NE, OH, PA, RI, TN, WA, and WV.

This benefit summary is designed to provide an overview of the different plan options that are available and the cost for each of the plans. Benefits shown are per calendar year per covered person. The calendar year is the employer-defined benefit cycle. HM Care Advantage pays a fixed amount for medical services. Employees are responsible for additional balances not covered by insurance. Employees and spouses ages 18 to 69 years may enroll for coverage. Benefits terminate at age 70.



May 16, 2011 11:45 AM


Additional benefits included with your HM Care Advantage plan…For additional information, go to www.hmcareadvantage.com and click on Member Information, or call the numbers below.

Pharmacy Discount Card*Provides discounts for brand and generic drugs with no limits on the number of prescriptions filled. Service is provided by Caremark, Inc. To obtain a list of participating pharmacies, go to the HM Care Advantage Web site or call 877.321.2652.

Health Information On-CallAccess to a toll-free telephone line to talk with health coaches who provide information and support for health-related concerns. This service is available 24/7, 365 days a year. Service is provided by Health Dialog Services Corporation.

Vision Discount*Covered persons must use a participating network vision provider to receive this benefit which includes a covered eye exam and reduced cost for other services such as frames, spectacle lenses, contact lenses and laser vision care. Service is provided by Davis Vision. To obtain the name of a Davis Vision provider near you, go to the HM Care Advantage Web site or call 800.999.5431.

Complementary Wellness Discount ProgramDiscounts on health-related products and services, including fitness center memberships, chiropractic care, acupuncture, vitamins, massage therapy and more. Service is provided by Healthways WholeHealth Networks, Inc. To find participating service providers and retail outlets, go to the HM Care Advantage Web site.

Health Information On-LineInternet site providing lifestyle improvement programs, health information and resources on a range of topics, including tobacco cessation, nutrition, weight management, stress management, chronic conditions, back pain, insomnia, depression, diabetes and other general health topics. Service is provided by HealthMedia® Inc.

*Replaced by insured prescription drug and/or vision coverage when insured coverage is offered.

HM Care Advantage is an HM Life Insurance Company product administered by Key Benefit Administrators (KBA). The medical portion of the product provides group limited medical indemnity benefits; it does not provide major medical or comprehensive medical insurance. Based on the plan selected, Medical and Vision coverages are underwritten by HM Life Insurance Company, Pittsburgh, PA, under policy form series HL902, HM905 or similar. For other insured products when available: Dental and Outpatient Prescription Drug coverages are underwritten by Fidelity Security Life Insurance Company, Kansas City, MO, under policy form series M-9037 and M-9031/M-9022. In certain states, Dental is underwritten by Renaissance Life & Health Insurance Company of America, Greenwood, IN, under policy form series DT-300A or DT-310A. Administrative and/or customer support services when available are provided: for Health Information On-Call – Health Dialog Services Corporation; for ComplementaryWellness Discount Program – Healthways WholeHealth Networks, Inc; for Health Information On-Line – HealthMedia® Inc.; for Pharmacy Discount Card – Caremark, Inc; for Vision – Davis Vision; for Provider Network Discounts – MultiPlan . Other administrative and/or customer support services may be provided by HM Life Insurance Company and HM Benefits Administrators. Certain exclusions and limitations may apply. See your certificate or other evidence of coverage for details. Coverage or service requested or the use of a specific association, franchise, trust or union may not be available in all states.

MONTHLY PREMIUM PLAN 1 PLAN 2 PLAN 3

Employee $155.91 $271.44 $439.57

Employee + Spouse $292.85 $515.24 $838.84

Employee + Child(ren) $298.73 $524.36 $852.67

Family $435.52 $768.00 $1,251.78

Spouse Only $145.39 $254.44 $413.13

Spouse + Child(ren) Only $278.54 $491.20 $800.63

Child(ren) Only $142.86 $246.46 $397.21



The SBU Group Indemnity Plan is approved and available in the following states:TX, AZ, CA, CO, CT, DE, DC, GA, HI, IL, IN, IA, KS, LA, MI, NE, OH, PA, RI, TN, WA, and WV.



May 16, 2011 11:45 AM


HM Care Advantage [01/18/2011]HM Care Advantage [01/18/2011] SBU Group Indemnity Plans – Page 6 of 6MTG-1743 (07/06/10)

HM CARE ADVANTAGE–MEDICAL EXCLUSIONS & LIMITATIONS

The following will not be Covered Expenses underthis Indemnity Medical Benefit unless specificallyprovided elsewhere in the Policy:

Treatment that is solely for the purpose of rest careor treatment while confined in a skilled nursing facility,custodial care, and any associated transportation;

Cosmetic surgery or care, or treatment solely forcosmetic purposes, or complication thereof. Thisexclusion does not apply to: cosmetic surgeryresulting from an accident, if initial treatment of theCovered Person is begun within 12 months of thedate of the Accident; reconstruction incidental to orfollowing surgery resulting from a covered Accidentor Sickness or from trauma, infection or otherdiseases of the involved part; correction of acongenital defect or anomaly that results in afunctional defect of a covered dependent child; withrespect to a mastectomy: all stages of reconstructionof the breast on which the mastectomy has beenperformed; surgery and reconstruction of the otherbreast to produce a symmetrical appearance; andtreatment of physical complications for all stages ofthe mastectomy, including lymph edema;

Examinations needed for employment, obtaininginsurance or travel;

Voluntary abortion, unless: the life of the mother wouldbe endangered if the fetus were carried to term; ormedical complications have arisen from an abortion;

Sex change procedures;

Experimental health care services or unless suchservices are: prescribed or recommended asAppropriate Treatment by the Covered Person'sPhysician; approved, on a basis other than limitedor experimental, by the American MedicalAssociation or the appropriate medical specialtysociety for such treatments;

Reversal of elective sterilizations for males or females;

Diagnosis and treatment of infertility in connectionwith the reversal of elective sterilizations;

Diagnosis and treatment of infertility in connectionwith: in vitro fertilization, gamete intra-fallopian tubetransfers or zygote intra-fallopian tube transfers;cloning; or medical or surgical services deemed tobe experimental;

Treatment of exogenous obesity, gastric bypasssurgery or weight control unless Medically Necessary;

Routine eye examinations or fitting of glasses orcontact lenses;

Hearing examinations or fitting of hearing aids;

Dental examinations or dental care other thanexpenses resulting from a Covered Accident;

Smoking cessation unless Medically Necessary;

Skilled Rehabilitation Services once a maintenancelevel has been established or no further progresscan be attained;

Suicide or any attempt thereat, while sane or insane,or any intentionally self-inflicted injury or sickness,unless as a result of a medical condition or an act ofdomestic violence;

Participation in a riot, civil commotion, civildisobedience, insurrection or unlawful assembly,unless a loss that occurs while a Covered Person isacting in a lawful manner within the scope ofauthority;

Committing, attempting to commit, or taking part in afelony or assault;

Participation in a contest of speed in power drivenvehicles, parachuting, parasailing, bungee jumping,mountain climbing, spelunking or hang gliding;

Air travel, except: as a fare-paying passenger on acommercial airline on a regularly scheduled route;a charter flight operated by a scheduled airline; oras a passenger for transportation only and not as apilot or crew member;

The Covered Person being legally intoxicated asdetermined according to the laws of the jurisdictionin which a Covered Accident occurred;

Any treatment for an accident or sickness resultingfrom the use of a controlled substance by aCovered Person that is not provided by or at thedirection of a Physician;

An act of war, whether declared or undeclared, orwhile performing police duty as member of anymilitary or naval organization. This exclusionincludes a Covered Accident occurring or Sicknesscontracted while in the service of any military, navalor air force of any country engaged in war; (theCompany will refund the pro rata unearnedpremium for any such period the Covered Person isnot covered);

An accident or sickness arising out of and in thecourse of any occupation for compensation, wageor profit or expenses which are payable underWorkers’ Compensation, Occupational Disease orsimilar law, whether or not application for suchbenefits has been made;

Any treatment received or expenses incurredduring a period of time that insurance for aCovered Person is not in force;

Any treatment received or expenses incurred afterthe Participation Certificate has terminated;

Any service, supply or treatment that is notprovided by or at the direction of a Physician, or isinconsistent with standards of medical practice forthe applicable condition;

Treatment of any accident or sickness outside theUnited States or Canada;

Services, supplies or treatment not consideredMedically Necessary even if ordered by a Physician;

Transportation except as provided for inAmbulance Services;

Benefits for services or treatment rendered by anyperson who is: employed or retained by thePolicyholder; living in the Covered Person'shousehold; a parent, sibling, spouse or child of aCovered Employee or of His spouse; or a CoveredPerson treating himself.

Depending on plan design, the treatment of: Mentalillness; function of organic nervous disorder,regardless of cause; alcohol abuse; or drug use,unless such drugs were taken on the advice of aPhysician and taken as prescribed;

Not available in all states. Some provisions,benefits, exclusions or limitations listed herein mayvary by state.

HM CARE ADVANTAGE –OUTPATIENT PRESCRIPTION DRUGEXCLUSIONS & LIMITATIONS

Benefits are not payable for the following items:All over-the-counter products and medicationsunless shown under the definition of PrescriptionDrug. This includes, but is not limited to,electrolyte replacement, infant formulas,miscellaneous nutritional supplements and allother over-the-counter products and medications.

Blood glucose meters; insulin injecting devices.

Depo-Provera; levonorgestrel; condoms,contraceptive sponges, and spermicides; sexualdysfunction drugs.

Biologicals (including allergy tests); bloodproducts; growth hormones; hemophiliac factors;MS injectables; immunizations; all otherinjectables unless shown under the definition ofPrescription Drug.

Aerochamber, Aerochamber with Mask; PeakFlow Meter; all other medical supplies anddurable medical equipment unless shown underthe definition of Prescription Drug.

Liquid nutritional supplements; pediatric LegendDrug vitamins; prenatal Legend Drug vitamins;prescribed versions of Vitamins A, D, K, B12, FolicAcid and Niacin - used in treatment versus as adietary supplement; all other Legend Drugvitamins and nutritional supplements.

Anorexiants; any cosmetic drugs including, butnot limited to, Renova, skin pigmentation preps;any drugs or products used for the treatment ofbaldness; topical dental fluorides.

Refills in excess of that specified by theprescribing Physician; or refills dispensed afterone year from the original date of the prescription.

All newly marketed pharmaceuticals or currentlymarketed pharmaceuticals with a new FDAapproved indication for a period of one year fromsuch FDA approval for its intended indication.

Any drug labeled “Caution - limited by FederalLaw for Investigational Use” or experimentaldrugs.

Any drug that the FDA has determined to becontraindicated for the specific treatment.

Drugs needed due to conditions caused, directlyor indirectly, by an Insured Person taking part in ariot or other civil disorder; or the Insured Persontaking part in the commission of a felony.

Drugs needed due to conditions caused, directlyor indirectly, by declared or undeclared war or anact of war; or drugs dispensed to an InsuredPerson while on active duty in any armed force.

Any expenses related to the administration of anydrug.

Needles or syringes unless shown under thedefinition of Prescription Drug.

Drugs or medicines taken while in or administeredby a hospital or any other health care facility oroffice.

Drugs covered under Workers' Compensation,Medicare, Medicaid or other Governmental program.

Drugs, medicines or products, which are notMedically Necessary.

Brand Name Prescription Drugs (except for Tier III).

Diaphragms; erectile dysfunction Legend drugs,unless specifically listed in the definition ofPrescription Drug; Infertility Legend drugs.

Epi-Pen, Epi-Pen Jr., Ana-Kit, Ana-Guard;Glucagon-auto injection; Imitrex-auto injection.

Smoking deterrents, Legend or over-the-counter.

Dispensing Limits and Authorized Refills: Retail:the lesser of a 30-day supply or specified unit doses.

Not available in all states. Some provisions,benefits, exclusions or limitations listed hereinmay vary by state.

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU2 HealthValu PlansGroups of 10+

Proposal for Small Business United II Austin, TexasProposal Date: November 10, 2010 | Effective Date of Coverage: January 1, 2011

Underwritten By: ACE American Insurance Company Term life insurance is underwritten by Combined Insurance Company of America, part of the ACE Group of Companies

Claims Administered By:Administrative Concepts, Inc. 994 Old Eagle School Rd., Ste. 1005 Wayne, PA 19087



May 16, 2011 11:45 AM

SBU2 HealthValu Plans

BASIC 25 CHOICE 50 MAX 75

INPATIENT

Hospital Confinement

- Days 1 Benefit Amount $2,500 $5,000 $5,000

- Days 2+ Benefit Amount Per Day $1,500x20 $2,500x20 $3,000x20

- Days 1+ ICU Benefit Amount Per Day $1,000x5 $2,000x5 $2,500x5

Surgery Benefit Amount (Incl. Maternity) Per Surgery $5,000x1 $5,000x2 $5,000x2

- Anesthesia Benefit Amount - Per Surgery $1,250 $1,250 $1,250

OUTPATIENT

Physician Office Visit Pre-Pay (1) $10 $10 $10

- Sickness Benefit Amount Per Visit $100x20 $100x20 $125x20

- Wellness Benefit Amount Per Visit $250x1 $250x1 $250x1

- Well Baby Care (Up to Age 1) Benefit Amount Per Visit $150x4 $150x4 $150x4

Accident Benefit Amount Per Year $25,000 $25,000 $25,000

- Benefit % Payable 80% 80% 80%

- Deductible Per Accident $0 $0 $0

Emergency Room (Sickness) Benefit Amount - Per Visit $1,000x2 $1,000x2 $1,000x2

Surgery Benefit Amount Per Surgery $2,500x1 $2,500x1 $2,500x2

- Anesthesia Benefit Amount - Per Surgery $625 $625 $625

Diagnostic, X-Ray, Lab - Benefit Amount Per Test

- Class I: Laboratory - Blood Work, CMP, Lipid Panel $50x6 $75x6 $75x6

- Class II: X-Rays, ECG, All Other Diagnostic $125x4 $150x4 $150x4

- Class III: Ultrasound, Mammogram $250x2 $250x2 $300x2

- Class IV: CT, PET, MRI $1,250x1 $1,250x1 $1,500x1

Prescription Benefit Maximum Per Year $1,000 $1,500 $1,500

- Retail - Generic Rx Copay $10 $10 $10

- Retail Preferred Brand Rx Copay $20 $20 $20

- Mail Order - Generic Rx Copay $25 $25 $25

- Mail Order - Preferred Brand Rx Copay $50 $50 $50

LIFE/AD&D/CRITICAL ILLNESS

Critical Illness Benefit Amount Payable for 10 Conditions $5,000 $5,000 $5,000

Accidental Death & Dismemberment Benefit Amount*$25,000 Emp

$5,000 Sp$1,000 Ch

$25,000 Emp$10,000 Sp$1,000 Ch

$25,000 Emp$10,000 Sp$1,000 Ch

Term Life Insurance (2) Benefit Amount* * Benefit amounts listed are for: Employee/Spouse/Child(ren)

$5,000 Emp$2,000 Sp$1,000 Ch

$5,000 Emp$2,000 Sp$1,000 Ch

$5,000 Emp$2,000 Sp$1,000 Ch

OTHER SERVICES (2)

Teladoc: Telephonic Doctor Office Visits - $38 Fee YES YES YES

Care24: EAP and Nurseline YES YES YES

PRE-EXISTING CONDITION LIMITATION* 6/12 pre-x Inpatient and Surgery onlyCritical Illness – 12 month pre-x and 90 days insured on plan

MONTHLY RATES

Member Only $250.60 $319.77 $361.77

Member + 1 $528.79 $671.06 $759.00

Family $753.35 $956.00 $1,082.00(1) The office visit pre-pay is a service through the PHCS Network (2) This service is not insurance and is not provided by ACE American Insurance Company. (3) Term Life is underwritten by Combined Insurance Company of America, part of the ACE Group of Companies.* Pre-existing Conditions occurring within the first 12 months of coverage (applies to Hospital and Surgery benefits only). “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the 6 month period before the Covered Person’s coverage became effective under this Policy.

An indemnity-based medical plan which provides limited coverage for accidents, illness, and specified disease to provide an affordable “Middle-Medical” solution. Benefit levels are between an LBMP and a comprehensive major medical plan.



May 16, 2011 11:45 AM

SBU2 HealthValu Plans - Continued

BENEFIT DESCRIPTION

Office Visits We will pay benefits if a covered person visits a Doctor’s office for treatment, care or advice of an injury or sickness covered under the policy.

Emergency Room Visits (Sickness Only)We will pay benefits for Emergency Room Visits if a covered person requires treatment or services in a Hospital emergency room for a life-threatening condition Covered expenses include the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

Wellness VisitsWe will pay benefits for an annual routine examination or well child care. Covered Services include a medical history, physical examination, X-rays and laboratory tests including a Pap test, colorectal screening, prostate cancer screening, mammography and bone density screening.

Outpatient Laboratory Tests and X-Ray Expenses

We will pay benefits for Outpatient Laboratory Tests and X-rays if a covered person is not confined in a Hospital and the tests or x-rays are ordered by a Doctor and performed by an appropriately licensed technician.

Outpatient Accident Only Medical Expense Benefit

We will pay benefits for medically necessary expenses that result directly from a covered accident. Initial treatment must begin within 72 hours of the accident and covered expenses must be incurred within 90 days after the accident. These benefits are subject to the Deductibles, Coinsurance Rates, Co-Payments, Benefit Periods, Benefit Maximums and other terms or limits, if any, shown in the Schedule of Benefits. Covered expenses include medical services and supplies, emergency care, ambulance expenses, treatment of an injured tooth, prescription drugs andrehabilitative braces or appliances prescribed by a doctor.

Hospital Confinement Benefit We will pay benefits if a covered person is confined in a hospital because of a covered injury or illness for at least 24 consecutive hours.

Surgery and Anesthesia BenefitWe will pay benefits if a covered person undergoes surgery at the direction of a doctor for a covered injury or sickness. We will also pay benefits for anesthesia services for pre-operative screening and the administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

Accidental Death and Dismemberment Benefit

If a covered person suffers a loss within 365 days of a covered accident we will pay the percentage of the principal sum shown opposite that loss. If multiple losses occur, only one benefit amount, the largest, will be paid for all losses due to the same covered accident.

Prescription Drug BenefitsWe will pay benefits for expenses incurred by a covered person for the purchase of generic and preferred brand name prescription drugs from a Participating or Non-Participating Pharmacy. The co-payment must be incurred for each prescription drug or authorized refill before benefits are payable.

Value-added benefits are included with the HealthValu Plan.These benefits are not insurance and are not provided by ACE American Insurance Group.

Office Visit Pre-Pay Service provides members affordable access to physicians by allowing them to pay a $10 Office Visit Pre-pay before insurance benefits are applied.

This proposal is not a contract of insurance. This proposal provides only brief descriptions of the coverage available. The policies contain reductions, limitations, exclusions and termination provisions. Full details of the coverage are contained in policy that will be issued to you, once we receive your acceptance. If there are any conflicts between this proposal and the policy issued to you, the policy shall govern. The policy is governed by the laws in the state in which it is delivered. Certain terms or provisions may be different if required by the laws of that state. This proposal is valid for 90 days from the date of the proposal. If you accept the terms of this proposal, coverage is subject to ACE’s determination that trade or economic sanctions or regulations do not prohibit us from binding coverage. Ternian Insurance Group reserves the right to extend or withdraw this proposal at any time by providing written notice to the requestor of this proposal. For agent/broker use only. Not for individual solicitations. IMPORTANT NOTICE: Insurance policies providing certain health insurance coverage issued or renewed on or after September 23, 2010 are required to comply with all applicable requirements of the Patient Protection and Affordable Care Act (PPACA). However, there are a number of insurance coverages that are specifically exempt from the requirements of PPACA (See § 2791 of the Public Health Services Act). ACE maintains that the Limited Accident and Sickness Plan presented in this proposal is “fixed indemnity insurance”, and is therefore, exempt from the requirements of PPACA. ACE continues to monitor healthcare reform laws and regulations to determine any impact on its products. Should there be any change that requires modification of this plan, we reserve the right to change the plan and rates accordingly. Please understand that this is not intended as legal advice. For legal advice on PPACA, please consult with your own legal counsel or tax advisor directly.

Insurance is underwritten by ACE American Insurance Company Term life insurance is underwritten by Combined Insurance Company of America, part of the ACE Group of Companies.



May 16, 2011 11:45 AM

Value Added Services

Value Added Services Enhance the Packaged Offering & Elevate the Consumer Experience for Employees

TelaDocA lot of time goes into setting a doctor’s appointment and taking time off from work or out of busy, everyday lives. And after all that, the average face-to-face time with a doctor in a traditional office visit appointment is 3-5 minutes*. With TelaDoc, members have on-demand access to U.S. board certified and licensed doctors for telephone consultations to diagnose, recommend treatment, and write short-term, non-narcotic prescriptions. For only a $38 consult fee, members can receive quality care from the convenience of their homes or offices, as opposed to more expensive and less productive settings like an urgent care center or emergency room. Teladoc is not designed to replace employees’ primary care physicians. It simply allows them to resolve their routine medical issues at a fraction of the cost and time. [*According to a Merritt Hawkins Survey, 2009]

Care24Ternian members are enrolled in an Employee Assistance Program and Nurseline through OptumHealth. With the Care24 program, members receive telephonic access to a Nurseline which provides an immediate and reliable source for non-emergency health information and confidential counseling for emotional and personal challenges. Consultations are provided by registered nurses and masters level counselors. Additional resources are available including legal, financial, dependent care specialists, and an audio health information library. In addition to the telephonic services, members also have access to up to 3 face-to-face counseling sessions per condition at no cost to the member.

Provider NetworksMultiPlan delivers primary PPO network access under the PHCS Network, HealthEOS Network, and PHCS Savility brands. PHCS Network offers access in all states to 568,000 healthcare professionals, over 4,100 hospitals and 63,000 ancillary care facilities. No matter where health plan participants live, work, and seek healthcare, they have access to the largest independent primary PPO in the nation. Our passive approach to utilizing participating providers does not reduce insurance benefits or penalize a member for seeing a non-network provider. Using a network provider will discount the cost of services rendered and help to stretch our members’ insurance benefits. For members that happen to reach their insurance benefit maximums, they can continue to receive discounted prices from the network providers.

Quick Tips

www.Ternian.com 602.216.0006•

When one size does not fi t all. SM

How to use your new insurance plan...

1. WHO IS THE INSURANCE COMPANY?

2. WHAT TO DO AT A DOCTOR’S OFFICE VISIT.

3. ADDITIONAL SERVICES INCLUDED WITH YOUR PLAN.

• ACE American Insurance Company (A+ Rated)• You can see ANY doctor or hospital of your choice, and the

insurance plan will pay the same level of benefi t - no penalties. • For benefi ts and coverage questions call 1-800-964-7096

• Give the doctor offi ce staff your ID Card• Have them call 1-800-964-7096 (on your ID Card) to verify your coverage• Pay your offi ce visit fee (on your ID Card) at the time of service• Have the doctor bill the insurance company on your behalf

• If your doctor is part of the MultiPlan PHCS Network, you will also receive discounts on their billed charges. 1-866-750-7427

• For only $38, you can have a doctor consultation over the phone from the convenience of your home or offi ce with TelaDoc. 1-800-Teladoc

• At no additional cost, you can call Optum Care24 Nurseline to speak to a registered nurse immediately! 1-866-923-0018

Quick Tips













Quick Tips














• ACE American Insurance Company (A+ Rated)• You can see ANY doctor or hospital of your choice, and the insurance

plan will pay the same level of benefit - no penalties.• For benefits and coverage questions call 1-800-964-7096


• Give the doctor office staff your ID Card• Have them call 1-800-964-7096 (on your ID Card) to verify coverage• Pay your office visit fee (on your ID Card) at the time of service• Have the doctor bill the insurance company on your behalf



• For only $38, you can have a doctor consultation over the phone from the convenience of your home or office with TelaDoc. 1-800-Teladoc


How to Use Your New Insurance Plan



May 16, 2011 11:45 AM

Exclusions & Limitations

For HealthSelect, HealthValu and CriticalMed, we will not pay benefits for any loss, injury or sickness that is caused by, or results from:• Pre-existing Conditions occurring within the first 12 months of coverage (applies to Hospital

and Surgery benefits only). “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the 6 month period before the Covered Person’s coverage became effective under this Policy.

• Intentionally self-inflicted injury, suicide or attempted suicide.• War or any act of war, whether declared or not.• Service in the military, naval or air service of any country or international organization.• Piloting or serving as a crewmember or riding in any aircraft except as a fare-paying passenger

on a regularly scheduled or charter airline.• Commission of, or attempt to commit, a felony, an assault or other illegal activity.• Commission of or active participation in a riot, or insurrection.• Bungee cord jumping, parachuting, skydiving, parasailing, hang-gliding.• Flight in, boarding or alighting from any aircraft except as a fare-paying passenger on a

regularly scheduled commercial airline.• An accident if the covered person is the operator of a motor vehicle and does not possess

a valid motor vehicle operator’s license, except while participating in Driver’s Education Program.

• Medical or surgical treatment, diagnostic procedure, administration or anesthesia, or medical mishap or negligence, including malpractice. [This exclusion applies to the Accidental Death and Dismemberment benefit only]

• Travel or activity outside the United States, except for a Medical Emergency.• Travel in any Aircraft owned, leased or controlled by the Policyholder, or any of its subsidiaries

or affiliates. An Aircraft will be deemed to be “controlled” by the Policyholder if the Aircraft may be used as the Policyholder wishes for more than 10 straight days, or more than 15 days in any year.

• Alcoholism, drug addiction or the use of any drug or narcotic except as prescribed by a Doctor unless specifically provided herein.

• Repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration.

• Repair, replacement, examinations for, prescriptions, or the fitting of eyeglasses or contact lenses.

• While the covered person is legally intoxicated (as determined by that state’s laws) or while under the influence of any drug unless administered under the advice and consent of a Doctor.

• Medical expenses and disability for which the covered person is entitled to benefits under any Worker’s Compensation Act.

• Medical expenses paid or payable under any mandatory no fault automobile insurance contract or mandatory basic reparations benefit of no fault.

• Elective Abortion. Elective Abortion means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.

• Mental and Nervous Disorders.• Covered medical expenses for which the covered person would not be responsible for in the

absence of this Policy.• Cosmetic surgery, except for reconstructive surgery needed as the result of an injury or

sickness.• Experimental or Investigational drugs, services, supplies or any procedure held to be

experimental or investigatory by Us at the time the procedure is done.

No Prescription Drug Benefits will be paid for:• Brand name prescriptions drugs (if generic only drug option is selected)• All over-the-counter products and medications unless shown in the definition of Prescription

Drug. This includes, but is not limited to, electrolyte replacement, infant formulas, miscellaneous nutritional supplements, and all other over-the-counter products and medications.

• Blood glucose meters and insulin injecting devices.• Depo-Provera; condoms, contraceptive sponges, and spermicides; sexual dysfunction drugs.• Biologicals (including allergy tests); blood products; growth hormones; hemophiliac factors;

MS injectables; immunizations; and all other injectables unless shown in the definition of Prescription Drug.

• Medical supplies and durable medical equipment.• Liquid nutritional supplements; pediatric Legend Drug vitamins; prescribed versions of Vitamins

A, D, K, B12, Folic Acid, and Niacin – used in treatment verses as a dietary supplement; and all other Legend Drug vitamins and nutritional supplements.

• Anorexiants; any cosmetic drugs including, but not limited to, Renova and skin pigmentation preps; any drugs or products used for the treatment of baldness; and topical dental fluorides.

• Refills in excess of that specified by the prescribing Doctor, or refills dispensed after one year from the original date of the prescription.

• Any drug labeled “Caution – limited by Federal Law for Investigational Use” or experimental drugs.

• Any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment.

• Drugs needed due to conditions caused, directly or indirectly, by a covered person taking part in a riot or other civil disorder; or the covered person taking part in the commission of a felony.

• Drugs needed due to conditions caused, directly or indirectly, by declared or undeclared war or any act of war; or drugs dispensed to a covered person while on active duty service in any armed forces.

• Any expenses related to the administration of any drug.• Drugs or medicines taken while in or administered by a Hospital or any other health care

facility or office.• Drugs covered under Worker’s Compensation, Medicare, Medicaid or other governmental

program.

• Drugs, medicines or products which are not medically necessary.• Diaphragms; erectile dysfunction Legend Drugs; and infertility Legend Drugs.• Epi-Pen, Epi-Pen Jr., Ana-Kit, Ana-Guard; Glucagon-auto injection; and Imitrex-auto injection.• Smoking deterrents, Legend or over-the-counter drugs.• Replacement of stolen medication (except under circumstances approved by us), or lost,

spilled, broken or dropped Prescription Drugs.• Vacation supplies of Prescription Drugs (except under circumstances approved by us).• All newly marketed pharmaceuticals or currently marketed pharmaceuticals with a new

FDA approved indication for a period of one year from such FDA approval for its intended indication.

In addition, Critical Illness Benefits will not be paid for:• Injury or Sickness, other than one of the Covered Illnesses, even though such Injury or Sickness

may have been complicated by one of the Covered Illnesses;• The use, existence or escape of nuclear weapons, material or ionizing radiation from or

contamination by radioactivity from any nuclear fuel or waste from the combustion of nuclear fuel;

• Misuse of medication or the abuse of drugs or intoxicants;• Any Preexisting Condition, except where coverage has been in effect for a period of twelve (12)

consecutive months following the covered person’s effective date of coverage. “Preexisting Condition” means a Sickness suffered by a covered person for which he or she sought or received medical advice, consultation, investigation, or diagnosis, or for which treatment was required or recommended by a Doctor during the 12 months immediately prior to the covered person’s effective date of coverage, that directly or indirectly causes the condition to occur within the first 12 months from the covered person’s most recent effective date of coverage.

No Dental indemnity Benefits will be paid for expenses incurred:• For services and supplies not listed in the Coverage Schedule, not recognized as essential for

the treatment of the condition according to accepted standards of practice or considered experimental.

• For cosmetic procedures, including but not limited to veneers and bleaching of teeth and procedures performed primarily for cosmetic reasons.

• For services related to, performed in conjunction with, or resulting from a non-covered procedure.

• For charges in excess of the Usual and Customary rate.• For any treatment program which began prior to the date the Insured is covered under the

Policy.• For crowns, inlays and onlays on teeth that can be restored by direct placement materials.• For the replacement of crowns, bridges, dentures, inlays or onlays that can be restored to

normal function.• For the replacement of crowns, bridges, inlays, onlays or prosthetic appliance within 5 years

from the date of last placement.• For any unmarried child age 19 and over unless he is dependent upon you for support and you

claim as an exemption on your federal income tax and/or while a full-time student. A full-time student is one who is enrolled for 12 semester hours of credit in an accredited junior college, college, or university. Any exemption will end at age 26.

• For service or supplies payable under any medical expense, auto or no-fault plan.• For any condition covered under any Worker’s Compensation Act or similar law.• For services applied without cost by any municipality, county or other political subdivision or

for which there would be no charge in the absence of insurance.• During any waiting period we require. When you voluntarily end your insurance without a

qualifying event and re-enroll at a later date, your waiting period is 2 years and begins on the date your coverage first ended.

• For services that are applied toward the satisfaction of a Deductible, if any.• For services subject to a waiting period that were incurred during the waiting period.• For charges resulting from changing from one provider to another while receiving treatment,

or from receiving treatment from more than one provider for one dental procedure to the extent that the total charges billed exceed the amount incurred if one provider had performed all services.

• For hospital facility charges for any dental procedure, including but not limited to: emergency room charges, surgical facility charges, hospital confinement.

• For drugs or the dispensing of drugs.• For oral hygiene instruction; plaque control; acid etch; prescription or take-home fluoride;

broken appointments; completion of a claim form; OSHA/Sterilization fees (Occupational Safety & Health Agency); or diagnostic photographs (except for orthodontic purposes), unless included within the Coverage Schedule.

• For implants; myofunctional therapy; athletic mouth guards; precision or semi-precision attachments; treatment of fractures, cysts, tumors, or lesions; maxillofacial prosthesis; orthognathic surgery; TMJ dysfunction; cleft palate; or anodontia.

• For orthodontia, unless included within the Coverage Schedule.• For services to replace teeth that were missing (extracted or congenitally) prior to the effective

date of coverage on Our Plan. This limitation ends after 36 months of continuous coverage on the Plan. Abutment teeth will be reviewed for eligibility of prosthetic benefits.

• For composite, resin, or white fillings on posterior primary teeth. Benefits will be reduced to that of an amalgam or silver filling.

• For the replacement of a filling within 24 months of placement, unless for specific health reasons.

• For the replacement of retainers.• For sealants not applied to permanent bicuspid or molar; applied at age 15 or older; applied 3

years from a previous sealant application; applied to a decayed tooth.• For lab fees for higher metals or porcelain crowns, bridges, inlays, or onlays, unless included

within the Coverage Schedule.



May 16, 2011 11:45 AM

Glossary of Terms

The following definitions apply to the 10 payable conditions for the Critical Illness benefit:

“Cancer” means a malignant tumor characterized by the uncontrolled growth and spread of malignant cells and invasion of tissue. This includes Leukemia, Hodgkin’s Disease and invasive melanoma, but does not include:

1. non-invasive carcinoma in situ;2. Kaposi’s Sarcoma or other AIDS related cancers and cancer in the presence of Human Immunodeficiency Virus (HIV);3. Skin cancer or melanoma that is not invasive and has not exceeded .75 millimeters in depth; or4. early Prostate cancer diagnosed as T1NOMO or equivalent staging.

A Doctor certified as an Oncologist must confirm the diagnosis in writing. No coverage is provided if any symptom or medical problem which initiated the investigation leading to a diagnosis of Cancer commenced within 90 days following the effective date of coverage. In the event of any diagnosis based on such a symptom or medical problem, insurance for that covered person will terminate, and Our sole liability with respect to this benefit will be limited to a refund of premiums paid since the effective date.

“Heart Attack” means the death of a portion of heart muscle as a result of inadequate blood supply to the relevant area. Diagnosis must be confirmed in writing by a Doctor who is a certified cardiologist and should be based on new electrocardiograph changes consistent with heart attack as well as an elevation in cardiac enzyme levels.

“Renal Failure” or “Kidney Failure” means end-stage renal disease due to chronic irreversible failure of both kidneys’ ability to function, requiring the covered person to undergo regular hemodialysis, peritoneal dialysis, or renal transplantation. A Doctor who is certified in Nephrology must confirm the diagnosis in writing.

“Stroke” means that the covered person has suffered a cerebrovascular incident, excluding transient ischemic attack (TIA), producing infarction of brain tissue due to thrombosis, hemorrhage from an intracranial vessel or embolization caused by an extracranial source. There must be evidence of measurable permanent neurological deficit persisting for 30 consecutive days, supported by evidence that the deficit is resulting from the Stroke,

confirmed in writing by a Doctor who is certified as a neurologist.

“Major Organ Transplant” means a surgery, as the recipient, for transplantation of any of the following organs or tissues: 1) heart2) liver3) lung4) kidney5) bone marrow.

“Multiple Sclerosis” means unequivocal diagnosis by a consulting Doctor who is a certified neurologist of a definite diagnosis of Multiple Sclerosis producing at least two episodes of welldefined neurological abnormalities lasting for a continuous period of at least 180 days and resulting in measurable disability. For a Covered Person diagnosed with Multiple Sclerosis, he or she must survive for a period of 180 days after diagnosis by a Doctor. The diagnosis must be supported by modern imaging techniques.

“Coronary Artery Bypass Surgery” means heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts, excluding:1) non-surgical techniques such as balloon angioplasty;2) laser embolectomy; and3) other non-bypass techniques.

“Alzheimer’s Disease” means a degenerative brain disease of unknown cause that is the most common form of dementia. Memory impairment is a necessary feature for the diagnosis of this type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. It results in a profound intellectual decline characterized by dementia and personal helplessness, and is marked histologically by the degeneration of brain neurons especially in the cerebral cortex and by the presence of neurofibrillary tangles and plaques containing betaamyloid.

“Lou Gehrig’s Disease” means amyotrophic lateral sclerosis (ALS), a rare fatal progressive degenerative disease that affects pyramidal motor neurons and is characterized by increasing and spreading muscular disease.

“Terminal Illness” means a Covered Person has a prognosis of twelve months or less to live, as diagnosed by a Doctor. For the purposes of determining the existence of a Terminal Illness, We will require that the Covered Person submit the following proof:

1) a written diagnosis and prognosis by two Doctors licensed to practice in the United States; and2) Supportive evidence satisfactory to Us, including but not limited to, radiological, histological or laboratory reports documenting the Terminal Illness.

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU2 HealthSelect PlansEmployers with 10+ Employees

or Preapproved Groups






May 16, 2011 11:45 AM

SBU2 HealthSelect Plans

BASIC CHOICE ADVANTAGE

INPATIENT

Hospital Confinement

- Days 1 Benefit Amount $1,000 $1,500 $2,500

- Days 2+ Benefit Amount Per Day $500x5 $750x10 $1,500x10

- Days 1+ ICU Benefit Amount Per Day N/A $500x5 $1,000x5

Surgery Benefit Amount (Incl. Maternity) Per Surgery $1,000x1 $1,500x1 $5,000x1

- Anesthesia Benefit Amount - Per Surgery $250 $375 $1,250

OUTPATIENT

Physician Office Visit Pre-Pay (1,2) $10 $10 $10

- Sickness Benefit Amount Per Visit $65x10 $100x10 $125x10

- Wellness Benefit Amount Per Visit N/A $150x1 $250x1

- Well Baby Care (Up to Age 1) Benefit Amount Per Visit N/A $100x4 $150x4

Accident Benefit Amount Per Year $1,000 $5,000 $10,000


- Deductible Per Accident $0 $0 $0

Emergency Room (Sickness) Benefit Amount - Per Visit $200x2 $500x2 $1,000x2

Surgery Benefit Amount Per Surgery N/A $750x1 $2,500x1

- Anesthesia Benefit Amount - Per Surgery N/A $188 $625

Diagnostic, X-Ray, Lab - Benefit Amount Per Test

- Class I: Laboratory - Blood Work, CMP, Lipid Panel $35x4 $50x4 $75x4

- Class II: X-Rays, ECG, All Other Diagnostic $75x2 $100x2 $125x2

- Class III: Ultrasound, Mammogram $150x1 $175x1 $250x1

- Class IV: CT, PET, MRI $500x1 $750x1 $1,000x1

Prescription Benefit Maximum Per Year $2,500 $2,500 $2,500

- Retail - Generic Rx Copay $10 $10 $10

- Mail Order - Generic Rx Copay $30 $30 $30

LIFE/AD&D/CRITICAL ILLNESS

Accidental Death & Dismemberment Benefit Amount*$10,000 Emp

$5,000 Sp$1,000 Ch

$15,000 Emp$5,000 Sp$1,000 Ch

$25,000 Emp$5,000 Sp$1,000 Ch

Term Life Insurance (2) Benefit Amount* * Benefit amounts listed are for: Employee/Spouse/Child(ren)

$5,000 Emp$2,000 Sp$1,000 Ch

$5,000 Emp$2,000 Sp$1,000 Ch

$5,000 Emp$2,000 Sp$1,000 Ch

OTHER SERVICES (2)

Teladoc: Telephonic Doctor Office Visits - $38 Fee YES YES YES

Care24: EAP and Nurseline YES YES YES

PRE-EXISTING CONDITION LIMITATION* 6/12 pre-x on Inpatient and Surgery only

MONTHLY RATES

Member Only $94.81 $163.06 $230.00

Member + 1 $199.35 $345.04 $484.16

Family $283.21 $490.59 $691.40 (1) The office visit pre-pay is a service through the PHCS Network (2) This service is not insurance and is not provided by ACE American Insurance Company. (3) Term Life is underwritten by Combined Insurance Company of America, part of the ACE Group of Companies.* Pre-existing Conditions occurring within the first 12 months of coverage (applies to Hospital and Surgery benefits only). “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the 6 month period before the Covered Person’s coverage became effective under this Policy.

An indemnity-based medical plan which provides limited coverage for accidents, illness, and specified disease to provide an affordable “Middle-Medical” solution. Benefit levels are between an LBMP and a comprehensive major medical plan.



May 16, 2011 11:45 AM

SBU2 HealthSelect Plans - Continued

BENEFIT DESCRIPTION

Office Visits We will pay benefits if a covered person visits a Doctor’s office for treatment, care or advice of an injury or sickness covered under the policy.

Emergency Room Visits (Sickness Only)We will pay benefits for Emergency Room Visits if a covered person requires treatment or services in a Hospital emergency room for a life-threatening condition Covered expenses include the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

Wellness VisitsWe will pay benefits for an annual routine examination or well child care. Covered Services include a medical history, physical examination, X-rays and laboratory tests including a Pap test, colorectal screening, prostate cancer screening, mammography and bone density screening.

Outpatient Laboratory Tests and X-Ray Expenses

We will pay benefits for Outpatient Laboratory Tests and X-rays if a covered person is not confined in a Hospital and the tests or x-rays are ordered by a Doctor and performed by an appropriately licensed technician.


We will pay benefits for medically necessary expenses that result directly from a covered accident. Initial treatment must begin within 72 hours of the accident and covered expenses must be incurred within 90 days after the accident. These benefits are subject to the Deductibles, Coinsurance Rates, Co-Payments, Benefit Periods, Benefit Maximums and other terms or limits, if any, shown in the Schedule of Benefits. Covered expenses include medical services and supplies, emergency care, ambulance expenses, treatment of an injured tooth, prescription drugs andrehabilitative braces or appliances prescribed by a doctor.


Surgery and Anesthesia BenefitWe will pay benefits if a covered person undergoes surgery at the direction of a doctor for a covered injury or sickness. We will also pay benefits for anesthesia services for pre-operative screening and the administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.



Prescription Drug BenefitsWe will pay benefits for expenses incurred by a covered person for the purchase of generic and preferred brand name prescription drugs from a Participating or Non-Participating Pharmacy. The co-payment must be incurred for each prescription drug or authorized refill before benefits are payable.





May 16, 2011 11:45 AM

Exclusions & Limitations

For HealthSelect, HealthValu and CriticalMed, we will not pay benefits for any loss, injury or sickness that is caused by, or results from:• Pre-existing Conditions occurring within the first 12 months of coverage (applies to Hospital

and Surgery benefits only). “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the 6 month period before the Covered Person’s coverage became effective under this Policy.

• Intentionally self-inflicted injury, suicide or attempted suicide.• War or any act of war, whether declared or not.• Service in the military, naval or air service of any country or international organization.• Piloting or serving as a crewmember or riding in any aircraft except as a fare-paying passenger

on a regularly scheduled or charter airline.• Commission of, or attempt to commit, a felony, an assault or other illegal activity.• Commission of or active participation in a riot, or insurrection.• Bungee cord jumping, parachuting, skydiving, parasailing, hang-gliding.• Flight in, boarding or alighting from any aircraft except as a fare-paying passenger on a

regularly scheduled commercial airline.• An accident if the covered person is the operator of a motor vehicle and does not possess

a valid motor vehicle operator’s license, except while participating in Driver’s Education Program.

• Medical or surgical treatment, diagnostic procedure, administration or anesthesia, or medical mishap or negligence, including malpractice. [This exclusion applies to the Accidental Death and Dismemberment benefit only]

• Travel or activity outside the United States, except for a Medical Emergency.• Travel in any Aircraft owned, leased or controlled by the Policyholder, or any of its subsidiaries

or affiliates. An Aircraft will be deemed to be “controlled” by the Policyholder if the Aircraft may be used as the Policyholder wishes for more than 10 straight days, or more than 15 days in any year.

• Alcoholism, drug addiction or the use of any drug or narcotic except as prescribed by a Doctor unless specifically provided herein.

• Repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration.

• Repair, replacement, examinations for, prescriptions, or the fitting of eyeglasses or contact lenses.

• While the covered person is legally intoxicated (as determined by that state’s laws) or while under the influence of any drug unless administered under the advice and consent of a Doctor.

• Medical expenses and disability for which the covered person is entitled to benefits under any Worker’s Compensation Act.

• Medical expenses paid or payable under any mandatory no fault automobile insurance contract or mandatory basic reparations benefit of no fault.

• Elective Abortion. Elective Abortion means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.

• Mental and Nervous Disorders.• Covered medical expenses for which the covered person would not be responsible for in the

absence of this Policy.• Cosmetic surgery, except for reconstructive surgery needed as the result of an injury or

sickness.• Experimental or Investigational drugs, services, supplies or any procedure held to be

experimental or investigatory by Us at the time the procedure is done.

No Prescription Drug Benefits will be paid for:• Brand name prescriptions drugs (if generic only drug option is selected)• All over-the-counter products and medications unless shown in the definition of Prescription

Drug. This includes, but is not limited to, electrolyte replacement, infant formulas, miscellaneous nutritional supplements, and all other over-the-counter products and medications.

• Blood glucose meters and insulin injecting devices.• Depo-Provera; condoms, contraceptive sponges, and spermicides; sexual dysfunction drugs.• Biologicals (including allergy tests); blood products; growth hormones; hemophiliac factors;

MS injectables; immunizations; and all other injectables unless shown in the definition of Prescription Drug.

• Medical supplies and durable medical equipment.• Liquid nutritional supplements; pediatric Legend Drug vitamins; prescribed versions of Vitamins

A, D, K, B12, Folic Acid, and Niacin – used in treatment verses as a dietary supplement; and all other Legend Drug vitamins and nutritional supplements.

• Anorexiants; any cosmetic drugs including, but not limited to, Renova and skin pigmentation preps; any drugs or products used for the treatment of baldness; and topical dental fluorides.

• Refills in excess of that specified by the prescribing Doctor, or refills dispensed after one year from the original date of the prescription.

• Any drug labeled “Caution – limited by Federal Law for Investigational Use” or experimental drugs.

• Any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment.

• Drugs needed due to conditions caused, directly or indirectly, by a covered person taking part in a riot or other civil disorder; or the covered person taking part in the commission of a felony.

• Drugs needed due to conditions caused, directly or indirectly, by declared or undeclared war or any act of war; or drugs dispensed to a covered person while on active duty service in any armed forces.

• Any expenses related to the administration of any drug.• Drugs or medicines taken while in or administered by a Hospital or any other health care

facility or office.• Drugs covered under Worker’s Compensation, Medicare, Medicaid or other governmental

program.

• Drugs, medicines or products which are not medically necessary.• Diaphragms; erectile dysfunction Legend Drugs; and infertility Legend Drugs.• Epi-Pen, Epi-Pen Jr., Ana-Kit, Ana-Guard; Glucagon-auto injection; and Imitrex-auto injection.• Smoking deterrents, Legend or over-the-counter drugs.• Replacement of stolen medication (except under circumstances approved by us), or lost,

spilled, broken or dropped Prescription Drugs.• Vacation supplies of Prescription Drugs (except under circumstances approved by us).• All newly marketed pharmaceuticals or currently marketed pharmaceuticals with a new

FDA approved indication for a period of one year from such FDA approval for its intended indication.

In addition, Critical Illness Benefits will not be paid for:• Injury or Sickness, other than one of the Covered Illnesses, even though such Injury or Sickness

may have been complicated by one of the Covered Illnesses;• The use, existence or escape of nuclear weapons, material or ionizing radiation from or

contamination by radioactivity from any nuclear fuel or waste from the combustion of nuclear fuel;

• Misuse of medication or the abuse of drugs or intoxicants;• Any Preexisting Condition, except where coverage has been in effect for a period of twelve (12)

consecutive months following the covered person’s effective date of coverage. “Preexisting Condition” means a Sickness suffered by a covered person for which he or she sought or received medical advice, consultation, investigation, or diagnosis, or for which treatment was required or recommended by a Doctor during the 12 months immediately prior to the covered person’s effective date of coverage, that directly or indirectly causes the condition to occur within the first 12 months from the covered person’s most recent effective date of coverage.

No Dental indemnity Benefits will be paid for expenses incurred:• For services and supplies not listed in the Coverage Schedule, not recognized as essential for

the treatment of the condition according to accepted standards of practice or considered experimental.

• For cosmetic procedures, including but not limited to veneers and bleaching of teeth and procedures performed primarily for cosmetic reasons.

• For services related to, performed in conjunction with, or resulting from a non-covered procedure.

• For charges in excess of the Usual and Customary rate.• For any treatment program which began prior to the date the Insured is covered under the

Policy.• For crowns, inlays and onlays on teeth that can be restored by direct placement materials.• For the replacement of crowns, bridges, dentures, inlays or onlays that can be restored to

normal function.• For the replacement of crowns, bridges, inlays, onlays or prosthetic appliance within 5 years

from the date of last placement.• For any unmarried child age 19 and over unless he is dependent upon you for support and you

claim as an exemption on your federal income tax and/or while a full-time student. A full-time student is one who is enrolled for 12 semester hours of credit in an accredited junior college, college, or university. Any exemption will end at age 26.

• For service or supplies payable under any medical expense, auto or no-fault plan.• For any condition covered under any Worker’s Compensation Act or similar law.• For services applied without cost by any municipality, county or other political subdivision or

for which there would be no charge in the absence of insurance.• During any waiting period we require. When you voluntarily end your insurance without a

qualifying event and re-enroll at a later date, your waiting period is 2 years and begins on the date your coverage first ended.

• For services that are applied toward the satisfaction of a Deductible, if any.• For services subject to a waiting period that were incurred during the waiting period.• For charges resulting from changing from one provider to another while receiving treatment,

or from receiving treatment from more than one provider for one dental procedure to the extent that the total charges billed exceed the amount incurred if one provider had performed all services.

• For hospital facility charges for any dental procedure, including but not limited to: emergency room charges, surgical facility charges, hospital confinement.

• For drugs or the dispensing of drugs.• For oral hygiene instruction; plaque control; acid etch; prescription or take-home fluoride;

broken appointments; completion of a claim form; OSHA/Sterilization fees (Occupational Safety & Health Agency); or diagnostic photographs (except for orthodontic purposes), unless included within the Coverage Schedule.

• For implants; myofunctional therapy; athletic mouth guards; precision or semi-precision attachments; treatment of fractures, cysts, tumors, or lesions; maxillofacial prosthesis; orthognathic surgery; TMJ dysfunction; cleft palate; or anodontia.

• For orthodontia, unless included within the Coverage Schedule.• For services to replace teeth that were missing (extracted or congenitally) prior to the effective

date of coverage on Our Plan. This limitation ends after 36 months of continuous coverage on the Plan. Abutment teeth will be reviewed for eligibility of prosthetic benefits.

• For composite, resin, or white fillings on posterior primary teeth. Benefits will be reduced to that of an amalgam or silver filling.

• For the replacement of a filling within 24 months of placement, unless for specific health reasons.

• For the replacement of retainers.• For sealants not applied to permanent bicuspid or molar; applied at age 15 or older; applied 3

years from a previous sealant application; applied to a decayed tooth.• For lab fees for higher metals or porcelain crowns, bridges, inlays, or onlays, unless included

within the Coverage Schedule.



May 16, 2011 11:45 AM

Glossary of Terms

The following definitions apply to the 10 payable conditions for the Critical Illness benefit:

“Cancer” means a malignant tumor characterized by the uncontrolled growth and spread of malignant cells and invasion of tissue. This includes Leukemia, Hodgkin’s Disease and invasive melanoma, but does not include:

1. non-invasive carcinoma in situ;2. Kaposi’s Sarcoma or other AIDS related cancers and cancer in the presence of Human Immunodeficiency Virus (HIV);3. Skin cancer or melanoma that is not invasive and has not exceeded .75 millimeters in depth; or4. early Prostate cancer diagnosed as T1NOMO or equivalent staging.

A Doctor certified as an Oncologist must confirm the diagnosis in writing. No coverage is provided if any symptom or medical problem which initiated the investigation leading to a diagnosis of Cancer commenced within 90 days following the effective date of coverage. In the event of any diagnosis based on such a symptom or medical problem, insurance for that covered person will terminate, and Our sole liability with respect to this benefit will be limited to a refund of premiums paid since the effective date.

“Heart Attack” means the death of a portion of heart muscle as a result of inadequate blood supply to the relevant area. Diagnosis must be confirmed in writing by a Doctor who is a certified cardiologist and should be based on new electrocardiograph changes consistent with heart attack as well as an elevation in cardiac enzyme levels.

“Renal Failure” or “Kidney Failure” means end-stage renal disease due to chronic irreversible failure of both kidneys’ ability to function, requiring the covered person to undergo regular hemodialysis, peritoneal dialysis, or renal transplantation. A Doctor who is certified in Nephrology must confirm the diagnosis in writing.

“Stroke” means that the covered person has suffered a cerebrovascular incident, excluding transient ischemic attack (TIA), producing infarction of brain tissue due to thrombosis, hemorrhage from an intracranial vessel or embolization caused by an extracranial source. There must be evidence of measurable permanent neurological deficit persisting for 30 consecutive days, supported by evidence that the deficit is resulting from the Stroke,

confirmed in writing by a Doctor who is certified as a neurologist.

“Major Organ Transplant” means a surgery, as the recipient, for transplantation of any of the following organs or tissues: 1) heart2) liver3) lung4) kidney5) bone marrow.

“Multiple Sclerosis” means unequivocal diagnosis by a consulting Doctor who is a certified neurologist of a definite diagnosis of Multiple Sclerosis producing at least two episodes of welldefined neurological abnormalities lasting for a continuous period of at least 180 days and resulting in measurable disability. For a Covered Person diagnosed with Multiple Sclerosis, he or she must survive for a period of 180 days after diagnosis by a Doctor. The diagnosis must be supported by modern imaging techniques.

“Coronary Artery Bypass Surgery” means heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts, excluding:1) non-surgical techniques such as balloon angioplasty;2) laser embolectomy; and3) other non-bypass techniques.

“Alzheimer’s Disease” means a degenerative brain disease of unknown cause that is the most common form of dementia. Memory impairment is a necessary feature for the diagnosis of this type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. It results in a profound intellectual decline characterized by dementia and personal helplessness, and is marked histologically by the degeneration of brain neurons especially in the cerebral cortex and by the presence of neurofibrillary tangles and plaques containing betaamyloid.

“Lou Gehrig’s Disease” means amyotrophic lateral sclerosis (ALS), a rare fatal progressive degenerative disease that affects pyramidal motor neurons and is characterized by increasing and spreading muscular disease.

“Terminal Illness” means a Covered Person has a prognosis of twelve months or less to live, as diagnosed by a Doctor. For the purposes of determining the existence of a Terminal Illness, We will require that the Covered Person submit the following proof:

1) a written diagnosis and prognosis by two Doctors licensed to practice in the United States; and2) Supportive evidence satisfactory to Us, including but not limited to, radiological, histological or laboratory reports documenting the Terminal Illness.

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU2 CriticalMed Plans






May 16, 2011 11:45 AM


CRITICALMED CRITICALMED CRITICALMED

$15,000 $25,000 $50,000

INPATIENT

Hospital Confinement Benefit Amount Per Day $1,000x10 $1,500x10 $2,000x20

Additional ICU Benefit Amount Per Day $1,000x5 $1,000x10 $1,000x10

OUTPATIENT ACCIDENT ONLY COVERAGE

Benefit Maximum, Per Year Up To $15,000 $25,000 $50,000


- Deductible Per Year $1,500 $2,500 $5,000

Accidental Death & Dismemberment$15,000 Emp

$5,000 Sp $1,000 Ch

$25,000 Emp $10,000 Sp $1,000 Ch

$50,000 Emp $10,000 Sp $1,000 Ch

CRITICAL ILLNESS

Benefit Maximum - Payable for 10 conditions:Cancer, Heart Attack, Renal Failure, Stroke, Major Organ Transplant, Multiple Sclerosis, Coronary Artery Bypass Surgery, Alzheimer’s, ALS, Terminal Illness.

$15,000 $25,000 $50,000

PRE-EXISTING CONDITION LIMITATION* 6/12 pre-x Inpatient and Surgery onlyCritical Illness – 12 month pre-x and 90 days insured on plan

MONTHLY RATES

Member Only $72.42 $98.88 $139.67

Member + 1 $152.95 $207.55 $293.65

Family $217.00 $296.80 $418.60 * Pre-existing Conditions occurring within the first 12 months of coverage (applies to Hospital and Surgery benefits only). “Pre-existing Condition” means an illness, disease, or other condition of the Covered Person, that was treated, diagnosed or required medications in the 6 month period before the Covered Person’s coverage became effective under this Policy.

A buy-up option for members enrolled in HealthSelect who are looking for enhanced coverage for catastrophic events. OR, a stand-alone option (instead of HealthSelect) for members who are willing to self-pay their day-to-day medical expenses because they are more concerned about major events. Cannot be offered as a buy-up option to HealthValu.



May 16, 2011 11:45 AM

BENEFIT DESCRIPTION


We will pay benefits for medically necessary expenses that result directly from a covered accident. Initial treatment must begin within 72 hours of the accident and covered expenses must be incurred within 90 days after the accident. These benefits are subject to the Deductibles, Coinsurance Rates, Co-Payments, Benefit Periods, Benefit Maximums and other terms or limits, if any, shown in the Schedule of Benefits. Covered expenses include medical services and supplies, emergency care, ambulance expenses, treatment of an injured tooth, prescription drugs and rehabilitative braces or appliances prescribed by a doctor.


Critical Illness

Payable for 10 conditions: Cancer, Heart Attack, Renal Failure, Stroke, Major Organ Transplant, Multiple Sclerosis, Coronary Artery Bypass Surgery, Alzheimer’s, ALS, Terminal Illness. After Limited Accident & Sickness coverage has been in effect for 90 days or more, if an employee is the diagnosed with any of the conditions listed in the schedule of benefits, we will pay the amount shown in the Schedule of Benefits for this benefit. The covered person must be under 65 years of age and survive for a period of one-hundred-eighty (180) days after diagnosis of Multiple Sclerosis. The covered person must be under 65 years of age and must survive for a period of thirty (30) days after diagnosis for any other covered illness. We will pay this benefit only once regardless of whether the covered person is diagnosed with more than one of the covered illnesses.






Administered by:


Offered through:

Toll Free 1-877-925-1840

Major Medical PlansGroups of 10+



May 16, 2011 11:45 AM

Health Insurance Renewals:Did you get the memo?

We did and we know the answers.Key Healthy Partners can help.

Key Healthy Partners (KHP) is a new Major Medical Program offered to Texas employers. Distributed by ETMG, LLC Administered by Key Benefit Administrators.

If you are an employer that meets the following criteria we would like to offer you a quote.

• Employer has between 10 & 120 employees• Has a 12 month loss ratio of 75% or less

To learn more visit us online at

www.etmg.us/khp.pdf

or call:

512.279.5600

Major Medical Plans - Groups of 10+

Administered by:


Offered through:

Toll Free 1-877-925-1840

Prudential Life & Disability Insurance



May 16, 2011 11:45 AM

Prudential Life & Disability Insurance

BASIC MEMBER LIFE $100,000 in Guaranteed Issued

MONTHLY PREMIUM $25.50

OPTIONAL MEMBER LIFE $10,000 increments to the lesser of 5x BAE or $200,000Guaranteed issue up to $150,000

OPTIONAL DEPENDENT LIFE Spouse: $5,000 increments up to $100,000 ($20,000 in Guaranteed Issue)Children: $10,000 (live birth to age 19 or 25 if full time student)

BASIC LIFE: Monthly Rate per $1,000 $0.235

BASIC AD&D: Monthly Rate per $1,000 $0.02

OPTIONAL LIFE MONTHLY RATE PER $1,000 DEPENDENT LIFE MONTHLY RATE PER $1,000

Spouse Rates/$1,000

LT 25 $0.07 LT 25 $0.07

25-29 $0.08 25-29 $0.08

30-34 $0.09 30-34 $0.09

35-39 $0.12 35-39 $0.12

40-44 $0.15 40-44 $0.15

45-49 $0.23 45-49 $0.23

50-54 $0.37 50-54 $0.37

55-59 $0.64 55-59 $0.64

60-64 $0.99 60-64 $0.99

65-69 $1.60 65-69 $1.60

70-74 $3.70 70-74 $3.70

75+ $3.70 75+ $3.70

Children $0.10

OPTIONAL MEMBERS AD&D $0.03 OPTIONAL FAMILY AD&D $0.03



May 16, 2011 11:45 AM

Prudential Dependent AD&D Benefits

FAMILY

Spouse only: 60%

Child only: 15%

Spouse/Child: 50%/10%

Benefit amount equal to optional like amount

Optional AD&D Schedule of Benefits

LOSS OF: % OF PRINCIPAL SUM

Life 100%

Both Hands or Both Feet 100%

One Hand and Foot 100%

One Hand or One Foot and Sight of One Eye 100%

One Hand or One Foot 50%

Thumb & Index Finger of Same Hand 25%

Sight in Both Eyes 100%

Sight in One Eye 50%

Speech 50%

Hearing in Both Ears 50%

Speech & Hearing in Both Ears 100%

Quadriplegia 100%

Paraplegia 75%

Hemiplegia 50%

ADDITIONAL BENEFITS FOR LOSS OF LIFE:

Seat Belt Additional 10% up to $10,000

Airbag Additional 10% up to $10,000

OPTIONAL BENEFITS SCHEDULE:

Tuition Reimbursement for Dependent Spouse Lesser of $2,500; 1% amount of insurance; or actual tuition; up to 4 years

Tuition Reimbursement for Dep. Child(ren) under age 23 Lesser of $2,500; 1% amount of insurance; or actual tuition; (excluding room/board) up to 4 years

Day Care for Dependent Child Lesser of $2,000; 1% amount of insurance; actual cost charged; up to 4 years

Felonious Assault 5% of coverage

Return of Remains Lesser of $2,000; actual covered expense

Exposure to the Elements & Disappearance Exposure treated as accidental injury; disappearance considered loss of life after one year.

Coma longer than 6 months 1% up to 11 months



May 16, 2011 11:45 AM

Eligibility Description Active Full Time Employees earning $60,000 or more annually working at least 30 hours per week

Definition of Earnings Base salary only

Service Waiting Period None

Contribution 100% contributory

Participation Requirement 15% - If this is not met, our rates/proposal will be revised and offer may not be valid.

Elimination Period 14 days accident / 14 days sickness

Maximum Weekly Benefit $300

Minimum Benefit $300

Benefit Duration 26 weeks

24 Hour Coverage Applies

Offsets for Other Income Does not apply

Partial Disability Applies

Pre-existing Condition Exclusion 3/12 Prudent Person pre-existing condition exclusion applies.

Evidence of Insurability Applies to late entrants

Telephonic Claim Submissions Excluded

Check Production Bi-weekly

Tax ServicesAs part of out service, we provide bi-weekly and quarterly financial reports in addition to the withholdings of appropriate employee FICA and any requested Federal Income Tax (FIT), State Income Tax (SIT), and/or local taxes. FICA matching and W-2 preparation can be provided at an additional cost with underwriting approval.

Prudential LTD Schedule of BenefitsEligibility Description Active Full Time Employees earning $60,000 or more annually working at least 30 hours per week

Definition of Earnings Base salary only

Service Waiting Period None

Contribution 100% contributory, benefits are not taxable

Participation Requirement 15% - If this is not met, our rates/proposal will be revised and offer may not be valid.

Elimination Period 180 days

Scheduled Benefit 60%

Maximum Monthly Benefit $3,000

Minimum Benefit Greater of $100 or 10%

Benefit Duration To Social Security Normal Retirement Age with ADEA I

Social Security Offset Family

Definition of Disability

First 24 months - unable to perform the material and substantial duties of your regular occupation and you have a 20% or more loss in your monthly earnings; and under the regular care of a doctor. After 24 months - unable to perform the duties of any gainful occupation for which you are reasonably fitted by education, training or experience; and you are under the regular care of a doctor. Gainful benefit while not working will match the scheduled benefit for the plan.

Partial Disability Applies/ During Regular Occupation period earnings cannot exceed 80%. During Gainful Occupation period earnings cannot exceed 60%.

Residual Applies

Return to Work Incentive Applies 12 months, Offsets based on lost earnings formula

Indexing of Pre-disability Earnings Offsets based on lost earnings formula

Mental Nervous / Drug Alcohol Limit Applies - 24 months

Survivor Benefit 3 x GMB

Pre-existing Conditions A 3/12 pre-existing exclusion applies, as well as for any increase in benefits to the prior plan

Evidence of Insurability Applies to late entrants

LTD Rate Rate/$100 of CMP $0.754

STD Rate Rate/$10 Weekly Benefit $0.59

Prudential STD Schedule Benefits

Administered by:


Offered through:

Toll Free 1-877-925-1840

Dental Benefits



May 16, 2011 11:45 AM

Ameritas Group Dental

Rates are guaranteed for 12 months following the effective association launch date and include Orthodontia if part of plan design.Rates include ID cards mailed to members home address.PLEASE NOTE: Rates assume enrollment in our electronic certificate (eCert) programContact your benefits administrator for details regarding these states.

COINSURANCE BASE PLAN BUY-UP PLAN

Type 1: 100% 100%

Type 2: 80% 80%

Type 3: 50% 50%

DEDUCTIBLE $75 per cal yr - Waived Type 1 (No Family Maximum)

MAXIMUM PER PERSON $1,000 per cal yr $2,000 per cal yr

PPO www.ameritasgroup.com/resources/419.asp

ALLOWANCE Type 1, 2, & 3 : 80th % of Usual and Customary

DENTAL REWARDS Dental Rewards is a program that if benefits used are less than $500 for the year then a $250 carryover will be awarded to your annual benefits maximum

WAITING PERIOD 3 months - Type 2 procedures & 6 months - Type 3 procedures (All Plan Members)

ORTHODONTIA SUMMARY Allowance All Plan Designs: In Network, discounted fee. Out of Network, U&C.

Coinsurance: 50%

Coverage for Adults: No

Lifetime Max: $1,000 per person

Waiting Period: 12 Months (All Plan Members)

TYPE 1: PROCEDURE (FREQUENCY)

Routine Exam (1 in 6 months) Bitewing X-rays (1 in 12 months)

Full Mouth/Panoramic X-rays (1 in 5 years) Periapical X-rays

Cleaning (1 in 6 months) Fluoride for Children 13 & under (1 per benefit period)

Routine Exam (1 in 6 months) Bitewing X-rays (1 in 12 months)

Full Mouth/Panoramic X-rays (1 in 5 years) Periapical X-rays

Cleaning (1 in 6 months) Fluoride for Children 13 & under (1 per benefit period)


Sealants (age 13 and under) Restorative Amalgams

Restorative Composites Denture Repair

Simple Extractions

Sealants (age 13 and under) Restorative Amalgams

Restorative Composites Denture Repair

Simple Extractions


Space Maintainers Onlays

Crowns (1 in 10 years per tooth) Crown Repair

Endodontics (nonsurgical) Endodontics (surgical)

Periodontics (nonsurgical) Periodontics (surgical)

Prosthodontics (1 in 10 years) (fixed bridge; removable complete/partial dentures)

Complete Extractions Anesthesia

Space Maintainers Onlays

Crowns (1 in 10 years per tooth) Crown Repair

Endodontics (nonsurgical) Endodontics (surgical)

Periodontics (nonsurgical) Periodontics (surgical)

Prosthodontics (1 in 10 years) (fixed bridge; removable complete/partial dentures)

Complete Extractions Anesthesia

MONTHLY RATE WITH ORTHODONTIA

AREA 1 AR, AL, IN, KY, LA, MO, MS, MT, ND, NC, NE, NM, OH, OK, SC, TN, UT, WV Not Approved in: NY, NH

Member Member + 1 Dependent

Member + 2 or More

$31.72 $60.32 $95.72

$36.16 $67.88

$105.56

AREA 2 AZ, CO, DC, DE, GA, ID, IL, KS, MD, ME, MI, MN, NV, OR, PA, RI, TX, VA, WI, WY Not Approved in: NY, NH


Member + 2 or More

$38.80 $76.08

$125.24

$45.76 $88.72

$143.80

AREA 3 AK, CA, CT, FL, HI, MA, NJ, WA, VT Not Approved in: NY, NH


Member + 2 or More

$47.52 $92.52

$150.28

$58.12 $111.56 $177.56

Administered by:


Offered through:

Toll Free 1-877-925-1840

EyeMed Vision Benefits



May 16, 2011 11:45 AM

EyeMed Vision Benefits

EYEMED ACCESS NETWORK OUT OF NETWORK

Annual Eye Exam Covered in Full Up to $35

LENSES (PER PAIR)

Single Vision Covered in Full Up to $25

Bifocal Covered in Full Up to $40

Trifocal Covered in Full Up to $55

Lenticular 20% discount No Benefit

Progressive See lens options N/A

Frames $130 Up to $65

Frequencies (Exam/Lens/Frames) 12/12/24 Based on date of service 12/12/24 Based on date of service

DEDUCTIBLE, MAXIMUMS

Deductible $10 Exam/$25 Eye Glass Lenses No Deductible

Max Cal Yr None None

CONTACT LENSES

Fit & Follow up Exams Standard: Member cost up to $55 Premium: 10% off of retail

No Benefit No Benefit

CONTACTS

Elective Up to $130 Up to $104

Medically Necessary Covered in Full Up to $200

Progressive LensesStandard: $65 + lens deductible

Premium: Lens cost - 20% discount - $120 allowance + Standard Progressive cost

Up to $35

Std. Polycarbonate $40 No Benefit

Scratch Resistant Coating $15 No Benefit

Anti-Reflective Coating $45 No Benefit

Ultraviolet Coating $15 No Benefit

LASIK or PRKAverage discount of 15% off retail price or 5%

off promotional price at US Laser Network participating providers.

No Benefit

RATES

Member $7.72

Member + 1 Dependent $13.76

Member + 2 Dependent $18.60

Rates are guaranteed for 24 months following the effective date listed above. Rates include: home address mailing.PLEASE NOTE: Rates assume enrollment in our electronic certificate (eCert) program. If you choose to receive paper certificates, monthly rates will increase $.20 per member.The EyeMed Vision Benefit is not approved in NY or NH.

Administered by:


Offered through:

Toll Free 1-877-925-1840

SBU Multiple Employer 401(k) Plan



May 16, 2011 11:45 AM

Contact Information

Summit Retirement Group1-877-343-0202

Your AdvisorMatthew Headley

(512) 342-0202

The process of choosing a retirement plan provider is about much more than comparing products and features. It’s about choosing the people and organization you can trust to deliver high-quality service you and your employees can depend on.

Our Culture - Three Companies - Three Values

The power of three. Small Business United, Summit Retirement Group and Ascensus present a multiple employer 401(k) Plan designed to reduce fiduciary responsibility and overall fees. The power of three synergy is best defined by our Core Values: People Matter. Quality First. Integrity Always.® Our Core Values are our identity and the criteria used for conducting business and shaping relationships.

People Matter - refers to the quality of people we hire as well as the personal service delivered by our skilled associates to plan sponsors and participants. Ascensus‘ retirement professionals are actively recruited for their breadth and depth of experience and are trained to treat every client with respect, professionalism and responsiveness.

Quality First - speaks to our emphasis on getting it right the first time. We operate with the understanding there is no substitution for diligent preparation and thorough quality control. This principle is well-reflected in our high client satisfaction ratings.

Integrity Always - is directly related to our high ethical standards, our commitment to delivering on our promises and our focus on building trust through consistently superior service. After all, in a business built on relationships, maintaining a client‘s confidence in our capabilities is essential for long-term success.

Presented by


Introduction 42

Participant Services 43

Getting Started 44

Pricing & Fee Schedule 45

Fund Line-up 46



May 16, 2011 11:45 AM

Introduction

Small Business United and Summit Retirement group asked the question...

”If you had the chance to build the perfect retirement plan for your company…what would you do?”

Together we created a retirement plan that provides the framework of a traditional 401(k) platform but removes much of the burden from the employer. We challenged ourselves to reach beyond the obvious to create a retirement plan designed for Small Business!

What is a Multiple Employer Plan ?A Multiple Employer Plan (MEP) is a retirement plan for businesses that typically have a common interest, but are not commonly owned. The common interest in this case is your Small Business United Membership. Your SBUA membership provides your business access to become an “Adopting Employer” of the MEP.

By electing to join the MEP you shift much of the burden of providing a retirement plan to Small Business United.

SUMMIT RETIREMENT GROUP is an independent retirement plan consulting firm specializing in comprehensive retirement plan advice. Summit provides clients with access to full retirement planning services, assistance with daily administrative responsibilities for their plan, fiduciary support and comprehensive financial advice for all interested plan participants. Our mission is to build and develop retirement plans by creating trusting relationships with our clients.

ASCENSUS is the nation‘s largest independent recordkeeper and administrator for retirement plans in the micro

to large market segments and a leading provider of regulatory expertise, plan document services and participant enrollment support. Servicing retirement plans is what we do.

SMALL BUSINESS UNITED is a Multiple Employer 401(k) Retirement Plan Sponsor. As a Multiple Employer Plan Sponsor SBU holds the master contract under which Adopting Employers (You) may join their retirement plan platform.

Small Business United established the Multiple Employer 401(k) Plan for the benefit of its member companies.




May 16, 2011 11:45 AM

Participant ServicesUser-friendly participant websiteAt the core of these offerings is our interactive participant website with full-service capabilities. Serving as a dashboard for a participant‘s account, the website provides a central place where users can easily go from checking the market to updating account information to monitoring investment progress over time. Users can also visit the Learning Center, a suite of retirement planning resources, including articles, calculators and research.

Tools can be used to:

• enroll in the plan• customize content layout• monitor account activity• set up automatic account re-balancing• process transactions• calculate personal rate of return• access fund fact sheets and prospectuses• utilize Morningstar Retirement Manager

Demo Participant Website

https://myaccount.ascensus .com/rplink

Web User ID: 777787755a

Password: SingleSource1

Date of Birth: 01/01/1971

SSN# 777-78-7755

Zip Code: 19025

Interactive Voice Response (IVR) SystemOur secure IVR system enables participants to manage their accounts using the telephone. Customized for your plan, our IVR system offers participants the ability to quickly and easily get up-to-date account information, complete transactions, submit distribution requests, access planning tools and speak directly with a representative. This system is available 24 hours a day, seven days a week and is accessible to all participants via a toll-free telephone number.

Demo Participant IVR System

Phone: 866-809-8146

SSN# 777-79-1234

PIN: 1234

Participant Service CenterFor participants who prefer to speak with someone over the phone, our Participant Service Center is supported by highly trained associates, dedicated to ensuring all participant service needs are handled promptly and with care. Equipped to respond to inquiries and requests in a timely, accurate and professional manner, this team is available Monday through Friday, from 8:30 a.m. to 7:00 p.m., Eastern Time.

Providing Ongoing SupportWe‘ve created a comprehensive brochure to educate you on the tools you can use to increase participation. The Participant Solutions from Ascensus brochure brings all the elements together by incorporating information on It’s Your Story, our enrollment presentations, Targeted Communications, (k)ruiseControl, TBC and more. This piece provides a clear understanding of how Ascensus‘ services can be customized to meet your unique objectives and to maximize the benefits for your employees throughout the life of your plan.

Easy-to-Understand Quarterly StatementsParticipants will receive a quarterly statement called Your Retirement. This statement includes a clear overview of everything a participant needs to know about his or her retirement account, including:

• a summary of holdings and performance over recent periods• personal rate of return for the quarter• information on loans (i.e., interest paid, principal paid and beginning

and ending balances) re-balancing• a breakdown of different money types as applicable—including salary

deferral, employer match and profit sharing• balances, rollover and Roth—as well as the amount vested• asset allocation pie charts, showing both current and future

allocations grouped by asset categories • In addition, plan sponsors can take advantage of custom

statement messaging capabilities to make special retirement plan announcements

Example




May 16, 2011 11:45 AM

Getting Started

1. Sign Adoption Agreement

2. Complete the enclosed Plan Establishment Kit (PEK). Or call an Ascensus retirement coordinator at 800-345-6363 to request one and receive assistance in completing it.

3. Mail or fax the completed PEK to: Ascensus

ATTN: New Business124 8th Avenue NEBrainerd, MN 56401Fax: 218-855-6010Installation coordinator

To ensure a smooth and successful transition of the plan into our ongoing service, you will be paired with a dedicated installation coordinator (IC) who is responsible for providing the resources and guidance for a seamless onboarding process.

The IC‘s role is to:

• help you prepare required documentation (e.g., a board resolution, blackout notice, etc.)• distribute appropriate notifications to both prior service providers and to your employees

(e.g., safe harbor, blackout notices, etc.)• review options that impact plan documentation, payroll and census submission• coordinate required enrollment materials• develop a custom installation timeline and manage to the agreed upon project milestones• prepare, review and explain plan documentation• set up and review plan provisions on the system• facilitate reconciliation and conversion of census and financial data• provide materials to support ongoing plan administration such as contribution submission/funding, submission of census

data, forfeiture allocations, etc. As the installation is nearing completion, the IC will introduce you to your Client Service Team.




May 16, 2011 11:45 AM

Pricing & Fee Schedule

Number of ParticipantsParticipants 1 - 15 $2,600 Base Fee

Participants 16 - 100 $60 (Additional Per Participant Fee)

Participants 101 - 500 $55 (Additional Per Participant Fee)

Participants 501 and greater $50 (Additional Per Participant Fee)

*Employer will receive a $150 credit toward the Base Fee if the plan is a 401(k) ADP/ACP Safe Harbor Plan

This is an annual fee payable quarterly in arrears beginning with the Effective Date of the Agreement. This fee assumes use of the Small Business United Multiple Employer 401(k) Retirement Plan document and assumes that payroll contribution dollars are remitted via Ascensus-initiated ACH. Additional fees (e.g., document, testing) may apply for a non-Ascensus-sponsored plan document or an Ascensus volume submitter document. A Participant includes any eligible individuals with a balance in the Plan including both current and terminated employees and beneficiaries

Annual Service Fee

Plan Amendment $400 signature required due to employer initiated or mandatory law or regulatory changes

Loan Processing and Establishment $125 per loan (one-time fee) - deducted from participant’s account

Distribution Processing $60 per distribution – deducted from participant’s check proceeds

Data Submission Services:Hardcopy Contribution Data Processing $1,000 annually

Manual Conversion Data $10 per participant; minimum $500

Trustee/Custodian Services provided by Frontier Trust CompanyNotes: 1. Frontier retains float. 2. Manual Processing Fees Apply

Basic Trustee/Custodian Services are included in annual service fee

Additional fees may apply for special services

Manual Contribution Processing via Check or Wire (Non-ACH) $300 annually

Plan Termination/Service Termination $750

Morningstar® Retirement ManagerSM

h Managed by MorningstarParticipant: Annual fee on assets of 0.45%

Age-weighted OR New Comparability Contribution Calculation with Cross-Testing $775 (3 hour minimum), $225/hour thereafter

Additional services are provided on a fee for services basis including but not limited to ERISA Support Services and specialized testing services.

NOTE: Sales tax may be applicable, either now or in the future, to the products and/or services provided by Ascensus under this Agreement. All applicable sales tax will be in addition to the fees set forth in this Agreement.

Other Fees

Setup Fee

Adoption Agreement $500

Summary Plan Description $100




May 16, 2011 11:45 AM

Fund Line-up

FUND NAME TICKER

JPMorgan Prime Money Market Inst jinxx

American Century Inflation Prot Bd Instl apisx

BlackRock Inflation Prted Bd BlackRock bplbx

Hartford Inflation Plus Y hipyx

JPMorgan Core Bond Select wobdx

Lord Abbett Total Return I ltryx

Metropolitan West Total Return Bond I mwtix

Fidelity Strategic Income fsicx

Franklin Strategic Income Adv fksax

Pioneer Strategic Income Y stryx

Vanguard Total Stock Mkt Idx Inv vtsmx

Schwab Total Stock Market Index swtsx

T. Rowe Price Total Equity Market Idx pomix

American Century Growth Instl twgix

Franklin Growth Adv fcgax

MainStay Large Cap Growth R1 mlrrx

First American Equity Income Y faqix

RidgeWorth Large Cap Value Equity I stvtx

T. Rowe Price Equity Income prfdx

Nationwide Mid Cap Market Index Instl gmxix

Northern Mid Cap Index nomix

Principal MidCap S&P 400 Index Inst mpsix

Goldman Sachs Growth Opportunities I ggoix

FUND NAME TICKER

Prudential Jennison Mid Cap Growth Z pegzx

MTB Mid-Cap Growth Instl I armex

American Century Mid Cap Value Inst avuax

Goldman Sachs Mid Cap Value Instl gsmcx

RidgeWorth Mid-Cap Value Equity I smvtx

Schwab Small Cap Index swssx

Vanguard Small Cap Index Inv naesx

Columbia Small Cap Growth I Z cmscx

JPMorgan Small Cap Growth Inst jisgx

Prudential Jennison Small Company Z psczx

Delaware Small Cap Value Instl devix

Oppenheimer Developing Markets Y odvyx

Hartford International Opp HLS IA hiaox

Manning & Napier World Opportunities A exwax

MFS International Diversification R4 mditx

Vanguard Total Intl Stock Index Inv vgtsx

DWS RREEF Real Estate Securities Inst rrrrx

Vanguard Target Retirement 2010 Inv vtenx

Vanguard Target Retirement 2015 Inv vtxvx

Vanguard Target Retirement 2020 Inv vtwnx

Vanguard Target Retirement 2025 Inv vttvx

Vanguard Target Retirement 2030 Inv vthrx

Vanguard Target Retirement 2035 Inv vtthx


Administered by:


Offered through:

Toll Free 1-877-925-1840

Individual(k) Retirement Plan



May 16, 2011 11:45 AM

Individual(k) Retirement Plan

Individual(k): A BIG PLAN for a SMALL BUSINESSIndividual(k) provides business owners with the same advantages of larger 401(k)

plans—without the extensive administrative responsibilities, complex discrimination tests

and associated costs. And when compared with other small business retirement plans,

Individual(k)s are uniquely positioned to help clients save, protect and grow their assets.

888-SBUA-INS (888-728-2467)

Licensed Benefit Solution SpecialistsAvailable from 8am - 5pm (CST).

An Individual(k) plan is a cost-effective 401(k)/profit sharing plan

for small business owners. This type of retirement plan provides

a number of substantial benefits that are not generally available

through traditional small business retirement plans. Designed

exclusively for owner-only businesses and small businesses that can

exclude certain employees from coverage, the Individual(k) plan has

many advantages over conventional 401(k) plans that are typically

sponsored by companies with multiple employees. The Individual(k)

plan is designed to maximize contributions, but to be less complex

and less costly to maintain than the conventional 401(k) plan.

Reasons to look at an Individual(k) Retirement Plan

• Tax Advantages• Higher Contributions• Loan Provisions• Roth Capabilities• Low Cost• Simplified Plan Administration

The Individual(k) plan will be available through SBU & Summit beginning February 1, 2011.

How Individual(k)s WorkThe law changes that made the Individual(k) plan possible did not explicitly create a completely new type of

business retirement plan. Instead, what the new laws did was make a number of changes to the rules governing

401(k) plans that made them more attractive to certain small business owners. Prior to the passage of pension

reform, there was no practical reason to use a 401(k) plan for an owner-only business since they could receive the

same or greater benefits with less expense by establishing a profit sharing or money purchase plan. However, there

are some very compelling reasons for certain small business owners to consider Individual(k) plans, chief among

them, to maximize retirement savings.

Individual(k) Plan Cost Installation and Plan Setup Fee $125 for daily valued/$75 for traditional valued

Annual Fee $315 for the first participant account $150 for each additional participant.

Self-employed who are Good Candidates for an I(k) include:

Lawyers & Doctors with their own practices Real Estate Agents Clergy FREELANCE Writers or Graphic Designers Interior designers Consultants Plumbers Accountants CONTRACTORS Photographers

Administered by:


Offered through:

Toll Free 1-877-925-1840

Long Term Care Insurance



May 16, 2011 11:45 AM

Long Term Care Insurance

Help Secure your future by planning aheadLong-term care refers to a variety of services and

supports that help you with health of personal care

needs over an extended period of time.

When might you need long-term care?

You may need long-term care if you:

• Develop a prolonged or chronic illness.• Sustain a serious injury or disability.• Develop a cognitive impairment that causes

memory loss or disorientation, such as Alzheimer’s.• Need assistance due to the normal frailties of aging.

There are several types of Long-Term Care“Skilled care” refers to care given by medical personnel, such as a registered nurse or professional therapist. It requires a physician-prescribed plan of care. “Personal care” focuses on helping with your activities of daily living. It is less involved and may be provided by trained professionals or even a family member.

It isn’t just for the elderly?Most of us think of long-term care as being only for the elderly and those in nursing homes, but that’s only part of the story. Forty percent of people currently receiving long-term care services are adults under the age of 65. And, most people receive long-term care services either in their own home, or in the home of a family member—not in a nursing home.

Anyone could need help with everyday Routines.The fact is, anyone at any age may need long-term care at some point in their lives. If you sustain an extensive injury or go through a prolonged illness, you may need help with your normal daily activities, such as bathing, getting dressed, or just getting around the house. If you become cognitively impaired, you may need help with meal preparation and eating, or reminders to take medications, or other kinds of support.

Understanding your need for long term care.Although these everyday activities may seem mundane, they are essential to maintaining your independence. Your ability, or inability, to perform these regular activities of daily living give long-term care professionals and those in the insurance industry a very practical measure to use when deciding if you need long-term care. Activities of daily living, often referred to as ADLs, include such regular activities as bathing, dressing, using the toilet, transferring to or from the bed or a chair, caring for incontinence, or eating.

It’s difficult to predict how long you may need care.You can’t predict the future, but these facts might give you an idea of how long you may need long-term care. On average, someone age 65 today will need some long-term care services for three years.

Your long term care needs may change overtime.The amount and type of long-term care services you need will often change gradually over time. For example, early on you may need only occasional help for a few activities of daily living, and may choose to receive that assistance in your own home. Over time, however, you may begin to require more regular assistance and choose to live in an assisted living center.

CALL TODAY! 1-877-YES-LTCI

43% of all claims for long-term care insurance benefits are from people under age 65.

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Medicare Supplemental & Medicare Advantage Plans



May 16, 2011 11:45 AM

Medicare Supplemental & Medicare Advantage Plans

Medicare Supplement Insurance (Medigap) In most states, Medicare Supplement plans, also known as Medigap, come in 10 plan options (labeled A-N). Each plan A-N has a different set of benefits, but for each plan that a private insurance company offers, the benefits must be the same. Therefore, the main way plans can vary is by cost & the underwriting requirements. You will want to choose a Medigap plan with the benefits that best suit your needs and find the insurance company that offers that plan at the lowest cost available.

Medicare Advantage Plans

Health plan options that are part of the Medicare program. If you join one of these plans, you generally get all your Medicare-covered health care through that plan. This coverage can include prescription drug coverage.

Medicare Advantage Plans include:

• Medicare Health Maintenance Organization (HMOs)• Preferred Provider Organizations (PPO)• Private Fee-for-Service Plans• Medicare Special Needs Plans

Medicare Part D Prescription Drug Coverage :

These plans (sometimes called “PDPs”) add drug coverage to Original Medicare, can be purchased stand alone in conjunction with original Medicare, or are included in Medicare Advantages plans labeled MAPD.

Our advisors provide expert, unbiased guidance in selecting and enrolling in the Medicare insurance that’s right for you. We have over 25 years of expertise in advising and servicing clients with their Medicare needs.*

We work with many insurance companies to help you choose the right plan to fit your needs and budget.

ETMG, LLC and Central have entered into a partnership to provide ETMG and SBU clients access to the latest news, assistance, and Supplemental Plans relating to Medicare.

Toll Free: 1-877-925-1840

1591 Washington St. East, Charleston, WV 25311 Toll Free: 1-877-925-1840 Facsimile 1-866-254-1879

Medicare Insurance providers include:

*AARP, Mutual of Omaha, and Humana Approved States: WV, NC, SC, TX, VA, OH, KY, GA and NY. (Additional States Pending Approval)

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