for more than 35 years, abacus - abacus...

FOR MORE THAN 35 YEARS, ABACUShas been offering dynamic voluntary benefits that deliver peace

of mind, confidence, and security. We are an experienced and

effective marketing and managing general underwriter, dedi-

cated to forging long-lasting relationships with our clients. Our

specialty is developing voluntary benefits that match your par-

ticular needs. With products issued through the world’s largest

re-insurers, we maintain underwriting authority and discretion

to bring you, the broker, the most competitive and flexible prod-

uct for your clients.

We are rooted in the belief that quality doesn’t just happen;

rather, it’s a result of high expectations, intelligent direction,

and skillful execution. Abacus continually measures the needs

of our market and leverages our experience and imagination to

set industry standards — for plan creativity, customer trust,

and voluntary benefit performance.

West Coast Corporate Office800-643-2212

East Coast Corporate Office800-653-5242

For more information, visit us at: www.abacusseries.com

YOU CAN COUNT ONCUSTOMIZED SOLUTIONS

Abacus believes in customized solutions. “Shelf Rates” are fine if

you are only selling product. But, we believe that the voluntary in-

surance market demands creativity. So, when you see a plan that

carries the Abacus name; you know that it’s a plan of flexibility,

choice, and unique design.

Features include:

• Flexibility in elimination and benefit periods

• No percentage participation requirements

• Minimum group size of five (5) enrolled

• Plans designed for associations, unions, PEO’s, and 1099’s

• No excluded W-2 industries

• Annual Guarantee Issue re-enrollments

• Pre-existing Condition

• Portability

YOU CAN COUNT ONPRICING FLEXIBILITY

Our philosophy is designed with a simple goal in mind: to provide

clients with a plan design that makes financial sense and that meets

the unique benefit needs of each group. Abacus offers:

• Pricing based on Issue or Attained age

• SIC Code classification and evaluation

• Group discounting based on size

• Replacement coverage

• Percentage of income covered

• Continuity of coverage

YOU CAN COUNT ONPERSONALIZED SERVICE

At Abacus, our post-sales support has been specifically designed to

uphold our voluntary employee benefits. Abacus provides respon-

sive service from experienced professionals who have a thorough

working knowledge of the Abacus Series products. You get expert-

ise and support in the following areas:

• Billing

• Live, toll-free customer support

• Flexible mode of payment

• Simplified billing statements

• Consolidated billing

• Claims

• Live, toll-free customer support

• Personal claims examiner

• 3-day average claim response turnaround

• STD claims paid weekly

YOU CAN COUNT ONFLEXIBILITY, SUPPORT, AND RESPECT

Support on every level is only a quick phone call away. When you

team up with Abacus, you have the flexibility you need to create vol-

untary insurance plans with the range of options your clients need.

Abacus supports your decisions, values your independence, and re-

spects your groups — as your clients. Call us and find out what a

growing number of brokers already know:

YOU CAN COUNT ON ABACUS

Difference!The

All Disability plans are NOT created equally. In today’s economy, price is important - but itis also important to “get what you pay for”. With the Abacus Series, you’re getting the mostfor your dollar.

The SimilarityOptional Benefit Amounts ................................................................

Optional Elimination Periods ............................................................

Optional Benefit Periods ..................................................................

The DifferenceNo Participation Requirement..........................................................

Claims Paid Weekly............................................................................

Pays in addition to all other sources of incomefor the first 10 days after the Elimination Period ..........................

Pays benefits up to 100% of all income forthe first calendar year ......................................................................

Waiver of Premium while receiving benefits ................................

Issue Age rates for initial policy and increases............................

Annual Guarantee Issue open enrollments ..................................

Pre-existing Condition benefit of 25% or 100% for 4 weeks........

Coverage offered to W-2 or 1099 employees working 20+ hours per week ............................................................

Signature-only Applications and Online Enrollment ....................

No census required on groups of less than 1,000 ........................

While many carriers discuss their coverage in terms of rates, our philosophy is to providecustomized plans that offer quality benefits at a competitive price. If we didn’t take thisapproach, we would be the same as every other carrier.

Abacus Series Your Competitor

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MONTHLY COST $ $

The Abacus Series allows you the flexibility to:• Change your Pre-existing Condition waiting period • Offer 24-hour or Off the Job-only coverage• Offer Weekly Claim payments • Add Portability • Allow varying coverage based on Income

To learn more about the Abacus Series of products,please call us at 1-800-643-2212

Assets Dec. 31, 2013 Dec. 31, 2012Investments:Fixed maturity securities availablefor sale, at fair value $ 2,618,620 $ 2,788,141Equity securities available for sale,at fair value 34,386 20,061Mortgage loans 629,256 674,034Real estate 142,536 1224,742Policy loans 83,518 77,133Short-term investments 40,712 24,902Other investments 1,247 2,572

Total investments 3,550,275 3,711,585

Cash 8,197 7,026Accrued investment income 33,795 34,747Deferred acquisition costs 256,386 176,275Reinsurance receivables 191,055 190,613Property and equipment 17,524 18,343Other assets 64,018 47,063Separate account assets 393,416 340,093

Total assets 4,514,666 4,525,745

LiabilitiesFuture policy benefits 910,228 889,107Policyholder account balances 2,096,212 2,128,002Policy and contract claims 36,783 29,813Other policyholder funds 160,421 155,749Other liabilities 192,202 232,580Separate account liabilities 393,416 340,093

Total liabilities 3,789,262 3,775,344

Stockholders' EquityCommon stock, par value $1.25 per shareAuthorized 36,000,000 shares,

issued 18,496,680 shares 23,121 23,121Additional paid in capital 40,989 40,969Retained earnings 823,408 805,730Accumulated other comprehensive income 14,170 54,094Treasury stock, at cost (2013 - 7,527,841 shares;2012 - 7,463,823 shares) (176,284) (173,513)Total stockholders’ equity 725,404 750,401

Total liabilities & stockholders’ equity 4,514,666 4,525,745

Summary ofasset strength

Industry RatingsBelow is a summary of ratings assigned toKansas City Life Insurance Company byone of the most recognized insuranceindustry analysts

A.M. Best Company RatingA (Excellent)Rating is based on Kansas City LifeInsurance Company's relative financialstrength and operation performance.According to Best, "A (Excellent) isassigned to companies which, in ouropinion, have demonstrated excellentoverall performance when compared to thestandards established by A.M. BestCompany.

A (Excellent) companies have a strongability to meet their obligations toPolicyowners over a long period of time."The 15 Best ratings range from A++(Superior) to F (In Liquidation).

as of 06/2013

(amounts in thousands, except share data)

Abacus Series PrePrinted Enrollments offer a hassle-free solution to the labor intensiveness andloss of production that employers and HR Directors have traditionally dealt with, providing a turn-keysolution that simplifies the process for everyone.

Our preprinted, signature-only benefit election and enrollment forms allow you to take advantage of:

✓ Minimal HR Involvement ✓ Maximum Effectiveness ✓ Less Effort and Errors

PrePrinted Enrollments

All you need is a census with Name, DOB, Salary and any other application data you want to include.

Contact us with any questions at: 800-653-5242

Our claims staff has a front line focus on delivering superior customer satisfaction and the very best outcomes. Better outcomes mean stronger returns.

Our telephonic Short-Term Disability claim submission process is fast and easy and most important, no time consuming forms to complete.

•  Claimant calls a dedicated toll free number to initiate their claim: (866) 590-7448. •  Claimant has immediate access to one of our knowledgeable Ability Analysts who are trained to

put the claimant at ease from the start by explaining what is necessary to adjudicate the claim as quickly as possible as well as what the claimant can expect next.

•  Within one business day, our Ability Analyst reaches out to the employer and attending physician to obtain the necessary information to make a claim decision.

Our Ability Analysts are diligent and adhere to strict performance guarantees. Most importantly, they ensure the claimant is regularly informed of the status of their claim.

•  Focus on return to work, •  determine reasonable recovery, •  set expectations, •  coordinate with the attending physician, and •  assess rehabilitation potential if appropriate.

•  90% of our Short-Term Disability claim decisions are made within 5 business days from receipt of complete information.

•  90% of employers were extremely satisfied with our claim services. •  Our claimant satisfaction rating has exceeded 90% for six years running.

How it works….

How we’re doing…

Our goals are to….

All of these goals can help claimants return to productivity, which helps you improve your bottom line.

Bob Broker

The Insurance Company

Your broker is:

Email:

Group Size:

Issued through Kansas City Life

800-555-0000

12345 Main St.Anytown, US 67890

Valid until: 11/19/14

PROPOSAL Sample Rates

249

GA

4213

Domicile State:

SIC Code:

[email protected]

VOLUNTARY SHORT TERM DISABILITYVOLUNTARY LONG TERM DISABILITYVOLUNTARY GROUP TERM LIFE AND AD&D

Valid until: 11/19/14 Page: 2 of 7Valid until: 11/19/14

PROPOSAL Prepared for:

The Abacus Group is an experienced and effective managing general underwriting firm dedicated to forginglong lasting relationships with our clients. With products backed by the worlds largest reinsurers, The AbacusGroup specializes in the design and pricing of Disability and Group life plans. With 38 years of experience, wemaintain underwriting authority and discretion to bring to you a product that is fundamentally sound. We are notdriven by Wall Street trends, stock prices, or corporate management whims. We are rooted in the belief that qualitydoesn't just happen; rather it is a result of high expectations, intelligent direction, and skillful execution.

Administration of The Abacus Series PlanThe Abacus Series, issued through KCL, is administered by North American Benefits Company. With specialemphasis on the worksite market, NABCO provides support in billing, policy issue, and customer service. Theirinnovative technology has allowed The Abacus Series to keep operating cost low, thereby maintaining competitivepremiums on outstanding products.

Abacus Series Claim AdministrationThe Abacus Series Claims Department is comprised of a fully staffed group of professionals, each with their ownexperience in a specific area of claim processing. Disability claims are administered by the Hartford, and everyclaim is approached knowing that work and income are an integral part of life. Abacus strives to utilize the mosteffective and expeditious methods of communication to ensure claim payment is seamless.

A.M. Best Company RatingRating is based on Kansas City Life Insurance Company's relative financial strength and operation performance.According to Best, "A (Excellent) is assigned to companies which, in our opinion, have demonstrated excellentoverall performance when compared to the standards established by A.M. Best Company.

A (Excellent) companies have a strong ability to meet their obligations to Policy owners over a long period oftime." The 15 Best ratings range from A++ (Superior) to F (In Liquidation).

Industry Rating

A

Sample Rates

Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

VOLUNTARY SHORT-TERM DISABILITY VOLUNTARY LONG-TERM DISABILITY

BENEFIT PERIODS13 weeks, 26 weeks,52 weeks, 104 weeks

BENEFIT PERCENTAGEUp to 65% of weekly earnings30% in statutory states (requiring statedisability benefits - CA, HI, NJ, NY, RI)

ELIMINATION PERIODS(refers to injury/sickness)0 days/7 days, 7 days/7 days, 0 days/14 days, 14 days/14 days,30 days/30 days

BENEFIT AMOUNTS$75 to $1,400 per week(from $50 in statutory states)sold in $25 increments

HIGHLIGHTS• Minimum participation - 5 enrolled

• No percentage participation requirement• Minimum 20 hours worked per week• Guarantee Issue up to $700 per week• Claims paid weekly• 12/12 Pre-existing Condition Limitation(state exceptions apply)

• 24 hour or Non-Occupational coverage• Survivor Benefit on 52 or 104 week plan• First Day Hospital Benefit available -benefits begin on first day of 24 hour ormore hospitalization - n/a with 30/30 plan

• Pre-existing Condition Benefit of 25% or100% of benefit for 4 weeks available

• Integration:• Pays in addition to all other sources ofincome for first 10 days afterelimination period• Pays benefits up to 100% of all incomefor the first calendar year

STD AND LTD SPECIAL FEATURES• No excluded W-2 industries

• Annual Open Enrollments Guaranteed Issue

• No census required on groups under 1,000 lives

• Coverage available for groups over 1,000 lives, Associations, PEO’s, Credit Unions and 1099’s

• 4 age bands

• Signature only applications & online enrollment capability

• Shorter Pre-existing Condition Limitation options available

• Issue Age rate structure for initial policy and increases(Attained Age rate structure available)

• Waiver of Premium while receiving benefits

• Replacement coverage with Continuity of Coverage

• Portability option available

• 2 year rate guarantee

ELIMINATION PERIODS(refers to injury/sickness)90 days, 180 days, 365 days

BENEFIT AMOUNTS$300 to $6,000 per monthsold in $50 increments

HIGHLIGHTS• Minimum participation - 5 enrolled for 2 year plan(No percentage participation requirement)

• Minimum participation - greater of 5 enrolled or 25% of eligiblesfor other plans

• Guarantee Issue up to $3,000 per month ($1,500 for ‘E’ industries)• 12/24 Pre-existing Condition Limitation (state exceptions apply)• Accidental Dismemberment and Loss of Sight option available

• Minimum 30 hours worked per week• Integration is Direct Full Family• Mental Illness/Drug/Alcohol/SpecialConditions Limitation

• 24 hour coverage• Survivor Benefit available

BENEFIT PERIODS2 years, 3 years, 5 years, Age 65, Normal Social Security Retirement Age

BENEFIT PERCENTAGEUp to 60% of monthlyearnings

BENEFIT AMOUNTSEmployee: from $20,000 to $500,000, up to thegreater of 5 times annual earnings or $100,000;in $10,000 increments Spouse: from $10,000 to $250,000 not to exceed50% of employee amount; in $5,000 incrementsChild: flat amount of $5,000 or $10,000

Accidental Death and Dismemberment [AD&D] (if offered): Employee:up to lesser of 2 times Life benefit amount or $500,000; Spouse: up toSpouse Life benefit amount; Child: equal to Child Life benefit amount• Employee coverage required to enroll Spouse and/or Child(ren)

For agent use only. For special limitations and exclusions please refer to our policy certificate. Coverage subject to availability by state.The ABACUS Series is issued through Kansas City Life Insurance Company.

HIGHLIGHTS• Minimum participation - greater of 5 enrolled or 20% of eligibles• Guarantee issue from $50,000 to $180,000 determined by group sizeat initial enrollment

• Annual Guaranteed Issue Employee “buy-ups”• Minimum 30 hours worked per week• Accelerated Death Benefit of 80% of coverage• Attained Age rate structure• 2 year rate guarantee• Disability waiver of premium• Portability up to 3 years

VOLUNTARY TERM LIFE

Benefits You Can Count On

BENEFITS YOU CAN COUNT ON START WITH PEOPLE YOU CAN COUNT ON.

THE ABACUS GROUP IS a marketing, underwriting, and risk-sharing company that partners with brokers, in-

surance carriers, and re-insurers to provide groups with the benefits they need. For over three decades, we have

been working with insurance companies, re-insurers and distribution sources specializing in the development of vol-

untary short-term disability, long-term disability, group life, critical illness plans and pharmacy cards.

BACKED BY A LEADING RE-INSURER in the insurance business, we’ve created an all-star lineup to deliveran insurance line of products that is adaptable and flexible. Not only does our line have the financial backing of an

industry leader, but it also provides claims service and customer support, delivered by a premier third-party admin-

istrator for full customer satisfaction. The result? A company you can count on for timely payment, reliable service,

support and products that exceed your expectations.

• A (Excellent) rating by A.M. Best

2541 Lafayette Plaza Dr.Albany, GA 31707PH: 229-436-6032

800-643-2212FX: 229-439-1644

252 Harry Lane Blvd.Knoxville, TN 37923PH: 865-539-5000

800-653-5242FX: 865-539-5011

For more information visit us at www.abacusseries.comTo request a quote e-mail: [email protected]

CORPORATE OFFICES

Short Term Disability

Traditional Plan Census: 249

RATES per $100 of Weekly benefit< 40 40 - 49 50 - 59 60 +

Weekly Premiums 3.332 3.787 4.5142.647

PRIMARY BENEFITS

THE ABACUS ADVANTAGE

Elimination Periods - Accident / Sickness 7 days / 7 days

Benefit Duration 26 weeks

Pre-existing Condition Limitation

Contributory Status Voluntary

Minimum Participation 5 Enrolled (Insured) Lives.

Hospital Confinements

Job Coverage

Issue Age Rate Structure

Non-Occupational - off the job only

For initial policy and benefit amount increases

Guarantee Issue Up to $700/week at group's initial orannual enrollment or as a new hire

Continuity of Coverage If replacing existing coverage

Pays 50% of the weekly benefit for up to 13 weeks

Paid weekly on all eligible claims

Covered the same as any other sickness

Partial Disability Benefit

Claim Payment

Claim Coordination

Pregnancy Claims


From $75 to $1,400 per week, up to 60% of salaryBenefit Amounts

Rate Guarantee 2 years

Replacement Continuity of Coverage

Minimum Hours Worked 20 Hours

If covered under the group plan for 12 months,coverage may be continued for up to 12 months

following termination of employmentPortability

Pays 25% of Benefit for 4 weeksPre-existing Condition Benefit

Annual Open Enrollment Guarantee Issue up to Underwriting limits


Only available with 52 or 104 week plansSurvivor Income Benefit

Definition of Disability Own Occupation - see Policy

While receiving STD benefitsWaiver of Premium

7/7-26WK-4213-C-TRAD-GA-WK-NOCC-FDH-PORT-25PREX-ISAG

Sample Rates

Benefits commence on First Day of HospitalConfinements of 24 hours or more

12/12 waiting period

Pays in addition to all other sources of income for thefirst 10 days, then pays benefit up to a maximum of

100% of gross income

Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

Monthly rateper $100 of

Weekly benefit

40-4950-5960+

< 40

40-4950-5960+

< 40

Age

Weekly Premiums

14.44

16.41

19.56

11.47

WeeklyBenefits

2.65 3.31 3.97 4.63 5.29 5.96 6.62 7.28 7.94 8.60 9.26 9.93 10.593.33 4.17 5.00 5.83 6.66 7.50 8.33 9.16 10.00 10.83 11.66 12.50 13.333.79 4.73 5.68 6.63 7.57 8.52 9.47 10.41 11.36 12.31 13.25 14.20 15.154.51 5.64 6.77 7.90 9.03 10.16 11.28 12.41 13.54 14.67 15.80 16.93 18.06

$100 $125 $150 $175 $200 $225 $250 $275 $300 $325 $350 $375 $400

$425 $450 $475 $500 $525 $550 $575 $600 $625 $650 $675 $700

Plan Highlights

11.25 11.91 12.57 13.23 13.90 14.56 15.22 15.88 16.54 17.21 17.87 18.5314.16 15.00 15.83 16.66 17.49 18.33 19.16 19.99 20.83 21.66 22.49 23.3316.09 17.04 17.99 18.93 19.88 20.83 21.77 22.72 23.67 24.62 25.56 26.5119.18 20.31 21.44 22.57 23.70 24.83 25.95 27.08 28.21 29.34 30.47 31.60

The information provided here is only a summary of the Short Term Disability plan.Refer to your certificate/policy for complete details and limitations of coverage.

7/7-26WK-4213-C-TRAD-GA-WK-NOCC-FDH-PORT-25PREX-ISAG 8/21/2014

Rates - Issue Age for initial policy and benefit amount increases.

Claim Payment - paid on a weekly basis on all eligible claims.

Pregnancy Claims - covered the same as any other illness.

Claim Amounts - pays in addition to all other sources of income the first 10 days, thenpays benefits up to a maximum of 100% of gross income.

Portability Options - If covered under the group plan for 12 months, you may continuecoverage under the group plan for up to 12 months following employment termination.Non-Occupational Coverage - off the job only.

Waiver of Premium - while receiving Short-Term Disability benefits.

Participation Requirement - 5 Enrolled (Insured) Lives.Guaranteed Issue up to $700/week - at group’s initial or annual enrollment or as anewly hired employee.Hospital Confinements of 24+ hours - benefits begin on 1st day of Hospitalization.

Partial Disability Benefit - pays 50% of the weekly benefit for up to 13 weeks.Pre-existing Condition Limitation - 12/12 waiting period.Pre-existing Condition Benefit - pays 25% of benefit for 4 weeks.Replacement Coverage - available up to policy limits if replacing existing coverage.

Traditional Plan

Short Term Disability

ELIMINATION PERIODS:

Sample Rates

BENEFIT PERIOD:7 Days Injury / 7 Days Sickness26 weeks

BENEFIT AMOUNTS: Employees can choose from $75 to $1,400 per week.Not to exceed 60% of weekly earnings.

Long Term Disability

Standard Plan Census: 249

RATES per $100 of Monthly benefit< 40 40 - 49 50 - 59 60 +

Weekly Premiums

PRIMARY BENEFITS


Elimination Period 180 days

Benefit Duration Up to 2 Years

Pre-existing Condition Limitation 12/24 waiting period


Minimum Participation 5 Enrolled (Insured) Lives

Job Coverage

Issue Age Rate Structure

24 Hour

For initial policy and benefit amount increases

Guarantee Issue Up to $3,000/month at group's initial orannual enrollment or as a new hire

Continuity of Coverage If replacing existing coverage

Pays 50% of the monthly benefit for up to 12 months

Paid monthly on all eligible claims

Pays dollar for dollar with full family offset

Partial Disability Benefit

Claim Payment

Claim Coordination

0.171 0.348 0.8120.067


From $300 to $6,000 per month, up to 60% of salaryBenefit Amounts


Replacement Continuity of Coverage

Minimum Hours Worked 30 Hours

If covered under the group plan for 12 months,coverage may be continued for up to 12 months

following termination of employmentPortability

2 YearOwn Occupation

Annual Open Enrollment Guarantee Issue up to Underwriting limits


Option not includedSurvivor Benefit

Definition of Disability Own Occupation for 2 years, then Any Occupation

Option not includedAccidental Dismemberment & Loss of Sight

After 180 days or when purchased STD plan is waivedWaiver of Premium

180-2Yr-4213-C-GA-WK-ISAG-2OCC-PORT

Sample Rates

Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

40-4950-5960+

< 40

40-4950-5960+

< 40

Age

MonthlyBenefits

The information provided here is only a summary of the Long Term Disability plan.Refer to your certificate/policy for complete details and limitations of coverage.

180-2Yr-4213-C-GA-WK-ISAG-2OCC-PORT 8/21/2014

Weekly Premiums

Plan Highlights

40-4950-5960+

< 40

40-4950-5960+

< 40

Age

MonthlyBenefits $300 $500 $700 $900 $1100 $1300 $1500$400 $600 $800 $1000 $1200 $1400

0.20 0.27 0.33 0.40 0.47 0.54 0.60 0.67 0.74 0.80 0.87 0.94 1.000.51 0.68 0.85 1.02 1.20 1.37 1.54 1.71 1.88 2.05 2.22 2.39 2.561.05 1.39 1.74 2.09 2.44 2.79 3.14 3.48 3.83 4.18 4.53 4.88 5.232.44 3.25 4.06 4.87 5.69 6.50 7.31 8.12 8.94 9.75 10.56 11.37 12.18

13.00 13.81 14.62 15.43 16.25 17.06 17.87 18.68 19.50 20.31 21.93 24.375.58 5.92 6.27 6.62 6.97 7.32 7.67 8.01 8.36 8.71 9.41 10.452.73 2.90 3.07 3.24 3.42 3.59 3.76 3.93 4.10 4.27 4.61 5.121.07 1.14 1.20 1.27 1.34 1.41 1.47 1.54 1.61 1.67 1.81 2.01

$2000 $2500 $3000$1700 $1900 $2100 $2300$1600 $1800 $2200 $2400 $27000.29

0.74

1.51

3.52Monthly rateper $100 of

Monthly benefit

BENEFIT PERIOD:BENEFIT AMOUNTS:

180 daysUp to 2 Years (graded over Age 65)Employees can choose from $300 to $6,000 per month.Not to exceed 60% of income.

Long Term Disability

ELIMINATION PERIODS:

Sample Rates

Guarantee Issue up to $3,000/month - at group’s initial or annual enrollment or asnewly hired employee.Pre-existing Condition Limitation - 12/24 waiting period.Waiver of Premium - after 180 days or when purchased STD plan is waived.Partial Disability Benefit - pays 50% of the monthly benefit for up to 12 months.Rate Guarantee - 2 Years.

Participation Requirement: 5 Enrolled (Insured) Lives.

Rates - Issue Age for initial policy and benefit amount increases.Own Occupation - 2 Year.Pregnancy Claims - covered the same as any other illness.

Coverage - 24 Hour.

Portability Options - If covered under the group plan for 12 months, you may continuecoverage under the group plan for up to 12 months following termination of employment.

If a discrepancy exists between this document and the group plan, the plan provisions shall control. This coverage contains limitationsand exclusions. Our plans comply with applicable state laws. We can cancel the plan after giving the policyholder advance written notice.

PORTABILITY: This plan may contain the Portability provision. The employee may continue coverage for up to 12 months if employment ends. TheLTD insurance continued is the benefit level in force on the date employment ended. In the event the employee becomes disabled, the monthlyearnings will be based on the earnings in effect on the date employment ended. The elimination period will be based on the elimination period of thisplan and the employee may receive benefits if employee continues to be disabled according to the terms of the plan. The STD insurance continuedis the insurance benefit amount in effect on the date employment ends, including the monthly (or weekly) benefit, the elimination period, themaximum period of payment, and the amount of monthly (or weekly) earnings. The employee will be eligible to apply for ported coverage if s/he hasbeen covered under the plan for 12 consecutive months before employment ends and meets the eligibility requirements outlined in the Certificate ofCoverage. Ported coverage will terminate on the earliest of: the last day of the period for which employee paid premium; the date employeebecomes a full-time member of the armed forces of any country; the date employee retires; the end of the 12 months during which employee’sinsurance is continued; the date the plan terminates; the date employee becomes covered under another group disability plan; the date theemployee was absent due to a labor strike; at the end of the 6 months after the effective date of Portability during which employee’s insurance wascontinued and employee was not employed.

OTHER EXCLUSIONS AND LIMITATIONS: The plan does not cover any disabilities caused by, contributed to by or resulting from the employee’s:(a) loss of professional license, occupational license, or certification; (b) participation in a felony; (c) intentionally self-inflicted injuries; (d)participation in a war, declared or undeclared or any act of war; (e) active participation in a riot; (f) engaging in any illegal or fraudulent occupation,work, or employment; (g) commission of a crime for which the employee has been convicted; (h) elective surgery except when required for yourappropriate care as a result of your injury or sickness; or (i) occupational sickness or injury (for plans that do not cover occupational sickness orinjuries). The plan does not cover any disability unless the employee is under the regular care of a physician. Kansas City Life will not pay a benefitfor any period of disability during which employee is incarcerated. Please note that state variations exist.

DISABILITIES WITH A LIMITED PAY PERIOD FOR ALL LTD PLANS AND ONLY STD PLANS WITH A BENEFIT DURATION OF 104 WEEKSOR GREATER: The lifetime cumulative benefit period for all disabilities due to mental illness, drug abuse or alcoholism, and special conditions is 12months. Special conditions means: (1) musculoskeletal and connective tissue disorders of the neck and back including any disease or disorder ofthe cervical, thoracic and lumbosacral back and its surrounding soft tissue including sprains and strains of joints and adjacent muscles, exceptarthritis; herniated intervertebral discs; scoliosis; spinal fractures; osteopathies; spinal tumors, malignancy, or vascular malformations;radiculopathies, documented by electromyogram; spondylolisthesis, gradeIIorhigher; myelopathies and myelitis; demyelinating disease; traumaticspinal cord neurosis; myofacial pain syndrome; (2) chronic fatigue syndrome; (3) fibromyalgia; (4) carpal tunnel syndrome; or (5) environmentalallergic illness, including but not limited to sick building syndrome and multiple chemical sensitivity.

LIMITATIONS & EXCLUSIONSPRE-EXISTING CONDITIONS: If this limitation is included, no benefits are payable for disabilities that commence within 24 months for LTDcoverage, and/or 12 months for STD coverage (other exclusion periods available) of the employee’s effective date that are caused by, contributed toby, or resulting from a pre-existing condition, for which the employee received medical treatment, consultation, care or services, including diagnosticmeasures, or took prescribed drugs or medicines for the disabling condition in the 12 months just prior to their effective date. Some STD cases offeran optional Pre-existing Benefit paying 25% or 100% of the weekly benefit for up to 4 weeks. Please refer to your Certificate of Coverage for furtherinformation. Please note that state variations exist.

DEDUCTIBLE SOURCES OF INCOME: The amount of benefit the employee receives, or is eligible to receive, from Social Security, Workers’Compensation (if the plan covers occupational sickness or injuries), State Teachers Retirement System (STRS) or other sources as listed in theplan will be subtracted from employee’s gross disability benefit.

ELIMINATION PERIOD: For LTD means a period of continuous disability, which must be satisfied before becoming eligible to receive benefits. ForSTD benefits commence period means a period of either continuous total disability or disabled and working which must be satisfied beforebecoming eligible to receive benefits. The elimination period begins on the first day of the employee’s disability. Benefits begin the day after theelimination period is completed.

MONTHLY OR WEEKLY EARNINGS MEANS: The employee’s gross monthly or weekly income from the Employer in effect just prior to theemployee’s date of disability. This includes the employee’s total income before taxes and deductions made for pre-tax contributions to a qualifieddeferred compensation plan, Section 125 plan, or flexible spending account. It does not include income received from bonuses, overtime pay, anyother extra compensation, or income received from sources other than the Employer.

ELIGIBILITY:: Employees are eligible to enroll for disability benefits if they are in active employment in the United States with the Employer, in aneligible class, working the minimum number of hours per week as required under the Plan, and have satisfied the waiting period, if applicable. Thewaiting period means the continuous period of time (shown in each plan) that the employee must be in active employment in an eligible class beforebecoming eligible for coverage under a plan.

PLAN ISSUED THROUGH

"A" RATING BY A.M. BESTwww.NABenefits.com www.ABACUSSeries.comThe rating represents A.M. Best’s opinion of Kansas

City Life’s financial strength and its ability to meetongoing obligations to policyholders as of 06/2013

Group Term Life and AD&D

Non-Tobacco / Tobacco Census: 249

RATES per $1,000 of benefit

40-44 45-49Weekly Premiums

PRIMARY BENEFITS


Employee coverageFrom $20,000 to $500,000 in $10,000 increments to amax of the greater of $100,000 or 5x annual earnings

Spouse coverage Up to 50% of employee benefit


Minimum Participation Greater of 5 Enrolled Lives or 20% participation.

Attained Age Rate Structure Based on employee's age at policy anniversary

0.0212


Up to 80% of benefit to a maximum of $250,000Accelerated Benefit

Up to 3 yearsPortability

Annual Open Enrollment


Non-Tobacco

<25 25-29 30-34 35-39 65-69 70-74 75+50-54 55-59 60-64

Tobacco 0.0318

AD&D

Child LifeFlat amount for unmarried dependent child(ren) ages 6 months to 19 years (or to age 23, if full-timestudent), regardless of the number of children. Benefit for ages 14 days to 6 months is $1,500.

0.0106

0.0318$10,000

0.0212

0.0335

0.0212

0.0425

0.0318

0.0635

0.0478

0.1006

0.0778

0.1625

0.1288

0.2718

0.2118

0.4218

0.2949

0.5631

0.4590

0.8015

0.8174

1.3152

1.4564

2.1466

$130,000 employee ($25,000 for 70+), $50,000 spouse oninitial enrollment. Health Questions required for over GIMaximum Guarantee Issue


Available after 9 monthsWaiver of Premium

Waiver of Premium Available after 9 months

May purchase additional $10,000 up to case GI withoutcompleting medical questions. One-time-only $20,000 GIfor employees who declined initial enrollment coverage.All spouse and child riders require medical underwriting.

GA-4213-NStd-WK-EeDepADD-10KCh

Sample Rates

2 year rate guarantee; includes Higher Education Benefit, Seat Belt Rider, Air Bag Rider.Employee may elect up to 2x Life benefit amount, Spouse may elect up to Spouse Life benefit, Childamount equals Child benefit..

Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

0.21 0.32 0.42 0.53 0.64 0.74 0.85AD&D 0.95 1.06 1.17 1.27 1.38 0.0459

Monthly rate per$1,000 of Benefit

<2525-29

35-39

45-4950-5455-5960-6465-6970-7475+

40-44

30-34

<2525-29

35-39

45-4950-5455-5960-6465-6970-7475+

40-44

Age

30-34

0.42 0.64 0.85 1.06 1.27 1.49 1.70

0.64 0.96 1.27 1.59 1.91 2.23 2.55

0.42 0.64 0.85 1.06 1.27 1.49 1.70

0.67 1.00 1.34 1.67 2.01 2.34 2.68

$20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000

$20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000

0.42 0.64 0.85 1.06 1.27 1.49 1.70

0.85 1.27 1.70 2.12 2.55 2.97 3.40

0.64 0.96 1.27 1.59 1.91 2.23 2.55

1.27 1.90 2.54 3.17 3.81 4.44 5.08

0.96 1.43 1.91 2.39 2.87 3.34 3.82

2.01 3.02 4.02 5.03 6.04 7.04 8.05

1.56 2.33 3.11 3.89 4.67 5.44 6.22

3.25 4.87 6.50 8.12 9.75 11.37 13.00

2.58 3.86 5.15 6.44 7.73 9.01 10.30

5.44 8.16 10.87 13.59 16.31 19.03 21.75

4.24 6.36 8.47 10.59 12.71 14.83 16.95

8.44 12.66 16.87 21.09 25.31 29.53 33.75

5.90 8.85 11.80 14.75 17.70 20.64 23.59

11.26 16.89 22.52 28.15 33.78 39.42 45.05

9.18 13.77 18.36 22.95 27.54 32.13 36.72

16.03 24.04 32.06 40.07 48.09 56.10 64.12

16.35 24.52 32.70 40.87 49.04 57.22 65.39

26.30 39.45 52.61 65.76 78.91 92.06 105.21

29.13 43.69 58.26 72.82 87.38 101.95 116.51

42.93 64.40 85.86 107.33 128.80 150.26 171.73

1.91 2.12 2.34 2.55 2.76

2.87 3.18 3.50 3.82 4.14

1.91 2.12 2.34 2.55 2.76

3.01 3.35 3.68 4.02 4.35

$100,000 $110,000 $120,000 $130,000

$100,000 $110,000 $120,000 $130,000

1.91 2.12 2.34 2.55 2.76

3.82 4.25 4.67 5.10 5.52

2.87 3.18 3.50 3.82 4.14

5.71 6.35 6.98 7.62 8.25

4.30 4.78 5.25 5.73 6.21

9.06 10.06 11.07 12.07 13.08

7.00 7.78 8.55 9.33 10.11

14.62 16.25 17.87 19.50 21.12

11.59 12.88 14.16 15.45 16.74

24.47 27.18 29.90 32.62 35.34

19.07 21.18 23.30 25.42 27.54

37.97 42.18 46.40 50.62 54.84

26.54 29.49 32.44 35.39 38.34

50.68 56.31 61.94 67.57 73.20

41.31 45.90 50.49 55.08 59.67

72.13 80.15 88.16 96.18 104.19

73.56 81.74 89.91 98.09 106.26

118.36 131.52 144.67 157.82 170.97

131.07 145.64 160.20 174.77 189.33

193.20 214.66 236.13 257.59 279.06

0.138

0.145

0.184

0.275

0.436

0.704

1.178

1.828

2.440

3.473

0.092

0.092

0.092

0.138

0.207

0.337

0.558

0.918

1.278

1.989

9.302

3.542

6.311

5.699

GA-4213-NStd-WK-EeDepADD-10KCh 8/21/2014

The information provided here is only a summary of the Group Term Life plan.Refer to your certificate/policy for complete details and limitations of coverage.

Non-Tobacco

Tobacco

Weekly Premiums

Group Term Life and AD&D

Plan Highlights

Spouse coverage: up to the lesser of $250,000 or 50% of employee coverage.

Employee coverage: from $20,000 to $500,000 in $10,000 increments to amaximum amount of the greater of $100,000 or 5x basic annual earnings.

Minimum participation: Greater of 5 enrolled lives or 20% participation.

Accelerated Benefit of up to 80% of benefit to a maximum of $250,000.

Attained age rate structure. 2 Year rate guarantee.AD&D Rider: 2 year rate guarantee; includes Higher Education Benefit, SeatBelt Rider, Air Bag Rider; Employee may elect up to 2x Life benefit or $500,000,Spouse may elect up to Spouse Life benefit, Child amount equals Child benefit.

Portability up to 3 years. Waiver of Premium included.

For unmarried dependent child(ren) ages 6 months to 19 years (orto age 23, if full-time student), regardless of the number of children.Benefit for ages 14 days to 6 months is $1,500.

$10,000 benefit for0.35 Weekly0.11 for Child AD&D

Maximum Guarantee Issue for 249 eligibles: $130,000 employee (age 70+ - $25K)and $50,000 spouse on initial enrollment. Health Questions required for over GI.

Sample Rates

ChildLife &AD&D

Benefits

AD&D EXCLUSIONS: No benefit will be paid for a Loss caused or contributed to by: sickness; disease; any medical or surgical treatment for items(1) or (2); any infection, except a pus forming infection of an accidental cut or wound; war or any act of war, whether war is declared or not; anyinjury received while in any armed service of a country which is at war or engaged in armed conflict; any intentionally self inflicted injury, suicide, orsuicide attempt, whether sane or insane; taking drugs, sedatives, narcotics, barbiturates, amphetamines or hallucinogens unless prescribed for oradministered by a licensed physician; the insured person's intoxication; riding in or boarding or alighting from any vehicle or device for aerialnavigation as a pilot or crew member; driving or riding in any vehicle used in a race, speed or endurance test or for acrobatic or stunt driving; orparticipation in an illegal occupation or activity or attempt to commit a felony.

ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D): 24-hour coverage provides a payment in the event of loss of life, limb or eyesight, as adirect result of an accident, provided the loss occurs within 90 days of the accident.

LATE ENROLLEES/CHANGES IN AMOUNT OF INSURANCE:• Insured employees may increase benefit amounts up to $10,000 without proof of good health during an annual enrollment period, provided theamount is under the guarantee issue. Increases in excess of $10,000 annually, or for amounts over the guarantee issue, require proof of goodhealth. An insured employee may also change amounts at other times, but must submit proof of good health for any increase.• Employees hired following the effective date of the plan who do not enroll within 31 days of becoming eligible may enroll during the first annualenrollment period following their original date of eligibility without providing proof of good health, up to the guarantee issue.• If employees are eligible for coverage and choose not to enroll, they are late applicants and will be required to provide proof of good health if theyelect coverage either during a subsequent annual enrollment period or if they elect coverage at any other time.• An insured employee may change a dependent’s amount of insurance at any time. Proof of good health is required for any dependent increase.

CONVERSION PRIVILEGE: When coverage is terminated for any reason except non-payment of premium, employees, their spouses and theirdependent children will have 31 days from the date any insurance is terminated to purchase an individual life policy without submitting proof of goodhealth. AD&D coverage is not eligible for conversion.

ACCELERATED BENEFIT: Pays up to 80% of the Life benefit to a maximum of $250,000 in the event of a life-threatening medical condition wherethere is a life expectancy of 12 months or less. An Accelerated Benefit may also be available for an insured spouse. Limitations and exclusionsapply.

GUARANTEE ISSUE: The amount of coverage available without answering proof of good health questions. Guarantee Issue amounts apply toemployees or dependents that apply for coverage within 31 days from the date that all eligibility requirements are met. The entire dependent childamount is guarantee issue for timely applicants. The guarantee issue amount depends on the number of eligible employees in the group. See youremployer or agent for your guarantee issue amount.

ELIGIBILITY: • Employees: Full-time employees of the employer or an associated company, at active work in the United States of America andworking the minimum hours per week as required under the Plan. Temporary or seasonal workers are not eligible. Any other requirements set bythe employer must also be met.• Eligible Dependents: Lawful spouse (if not disabled or hospital confined on the effective date) and unmarried children (if not hospital confined) - 14days to age 19, or to age 23 if a full-time student. The hospital confinement exception does not apply to a child born while dependent insurance is ineffect. Spouses who both work for the policyholder/employer and who are both eligible for this insurance as employees cannot cover each other asdependents, and only one insured employee may insure any dependent children.

If a discrepancy exists between this document and the group plan, the plan provisions shall control. This coverage contains limitationsand exclusions. Our plans comply with applicable state laws. We can cancel the plan after giving the policyholder advance written notice.

PORTABILITY: Allows employees to continue life and any dependent life coverage (not AD&D) after a covered employee is no longer eligible forinsurance for a specified period of time as defined by the employer’s contract. Limitations and exclusions apply.

DISABILITY BENEFIT (WAIVER OF PREMIUM): If an insured employee becomes disabled prior to age 60 and remains continuously disabled for 9months, life insurance protection will remain in force without further premium payment until the earliest of the date of recovery, age 65 or retirement.If an insured employee becomes disabled on or after age 60, but before age 65, insurance may continue for up to 1 year, but not past the earlier ofage 65, or the date of retirement. Limitations and exclusions apply.

LIFE SUICIDE LIMITATION: Applies to both employees and dependents and limits payment of benefits for death from suicide during the first 2years of new or additional coverage to only a return of premium payments to the beneficiary.

AGE REDUCTIONS: (applies for both Life and AD&D): Spouse coverage terminates at age 70.• At age 70, reduce by 33% of the original scheduled amount. • At age 75, reduce by 55% of the original scheduled amount.

PLAN ISSUED THROUGH

"A" RATING BY A.M. BESTwww.NABenefits.com www.ABACUSSeries.comThe rating represents A.M. Best’s opinion of Kansas

City Life’s financial strength and its ability to meetongoing obligations to policyholders as of 06/2013

The AD&D option includes the following features which pay an additional amount of benefit if accidental death occurs.• Higher Education Benefit: 2.5% of the principle sum up to $2,500 for eligible dependents.• Automobile Accident Benefit: Seat belt benefit is 10% of the scheduled AD&D benefit to a maximum of $10,000; Air bag benefit is 5% of thescheduled AD&D benefit to a maximum of $5,000. Limitations and exclusions apply.

Bob Broker


Your broker is:

Email:

Group Size:

Issued through Kansas City Life

800-555-0000



PROPOSAL Sample Rates

249

GA

4213

Domicile State:

SIC Code:

[email protected]

SUPPLEMENTAL HOSPITAL INDEMNITYCANCER AND SPECIFIED DREAD DISEASEBASIC CANCER

Affordable Supplemental Hospital Indemnity

Plan Design Census: 249

RATES EmployeeOnly

Employee& Spouse

Employee& Child

Employee& Family

Weekly Premiums

IN HOSPITAL BENEFITS


Guarantee Issue No Health Questions to answer

Composite Rates

Benefit Payment Pays directly to the insured in addition to all other plans

Pre-Existing Condition Limitation 12/12 Waiting Period

Minimum Group Size 5 Enrolled (Insured) Lives.

$33.82 $25.81 $42.52$17.11


You choose your own providerNo Physician / Hospital Restrictions

Claim Filing Telephonic Claims initiation

Sample Rates

One rate, regardless of age or gender

OUTPATIENT BENEFITS

BENEFIT AMOUNTS

BENEFIT AMOUNTS

Underwritten by: Valid until: Nov 19, 2014

Daily Hospital Confinement (REQUIRED)$10Pays a Daily Benefit for hospitalization (resident bed patient) due to a covered Injury or Sickness for 180

Days of Confinement.

Lump Sum Indemnity

First Hospital ConfinementPays the Benefit Amount for an Insured’s First Hospital Confinement based on the total number of days ofHospital Confinement. Limited to the First Hospital Confinement each Calendar Year for each Insured.

Pays the Benefit Amount for the FIRST time an Insured is confined to a Hospital (resident bed patient) dueto covered Injury or Sickness, payable one time per Calendar Year per Insured.

$500

Up to $9000

Emergency Accident$300Pays a specified Benefit Amount for Emergency Care due to a covered Injury that is rendered within 72

hours of the injury by a Physician in a Hospital Emergency Room or Physician’s Office.

Diagnostic & Health Screening

Specified Injury

Surgical

Pays the specified Amount for Diagnostic and Health Screening; when performed in a Hospital, SurgicalCenter or Physician's office and ordered by a Physician due to an indicated Injury or Sickness.

Pays the Benefit listed in the Surgical Schedule for Surgery performed by a Physician, if due to a coveredInjury or Sickness. Pays 25% of the Benefit for Anesthesia administered in connection with such Surgery.

Pays a specific Amount for a covered Injury for: Appliances, Ambulance, Blood/Plasma, Burns, Dislocations,Eye Injuries, Fractures, Ruptured Disk, Tendons, Torn Knee Cartilage, and Gunshot Wound.

Up to $300(See Schedule)



Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

First Hospital Confinement Up to $9000Pays the Benefit Amount for an Insured’s First Hospital Confinement based on the total number ofdays of Hospital Confinement. Benefits for the rider will be limited to the First Hospital Confinementeach Calendar Year for each Insured and will not exceed $9000. Hospital Confinement Schedule:1 day - $1,000; 2 days - $2,000; 3 days - $3,600; 4 days - $5,400; 5 days - $7,200; 6 days - $9,000.

In Hospital Benefits

Kansas City Life Insurance Company is rated “A” Excellent by A.M. Best

Benefit Amounts

EmployeeEmployee & Spouse

Employee & Child(ren)Employee & Family

Weekly Premiums

This brochure contains a summary of benefits, limitations and exclusions. Some provisions, benefits, exclusions or limitations listed herein may vary depending onyour state of residence. Not available in all states. For complete information, please refer to the policy.

$15.59$7.80

$11.86$19.66

Daily Hospital Confinement (REQUIRED) $10Pays a Daily Benefit for hospitalization (resident bed patient) due to a covered Injury or Sickness for180 Days of Confinement. Benefits begin at the end of the chosen Elimination Period and continuewhile hospitalized until the benefit period expires.

Lump Sum Indemnity $500Pays the Benefit Amount for the FIRST time an Insured is confined to a Hospital (resident bedpatient) due to covered Injury or Sickness. Payable one time per Calendar Year per Insured. Thefirst day of Confinement must be in the Calendar Year for which the Benefit Amount is payable.

Summary / OverviewThrough your employer, you are presently covered under your group medical plan, with benefits that are mandated through the PPACA PatientProtection and Affordable Care Act (PPACA), which was passed into law by Congress. Based on your specific plan benefits, your coverage hasdeductibles and co-pays that may require you to pay out of pocket expenses for as much as $6,350 on an individual and $12,750 on the family.You can’t stop medical costs from rising! You can’t prevent gaps in coverage from occurring! However, you can help manage the cost you will incurthrough deductibles and co-pays by purchasing the Abacus Affordable Supplemental Hospital Indemnity Plan.

HELP PROTECT YOUR SAVINGS WITH ABENEFIT THAT COVERS DEDUCTIBLESAND CO-PAYS.

No one plans to get sick or injured;be prepared if it happens to you.

The Affordable SupplementalHospital & Medical ExpenseIndemnity Insurance PlanIssued through Kansas City Life Insurance Company



Outpatient Benefits Benefit Amounts

EmployeeEmployee & Spouse

Employee & Child(ren)Employee & Family

Weekly Premiums

Diagnostic & Health Screening

Surgical

Emergency Accident

Specified Injury


$300



Pays a specified Benefit Amount for Emergency Care due to a covered Injury that is rendered within72 hours of the injury by a Physician in a Hospital Emergency Room or Physician’s Office. Paymentwill be made for up to four such Emergency Care treatments in a Calendar Year per insuredcategory (ie; 4 for employee, 4 for spouse, and a total of 4 for all children).

Pays $150 for Diagnostic Benefit 1, $300 for Diagnostic Benefit 2, and $75 for the Health ScreeningBenefit; when performed in a Hospital, Surgical Center or Physician's office and ordered by aPhysician due to an indicated Injury or Sickness.

Pays a specific Amount for a covered Injury as indicated within the Rider for: (1) Appliances; (2)Ambulance; (3) Blood/Plasma; (4) Burns; (5) Dislocations; (6) Eye Injuries; (7) Fractures; (8)Ruptured Disk; (9) Tendons; (10) Torn Knee Cartilage; and (11) Gunshot Wound (for PrimaryInsured only).

Surgical - Pays the Benefit listed in the Surgical Schedule for Surgery performed by a Physician, ifdue to a covered Injury or Sickness. Anesthesia - Pays 25% of the Surgical Benefit for Anesthesiaadministered by a Physician in connection with such Surgical procedure. (If more than one Surgicalprocedure is performed at the same time, only one Benefit, the largest, will be paid.)

$18.23$9.32

$13.95$22.86

HighlightsMinimum Group Size 5 Enrolled - No Percentage Participation requirementGuarantee Issue No Health Questions to answerPre-Existing Condition Limitation 12/12 Waiting PeriodComposite Rates One rate, regardless of age or genderClaim Filing Telephonic Claims initiationBenefit Payment Pays directly to the insured in addition to all other plansNo Physician/Hospital Restrictions You choose your own provider

SURGICAL RIDERSSchedule of Operations

If a physician performs surgery due to Injury or Sickness while the Rider is in force for the Insured, we will pay a Surgical Benefit. If an operation is not listed in this Schedule, we will find acomparable procedure, similar in severity and complexity, and pay that amount. If two or more surgical procedures are performed simultaneously through the same or different incisions,only one benefit -- the largest -- will be paid. (Coverage is for In Hospital or Out of Hospital). Maximum benefit is $2,000.

Operations

CARDIOVASCULAR SYSTEMHEARTHeart TransplantCatheterization of HeartSuture of Heart wound or injuryValvotomy, aortic and pulmonic valveValvotomy, mitral valveValvuloplasty or Replacement, aortic and mitral valveCoronary Bypass, single or multipleRepair of Myocardial AneurysmRepair of Septal DefectAngioplasty, percutaneousPervenous or Transvenous insertion of PacemakerARTERIESArteriotomy, extremityThromboendartectomyCartoid endurterectomyExcision and graft, Abdominal Aortic AneurysmInjection - Varicose VeinsMUSCULOSKELETAL SYSTEMBONE OR CARTILAGE GRAFTSpinal FusionSpinal Fusion with removal of intervertebral discSpinal Fusion for ScoliosisFRACTURES (Requiring Reduction)SkullNoseJawVertabrae, one or moreCollar BoneShoulder blade (Scapula)Upper ArmLower ArmHandFingers or ToesUpper LegLower LegAnkleFootJOINTSShoulder or Elbow Arthrotomy ArthroplastyWrist Arthrotomy ArthroplastyHip Arthrotomy ArthroplastyKnee Arthrotomy ArthroplastyAnkle ArthrotomyArthroplastyHammertoeDISLOCATIONSJawCollar Bone (requiring reduction)Shoulder (humerus with anesthesia) or ElbowWristFingers or ToesHip or KneeAnkleTENDONSRepair or SutureLengthening or Shortening (e.g. Achilles tendon)AMPUTATIONSArm at Shoulder JointArm below Shoulder JointFingerLeg at Hip JointLeg at KneeLeg above or below kneeToe

SurgicalBenefit

$2,000.00$150.00

$1,000.00$1,500.00$1,400.00$2,000.00$2,000.00$2,000.00$1,800.00$1,000.00

$500.00

$600.00$1,200.00$1,200.00$1,500.00

$10.00

$800.00$800.00

$1,200.00

$750.00$50.00

$300.00$300.00$150.00$550.00$250.00$150.00$100.00

$50.00$400.00$150.00$250.00$100.00

$500.00$800.00

$400.00$800.00

$700.00$1,000.00

$500.00$1,000.00

$500.00$750.00$200.00

$50.00$100.00

$50.00$50.00$20.00

$200.00$100.00

$120.00$300.00

$750.00$350.00$150.00$800.00$400.00$500.00$100.00

Operations

RESPIRATORY SYSTEMNOSEExcision of Nasal PolypsSubmucous resection, Classic Nasal SeptSINUSESFrontal Sinusotomy - simpleFrontal Sinusotomy - radicalLARYNXLaryngectomyLaryngoscopyTRACHEA AND BRONCHITracheotomyBronchoscopyClosure of TracheotomyLUNGSThoracotomyPneumonotomyPneumonocentesisThoracentesisPneumonectomy, totalWedge Resection of Lung, Single or MultipleThoracoscopy (including biopsy)DIGESTIVE SYSTEMGastrotomyGastrectomy, TotalGastrectomy, PartialGastroscopyGastrostomyGastrorrhaphyEnterotomyEnterectomyColostomyEnterostomyEnterolysisDiverticulectomyAppendectomyProctectomyProtosigmoidoscopyProctoplastyFistulotomySphincterotomyFissurectomy or HemorrhoidectomyRemoval of External HemorrhoidsAspiration biopsy of liver, pancreas or bile ductCholecystotomyCholecystectomyPancreatectomy - partialPancreatectomy - totalLaparotomyHerniotomyINTEGUMENTARY SYSTEMSKINIncision and Drainage of CystAcne SurgeryBiopsyExcision of Benign TumorExcision of Malignant Tumor (Trunk, Arms or Legs)Excision of Malignant Tumor (Face, Scalp, Ears, Neck, Hands, Feet, Genitalia)Excision of Malignant Tumor (Eyelids, Nose, Lips, Mucous Membrane)Excision of NailRepair - Simple WoundsRepair - Complex Wounds (Linear Repair)Repair - Skin Grafts (Single Stage)Repair - Skin Grafts (Multiple Stage)Electro-surgical destruction or ChemocauteryChemosurgery - malignancies of skinBREASTBiopsyExcision of Cyst or Benign TumorExcision of Chest Wall TumorMastectomy, simpleMastectomy, radicalMammoplasty, ReconstructiveMammoplasty, Prosthetic Devices

SurgicalBenefit

$30.00$300.00

$200.00$600.00

$1,000.00$40.00

$200.00$150.00$250.00

$500.00$600.00$50.00$30.00

$1,000.00$800.00$200.00

$500.00$1,000.00

$800.00$150.00$400.00$500.00$600.00$700.00$800.00$500.00$400.00$500.00$400.00

$1,000.00$30.00

$400.00$100.00$50.00

$200.00$30.00$50.00

$500.00$600.00$800.00

$1,400.00$400.00$350.00

$20.00$15.00$30.00$40.00

$60.00

$100.00

$150.00$100.00$20.00$70.00$50.00

$150.00$20.00

$200.00

$150.00$150.00$700.00$300.00$700.00

$1,000.00$700.00

Operations

HEMIC AND LYMPHATIC SYSTEMSSplenectomyBiopsy of Lymph NodeRadical LymphadenectomyENDOCRINE SYSTEMIncision and drainage of Thyroid GlandLocal excision of thyroid cyst or adenomaThyroidectomy or ParathyroidectomyAdrenalectomyURINARY SYSTEMNephrolithotomyRenal BiopsyNephrectomyLithotripsyKidney TransplantCystotomyCystectomy - partialCystectomy -- completeUrethroscopy or CystoscopyCystoplastyDilation of UrethraGENITAL SYSTEMMALECircumcisionOrchiectomyReduction of Torsion of TestisExcision of Epididymis, Hydrocele, VaricoceleVasectomyBiopsy, ProstateProstatectomy - partialProstatectomy - radicalFEMALEHysterectomy, Vaginal or AbdominalHysterectomy, radical for cancer including lymph nodesSalpingo-oophorectomyRepair of cystocele or rectoceleRepair of cystocele and rectoceleTubal LigationBiopsy or removal of cervical lesion or polypDilation and CurettageMyomectomyRepair of uterine suspensionCesarian SectionObstetrical DeliveryAmniocentesisNERVOUS SYSTEMBurr HolesCranioplastyCraniotomy or CraniectomyLaminectomySpinal PunctureParavertebral block, lumbar or thoracic nerveMedian nerve decompression (Carpal Tunnel)EYERemoval of eyeExcision of pterygiumSclerotomy - anteriorSclerotomy - posteriorIridectomyExtraction of lens (including cataract extraction)Reattachment of retinaMuscle operation (one or more muscles)Excision of lacrimal gland or sacEARDrainage of abscessOtoscopyMyringotomyTympanotomy (diagnostic)Tympanotomy with insertion of Collar Button TubeMastoidectomy - simpleTympanoplastyLabyrinthotomy or LabyrinthectomyANESTHESIAPays 25% of the Surgical Benefit for Anesthesia administeredby a Physician in connection with such surgical procedure.

SurgicalBenefit

$600.00$50.00

$500.00

$30.00$400.00$700.00$800.00

$800.00$50.00

$800.00$500.00

$1,250.00$500.00$700.00

$1,000.00$50.00

$800.00$20.00

$30.00$200.00$300.00$300.00$150.00

$50.00$800.00

$1,000.00

$600.00$1,000.00

$450.00$350.00$500.00$400.00

$30.00$150.00$500.00$400.00$500.00$200.00

$50.00

$300.00$1,000.00

$400.00$1,000.00

$20.00$50.00

$300.00

$400.00$250.00$500.00$300.00$500.00$800.00

$1,000.00$600.00$500.00

$20.00$20.00$30.00

$500.00$250.00$500.00

$1,000.00$1,000.00

SPECIFIED INJURY RIDERPays the specified amount due to an Injury as indicated within the Rider for:

• Gunshot Wound (for Primary Insured only)• Ruptured Disk Injury which occurs less than one year after the Effective Date of this Rider Injury which occurs one year or more after the Effective Date of this Rider• Tendons/Ligaments Repair of one tendon or ligament Repair of all tendons/ ligaments if more than one• Torn Knee Cartilage Injury which occurs less than one year after the Effective Date of this Rider Injury which occurs one year or more after the Effective Date of this Rider

• Appliances• Ambulance• Blood/Plasma• Burns (Second degree burns that cover at least 36% of the body or third degree burns that cover at least 9 square inches.)• Dislocation Joint Hip Knee (except Patella) Shoulder Glenohumeral Collar Bone Sternoclavicular Acromioclavicular Acromioclavicular Separation Ankle – Bone or Bones of the Foot (other than Toes) Bone or Bones of the Hand (other than Fingers) Lower Jaw Wrist Elbow One Toe or Finger• Eye Injuries

$25$25$50

$600

$1,500$1,100

$800

$800$720$720

$660

$600$500$450$325$150$100

• Fractures Hip, Thigh (Femur) Vertebrae, Body of (except Vertebral Process) Pelvis (includes Ilium, Ischium, Pubis Acetebalum except Coccyx) Skull (except Bones of Face or Nose) Simple Non-reduction Skull Fracture Depressed Skull Fracture Leg (Tibia and/or Fibula) Forearm (Radius and/or Ulna) Hand or Wrist (except Finger) Foot (except Toes) Ankle, Kneecap (Patella) Lower Jaw, Mandible (except Alveolar Process) Shoulder Blade (Scapula), Collar Bone (Clavicle, Sternum) Arm, between Elbow and Shoulder (Humerus) Upper Jaw, Maxilla (except Mandible or Maxilla) Bones of Face or Nose (except Mandible or Maxilla) Vertebral Processes - Transverse, Spinous, etc. Coccyx, One Rib, Finger, Toe

$1,800

$1,600

$1,400

$600$1,350$1,100

$900

$900

$720

$720

$630

$630

$550

$350$150

$100

$400

$500

$750

$100

$400

$1,000

Benefit Amounts shown are for the Primary Insured. Benefit Amounts for Dislocations and Fractures may vary for the Insured Spouse and/or Children.

In addition to Limitations and Exclusions contained in policy form to which this Rider is attached, the following also apply. Please refer to the Policy for exact Definitions, Provisions,Exclusions and Limitations.

ELIGIBILITYIn addition to the Employee, the Spouse and/or Children must be covered under the Base Plan to be eligible for this Rider.

LIMITATIONS AND EXCLUSIONSFor this Rider, the following are added to the list of Limitations and Exclusions contained in the Policy: a. riding in or driving any motor-driven vehicle in a race, stunt show or speed test; or b. driving a car or any other licensed vehicle on a highway without a valid operator’s license; or c. mountaineering, sky diving, hang gliding or bungee jumping; or d. Insured Dependent(s) practicing for or participating in any high school, college, semi-professional or professional competitive athletic contest. This does not apply to intramural sports.

PREMIUMSWhile this Rider is in force, Premiums are due based on the terms of the Policy to which this Rider is attached.We reserve the right to change the Premiums for this Rider. If We do change the Premiums, We will do so: a. if We change the Premiums for all riders of this same form and issue age in Your state of issue; and b. if such change complies with the laws and regulations of Your state of issue; and c. if We give You 60 days written notice before such change becomes effective.

Limitations and ExclusionsThis brochure contains a brief summary of benefits and limitations. If discrepancies exist between this document and the group plan, the plan provision shall control. This coverageincludes limitations and exclusions. All plans comply with applicable state laws.

Diagnostic and HealthScreening Benefits Rider

Conditions: We will pay a Benefit when an Insured has one of the diagnostic or health screening tests listed below while this Rider is in force forthe Insured. For the Diagnostic and Health Screening Benefit to be paid, the tests must be:

a. performed in a Hospital, Ambulatory Surgical Center or Physician's office; andb. ordered by a Physician due to an Injury or Sickness indicated by symptoms that would suggest an Injury or Sickness has occurred.

Benefits are payable regardless of the results of the tests.

Pre-Existing Conditions: Benefits are subject to the Pre-existing Condition Limitation contained in the Policy. Any loss resulting from aPre-existing Condition will not be covered if it occurs during the first 12 months after the Effective Date of this Rider.

Diagnostic Benefit 1• Arthroscopy• Bronchoscopy• Colonoscopy• Cystoscopy• Esophogogastroduodenoscopy (EGD)• Laryngoscopy• X-rays• EKG

3 Units$150

Limited to one test per CalendarYear per Insured. Benefits will notbe paid for tests performed forroutine well care, treatment orexaminations.

Diagnostic Benefit 2• Angiogram• Arteriogram• Computed Tomography Scan (CT)• Electroencephalogram (EEG)• Magnetic Resonance Imaging (MRI)• Myelogram• Positron Emission Tomography Scan (PET)• Thallium Stress Test• Multiple Gated Acquisition (MUGA)

Limited to one test per CalendarYear per Insured. Benefits will notbe paid for tests performed forroutine well care, treatment orexaminations.

Health Screening Benefit• Bone Marrow Testing• Breast Ultrasound• Chest X-rays• Colonoscopy• Flexible Sigmoidoscopy• Mammography• PSA (blood test for prostate cancer)• Pap smear• Stress test on a bicycle or treadmill• Blood test for triglycerides• CA 15-3 (blood test for breast cancer)• CA 125 (blood test for ovarian cancer)• CEA (blood test for colon cancer)• Serum Protein Electrophoreses (blood test for myeloma)• Serum cholesterol test to determine level of HDL and LDL• Fasting blood glucose test• Hemoccult stool analysis

Limited to three tests per CalendarYear per Insured. Benefits will notbe paid for tests payable under aDiagnostic Benefit.

3 Units$300

3 Units$75

Tests Benefits Limitations

Read your certificate carefully. This Outline of Coverage provides a verybrief description of some important features of your Hospital IndemnityPolicy issued to the Policyholder. This is not the Insurance Contract, butonly a summary of coverage. Only the Policy contains governingcontractual provisions. The Policy itself sets forth, in detail, the rights andobligations which apply to you, to the Policyholder, and to the InsuranceCompany; the Certificate summarizes the Policy. It is therefore importantthat you Read Your Certificate Carefully!

Hospital Indemnity CoverageThis plan provides a fixed daily benefit during periods of hospitalizationresulting from a covered accident or sickness, subject to any limitationsset forth in the Policy. The plan will pay benefits for up to 180 days perperiod of confinement, as defined in the Policy.

Optional BenefitsAdditional benefits elected by the policyholder are:• an additional benefit for specified diagnostic tests• an additional benefit for specified health screenings• an additional benefit for emergency care received by a physician to treat an injury• an additional benefit for the first hospital confinement each year• an additional benefit for the outpatient treatment of a covered sickness• an additional benefit for specified covered injuries• an additional benefit for specified surgeries

Limitations, Exclusions and Reductions

Pre-existing Condition Limitation:Are benefits limited for Pre-existing Conditions?Pre-existing conditions: Benefits will not be paid for a hospitalization orloss due to a condition which begins within the first 12 months after youreffective date of coverage and which is due to a pre-existing condition. Apre-existing condition is defined as a condition, diagnosed orundiagnosed, for which medical advice, treatment, care or services arereceived from a physician during the 12 months prior to your effectivedate, or symptoms which would have caused a prudent person to seekmedical advise or treatment during the 12 months prior to your effectivedate.

Exclusions:What losses are not covered?Benefits will not be paid for hospitalizations due to any of the following:• being legally intoxicated as defined by state law where the loss occurredor being under the influence of any narcotic unless administered on theadvice of a Physician; or• alcoholism or drug addiction; or• attempted suicide while sane or insane or intentionally self-inflictedInjury; or• mental or nervous disorders; or• being exposed to war or any act of war, declared or undeclared or whileserving in the armed forces; or• engaging in an illegal activity; or• participation in any form of aviation other than as a fare-payingpassenger in a fully licensed passenger carrying aircraft; or• voluntary inhalation of gas; or• mountaineering, sky diving, hang gliding or bungee jumping; or• riding in or driving any motor-driven vehicle in a race, stunt show orspeed test; or• conditions specifically excluded by amendment; or• any Pre-Existing Conditions as defined in the policy.

Benefits will not be paid for any period an insured is incarcerated in anytype of penal institution.

* Coverages issued in California will be on a Hospital Indemnity chassis.* Coverages issued in AL, AZ, FL, GA, IA, LA, MA, MS, MO, PA, SC, TN,& TX will be on a Disability chassis.

Below is a brief summary of coverages, exclusions and limits.

IMPORTANT NOTICEThis is a Supplement to Health Insurance.

It is not a substitute for essential Health Benefits or minimum essential coverage as defined in Federal Health Law.

DEFINITIONSWhen We us the following words, We mean:

Hospital Income Benefit: What benefits are payable if I am Confined in aHospital?If You or Your Dependent are Confined in a Hospital: 1) while coveredunder the Policy; and 2) due to Sickness or Injury; then we will pay theDaily Benefit for each Day of Confinement, up to the Maximum PaymentPeriod.

Actively at Work: means You are performing the Substantial and MaterialActs of Your Occupation for wage or profit on a full-time basis (at least 20hours per week).

Eligible Dependent Child(ren) unless specifically excluded in any part ofThe Policy, means:Your unmarried Dependent Child under age 26 who is chiefly dependenton You for support and maintenance;

Eligible Spouse: means Your spouse who is not divorced from You.Spouse will include Your domestic partner or party to a civil union.

Hospital: means an institution which: operates facilities for medical andsurgical diagnosis and treatment by or under the supervision of a staff oflegally qualified physicians; and provides 24 hour a day nursing serviceby or under the supervision of registered graduate nurses (R.N.).

Hospital Confinement: means admission to a Hospital and confinement asa resident bed patient due to an Injury or Sickness. The confinement mustbe on the advice of a Physician and be Medically Necessary.Confinement to an emergency room, outpatient treatment room, orobservation unit is not considered a hospital confinement.

Termination: When will my coverage stop?Your coverage will end on the earliest of the following:1) the date The Policy terminates;2) the date The Policy no longer insures Your class;3) the date premium payment is due but not paid, subject to Your Grace Period;4) the last day of the month on or next following the month in which Your Employer terminates Your employment;5) the date You cease to be a Full-time Active Employee in an eligible class for any reason, unless coverage is extended under the Continuation Provisions; or7) the date Your Employer ceases to be a Participating Employer.

All coverage under the Policy and any attached Rider(s) will terminatewhen the Policy ceases to be in force.

Coverage for an insured dependent will end on the date such insuredceases to be an Eligible Dependent Child or Eligible Spouse.

Waiver of Premium: Am I required to pay Premiums while I am receivingbenefits? No premium will be due for You for as long as benefits arepayable.

Portability: Can I continue my coverage if my employment ends?Insurance continued under this provision will cease on the earliest of:1) the date the Policy terminates;2) the last day of the period for which You make any required premium contribution;3) the date You become a full-time member of the armed forces of any country;4) the end of the 12 month period during which Your coverage is continued under this Portability provision;5) the date you become covered under any other group insurance plan;6) the end of a 6 month period during which Your coverage is continued under this Portability provision and you are not employed with any employer.

Cancer and Specified Dread Disease

Plan Design Census: 249

RATES EmployeeOnly

Employee& Family

Weekly Premiums

BENEFITS


Eligibility Waiting Period First of the month following 30 days (minimum)

Annual Open Enrollments

Underwriting Guidelines Up to 1,000 Eligible Lives, No census required

Rate Guarantee

12/12 Waiting Period

Portability Available

$6.29$3.59


For 1,000+ life groups , 1099's, Associations, PEO’s, UnionsCustom Quotes

Coverage 24 Hour

Sample Rates

EOI applies for new applications at re-enrollment

BENEFIT AMOUNTS

Underwritten by: Valid until: Nov 19, 2014

Comprehensive Intensive Care - No Lifetime Maximum

Comprehensive Care - No Lifetime Maximum

First Occurrence

Pays a daily benefit up to 20 days per confinement, in addition to any policy benefits, for each day andbeginning on the first day of confinement in a Hospital’s Intensive Care Unit for any covered Injury or Sickness.

Pays a $500 Initial Benefit when a covered Cancer or Specified Dread Disease other than skin cancer is FirstDiagnosed, as well as a progressive benefit equal to 5% of the Initial Benefit each month up to $1000.

Pays actual charges or up to a maximum amount for Blood, Plasma & Platelets; Ambulance; Initial PositiveTesting; Recurrence Testing; Transportation; and Lodging; for a covered Cancer or Specified Dread Disease.

ACTUALCHARGE

$100/Day and15% of Benefit

$500 - $1500

Physicians Attendance and Private Duty Nurse - No Lifetime Maximum

Surgical and Anesthesia - No Lifetime Maximum

X-ray, Radium, Chemotherapy and Cobalt Treatment - No Lifetime Maximum

Pays actual charges up to the daily benefit for each day for physician services in a Hospital, and will pay up totwice the daily benefit for a Private Duty Nurse.

Pays actual charges up to $5000 for X-Ray, Radium, Chemotherapy, and Cobalt Therapy treatment whenreceived in a Hospital or Outpatient facility for treatment of a covered Cancer or Specified Dread Disease.

Surgical pays actual charges based on the schedule of operations for surgery performed due to a coveredCancer or Specified Dread Disease. Anesthesia pays actual charges up to 25% of the Surgical benefits paid.

up to $50Physician &$100 Nurse

up to $1000Annually

up to $5000

$300 Annually

$100 DAILYBENEFIT

Daily Hospital Confinement - No Lifetime MaximumPays a daily benefit for each day of hospitalization and up to 15% of the daily benefit paid for drugs andmedicine administered in the hospital due to the treatment of a covered Cancer or Specified Dread Disease.

Hospice CareInpatient Services pays a daily benefit for services provided by Hospice, Outpatient Services pays 1/2 of allservices provided by Hospice, Counseling Services pays for counseling services; up to each lifetime maximum.

Pre-Existing Condition Limitation

Minimum Hours Standard is 20 hours

Available Purchase Employee & Family (Employee must be covered to insure Family)

2 Years

Bob Broker


Your broker is:

Email:

800-555-0000


[email protected]

Benefits


Benefit Amounts


Cancer and Specified Dread DiseaseIssued through Kansas City Life Insurance Company

First OccurrencePays a $500 Initial Benefit when a covered Cancer or Specified Dread Disease other than skincancer is First Diagnosed, as well as a progressive benefit equal to 5% of the Initial Benefit for eachmonth this rider is in force (maximum progressive amount of $1000).

$500 - $1500

Daily Hospital Confinement - No Lifetime MaximumPays a daily benefit for each day of hospitalization due to the treatment of a covered Cancer orSpecified Dread Disease (if diagnosed more than 30 days after policy effective date) Pays the actualcharges, up to 15% of the daily benefit payable, for drugs and medicine administered in the hospitalfor the treatment of a covered Cancer or Specified Dread Disease.

$100/Day and15% ofBenefit

Comprehensive Care - No Lifetime MaximumPays the following when the result of or due to a covered Cancer or Specified Dread Disease:Blood, Plasma, Platelets - actual charges when received in a hospital (as inpatient or outpatient) ornon-hospital facility. Ambulance (to/from a Hospital as inpatient) - up to $75 per trip. InitialPositive Testing (not for Skin Cancer) - actual charges up to $250 if the diagnostic test results in aninitial positive diagnosis within 90 days of testing. Recurrence Testing (not for Skin Cancer) -actual charges up to $500 a calendar year for all tests used to monitor for recurrence.Transportation - actual charges for (1) round-trip coach air fare, rail, or bus (patient and one adultfamily member) to the nearest treatment center or (2) $0.30 per mile for an automobile for up to 700

ACTUALCHARGE

Comprehensive Intensive Care - No Lifetime MaximumPays a daily benefit, in addition to any policy benefits, for each day of confinement in a Hospital’sIntensive Care Unit for any covered Injury or Sickness. This benefit is payable for up to 20 days forany one period of confinement. Benefits begin on the first day of ICU confinement.

$300Annually

Weekly PremiumsEmployee Only

$6.29$3.59

Employee & Family

X-ray, Radium, Chemotherapy and Cobalt Treatment - No Lifetime MaximumPays up to the $5000 Maximum Annual Benefit for each insured person for the treatment of acovered Cancer or Specified Dread Disease, which is first diagnosed more than 30 days after thisrider is in force, not to exceed the actual charges for such treatments. Benefits include drugs andmedicine administered to provide such treatments when received in a Hospital (on an inpatient oroutpatient basis) or in an Out-of-Hospital facility. Benefits do not include diagnostic X-Ray or otherdiagnostic procedures or laboratory tests related to these treatments.

up to $5000

Surgical and Anesthesia - No Lifetime MaximumSurgical pays the actual charges up to the percentage of maximum listed on the schedule ofoperations for surgery performed in a Hospital (on an inpatient or outpatient basis) or in anAmbulatory Surgical Center due to a covered Cancer or Specified Dread Disease. Limited benefitsfor skin cancer ($250 Lifetime Maximum). Anesthesia pays the actual charges up to 25% of theSurgical benefits paid for anesthesia administered in connection with surgery performed due to acovered Cancer or Specified Dread Disease.

up to $1000Annually

Physicians Attendance and Private Duty Nurse - No Lifetime MaximumPays actual charges up to the daily benefit for each day for physician services in a Hospital, and willpay up to twice the daily benefit for a Private Duty Nurse (when medically necessary for at least 8hours a day).

up to $50Physician &$100 Nurse

Hospice CareInpatient Services Pays a daily benefit for all services provided by Hospice when confined as aninpatient, but not to exceed a 50 day limited lifetime maximum. Outpatient Services Pays one-half(1/2) of the daily benefit for all services provided by Hospice (on an outpatient basis or in an Insuredperson’s home); but not to exceed an 80 day lifetime maximum. Counseling Services Pays theexpense of counseling services provided by Hospice for a Terminally Ill person and his/herimmediate family, but not to exceed a lifetime total of $100 for all counseling services.

$100 DAILYBENEFIT

DEFINITIONSWhen We use the following words, We mean:Cancer - a sickness or disease which:(1) has been pathologically diagnosed by a Physician to be a malignantneoplastic growth or disorder; or if such a pathological diagnosis ismedically inappropriate, has been clinically diagnosed; and(2) has been defined and recognized as Cancer by the American MedicalAssociation Nomenclature Index.Dread Disease - any of the following:Addison's Disease, Bubonic Plague, Diphtheria, Encephalitis, Hansen'sDisease, Malaria, Meningitis, Muscular Dystrophy, Multiple Sclerosis,Osteomyelitis, Poliomyelitis, Rabies, Rocky Mountain SpottedFever,Scarlet Fever, Sickle Cell Anemia, Smallpox, Tetanus,Tuberculosis,Tularemia, Typhoid Fever, Undulant Fever.First Diagnosed - For Cancer, this is the day the tissuespecimen,culture(s) and/or titer(s) is (are) taken and upon which thediagnosis of Cancer is based. For Dread Disease, this is the day theexistence of the disease is conclusively established.In South Carolina, First Diagnosed For Cancer means the day (a) thetissue specimen, culture(s) and/or titer(s) is (are) taken and upon whichthe diagnosis of Cancer is based; or (b) if such a pathological diagnosis·is medically inappropriate, has been clinically diagnosed.For a Dread Disease, this is a day the existence of the disease isconclusively established.Hospital - A lawfully operating institution which:(1) has resident facilities for sick or injured patients; and(2) mainly provides diagnostic, medical and surgical treatment for a fee tosick or injured persons (or has such treatment facilities available onpre-arranged contractual basis). In Missouri, solely provides diagnostic,medical and surgical treatment for a fee to sick or injured persons (or hassuch treatment facilities available on a pre-arranged contractual basis);and in South Carolina:mainly provides diagnostic medical and surgicaltreatment to sick or injured persons (or has such treatment facilitiesavailable on a pre-arranged contractual basis).(3) has a 24-hour nursing service by or under the supervision of agraduate registered nurse; and(4) has at least one Physician on the staff who is on call at any time; or(5) is accredited by the Joint Commission on Accreditation of Hospitals orthe American Osteopathic Association, subject to the limitations in theparagraph below.A Hospital is not an institution or part of an institution which mainlyprovides convalescent, nursing, or extended care.In Utah, a Hospital is an institution which is licensed as such and isoperating within the scope of such license.Totally Disabled or Total Disability - You are Totally Disabled whenunable, because of Cancer or a Dread Disease, to perform all thesubstantial and material duties of Your principal occupation at the timesuch disability commenced.

RENEWABILITYThis policy is a group renewable plan. You may renew and continue thispolicy in force by paying the correct premium when due or within theGrace Period. Plan coverage will continue as long as the master groupcontract remains in force.

LIMITATIONS AND EXCLUSIONSWe do not cover Hospital confinements or medical treatment:• for any loss that is not directly due to Cancer or a Dread Disease(InSouth Carolina: for any loss that is not directly due to or caused oraggravated by Cancer or a Dread Disease or the treatment thereof)• for Cancer or a Dread Disease covered under Workers' Compensation,an Employer's Liability Law or similar law;• which are adjudged experimental by the American Medical Association(A.M.A.) (In Illinois, no coverage shall be denied on the basis of theprocedure being deemed experimental unless supported by adetermination of the Office of Health Care Technology Assessment ratherthan the Office of Medical Application of Research of the National Instituteof Health);• which is rendered outside the United States, its possessions, orCanada; nor• for which payment is not legally required, except for:(a) Medicaid;(b) treatment of non-service connected disabilities in VeteranAdministration hospitals; and(c) inpatient care rendered to armed services retirees and dependents inmilitary facilities of the United States Government. (Does not apply inMissouri & South Carolina).• In New Mexico, for any loss due to Cancer or a Dread Disease that isFirst Diagnosed within 30 days after the Effective Date of coverage.

PRE-EXISTING CONDITIONSWe do not cover pre-existing conditions for the first 2 years after theEffective Date of coverage.By pre-existing conditions, We mean:(1) the existence of symptoms which would cause an ordinarily prudentperson to seek medical diagnosis, care or treatment during the 2 yearsbefore or within the 30 days after the Effective Date of his/her coverage;or(2) a condition for which medical advice or treatment was recommendedby or received from a Physician within the two years before or within the30 days after the Effective Date of his/her coverage.In New Mexico, no claim for loss incurred or disability (as defined in thepolicy) shall be reduced or denied on the ground that a disease orphysical condition not excluded from coverage by name or a specificdescription had existed prior to the effective date of coverage of thispolicy.In South Carolina, by pre-existing conditions, We mean a condition:(a) misrepresented or not revealed in the application; and(b) for which symptoms existed within the 2 years before or within the 30days after the Effective Date(1) that would cause an ordinarily prudent person to seek diagnosis, careor treatment: or(2) for which medical advice was recommended by or received from aPhysician.In Texas, for persons age 65 and over when their coverage becomeseffective, We do not cover pre-existing conditions for the first 6 monthsafter the Effective Date of their coverage.In Virginia, by pre-existing conditions, We mean a condition:(1) which manifests itself within the 6 months before or within the 30 daysafter the Effective Date of his/her coverage; or(2) which was diagnosed by a Physician prior to or within the 30 daysafter the Effective date of his/her coverage; or(3) for which medical advice or treatment was recommended by orreceived from a Physician within 10 years before or within the 30 daysafter the Effective Date of his/her coverage.This provision does not affect a newborn dependent child added after thePolicy Date.Pre-existing conditions specifically named or described as excluded inany part of this contract are never covered.

Product underwritten by Kansas City Life Insurance Company

This brochure is presented as a matter of general information and only applies after the Effective Date of the policy.For specific details about benefits, including definitions, limitations and exclusions, refer to the policy form KCLI88 (or state edition).

DAILY HOSPITAL CONFINEMENT POLICY

Not to exceed the amount purchased per visit, nor one visit per day while confined to a hospital. No Lifetime Maximum.up to $10/visit,one visit/day

ATTENDING PHYSICIAN

Pays usual and customary charges (this does not include diagnostic X-Ray or other diagnostic procedures or laboratory tests related to treatment ofcancer.)

up to $2,000per insured

X-RAY, RADIUM, CHEMOTHERAPY AND RADIO-ACTIVE ISOTOPES

Pays a daily benefit for hospitalization for the treatment of Cancer. No Lifetime Maximum.$90/Day for the

first 7 days, $50/Dayfor the next 83 days

Pays the benefit amount purchased, not to exceed the benefit amount per operation as provided in the Surgical Schedule. No Lifetime Maximum.SURGICAL BENEFITS $60 to $1,000

Weekly PremiumsEmployee Only ..................................................................................................................................................................................................... $1.96

8/22/2014

BENEFIT AMOUNTS

Up to 10% ofDaily Benefit

All of these benefits are payable in addition to all other insurance.

Administered in the hospital, pays up to the percentage of the total payable hospital confinement benefit. No Lifetime Maximum.DRUGS AND MEDICINE

ANESTHETICSNot to exceed the benefit amount purchased if administered by an anesthetist not employed by the hospital. No Lifetime Maximum.

Up to $140 ($60for Skin Cancer)

Employee & Family .............................................................................................................................................................................................. $3.16

Pays for service of R.N. or L.P.N. while hospitalized and when required and authorized by the attending physician. No Lifetime Maximum.up to $48/dayGRADUATE NURSING BENEFITS

Pays usual and customary charges (No maximum limit for leukemia).up to $600per insured

BLOOD AND PLASMA

Pays the benefit amount purchased for regular airplane or railroad fare when required and authorized by the attending physician for hospitalconfinement due to cancer.

up to $1,000TRANSPORTATION EXPENSE

Pays the benefit amount purchased per hospital confinement. No Lifetime Maximum.up to $100AMBULANCE

Pays 100% of the actual charges made by the hospital for care and treatment beginning on the ninety-first day of continuous confinement.up to $10,000

per monthEXTENDED BENEFIT

An additional payment of 20% of each claim paid shall be made to the insured.ADDITIONAL SUPPLEMENTAL INCOME BENEFIT

*Successive periods of hospital confinement will be considered as one if separated by less than 30 days out of the hospital.Family coverage includes the Spouse of the named insured and unmarried Children under 26 years of age.

(Insurance continued for handicapped dependents as provided by statute.)

Benefits are payable from the 1st day of confinement due to injury and from the 2nd day of confinement due to sickness.$260/dayCOMPREHENSIVE INTENSIVE CARE RIDER

up to 15 days

$10,000

WHEN HOSPITALIZED FOR CANCER...$30/day for the

first 7 days,$20/day for thenext 83 days

ADDITIONAL DAILY INDEMNITY

Pays benefits for Intensive Care confinement in connection with any one hospital admission.If less than 30 days separate two periods of confinement, the second confinement will be considered a continuation of the initial confinement.Lifetime Maximum Benefits to one insured is . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

This rider pays an additional daily benefit for hospitalization for the treatment of cancer.

Coverage under these riders are renewable under the same terms and conditions as the base policy. The limitations and exclusions in thebase policy also apply to these riders.

SSAAMMPPLLEE RRAATTEESS

Basic Cancer CoverageEspecially Designed for the Employees of:

DEFINITIONSWhen We use the following words, We mean:Cancer - a sickness or disease which:(1) has been pathologically diagnosed by a Physician to be a malignantneoplastic growth or disorder; or if such a pathological diagnosis ismedically inappropriate, has been clinically diagnosed; and(2) has been defined and recognized as Cancer by the American MedicalAssociation Nomenclature Index.First Diagnosed - This is the day the tissue specimen,culture(s) and/ortiter(s) is (are) taken and upon which the diagnosis of Cancer is based.In South Carolina, First Diagnosed means the day (a) the tissuespecimen, culture(s) and/or titer(s) is (are) taken and upon which thediagnosis of Cancer is based; or (b) if such a pathological diagnosis· ismedically inappropriate, has been clinically diagnosed.Hospital - A lawfully operating institution which:(1) has resident facilities for sick or injured patients; and(2) mainly provides diagnostic, medical and surgical treatment for a fee tosick or injured persons (or has such treatment facilities available onpre-arranged contractual basis). In Missouri, solely provides diagnostic,medical and surgical treatment for a fee to sick or injured persons (or hassuch treatment facilities available on a pre-arranged contractual basis);and in South Carolina:mainly provides diagnostic medical and surgicaltreatment to sick or injured persons (or has such treatment facilitiesavailable on a pre-arranged contractual basis).(3) has a 24-hour nursing service by or under the supervision of agraduate registered nurse; and(4) has at least one Physician on the staff who is on call at any time; or(5) is accredited by the Joint Commission on Accreditation of Hospitals orthe American Osteopathic Association, subject to the limitations in theparagraph below.A Hospital is not an institution or part of an institution which mainlyprovides convalescent, nursing, or extended care.In Utah, a Hospital is an institution which is licensed as such and isoperating within the scope of such license.Totally Disabled or Total Disability - You are Totally Disabled whenunable, because of Cancer, to perform all the substantial and materialduties of Your principal occupation at the time such disability commenced.

LIMITATIONS AND EXCLUSIONSWe do not cover Hospital confinements or medical treatment:• for any loss that is not directly due to Cancer (In South Carolina: for anyloss that is not directly due to or caused or aggravated by Cancer or thetreatment thereof)• for Cancer covered under Workers' Compensation, an Employer'sLiability Law or similar law;• which are adjudged experimental by the American Medical Association(A.M.A.) (In Illinois, no coverage shall be denied on the basis of theprocedure being deemed experimental unless supported by adetermination of the Office of Health Care Technology Assessment ratherthan the Office of Medical Application of Research of the National Instituteof Health);• which is rendered outside the United States, its possessions, orCanada; nor• for which payment is not legally required, except for:(a) Medicaid;(b) treatment of non-service connected disabilities in VeteranAdministration hospitals; and(c) inpatient care rendered to armed services retirees and dependents inmilitary facilities of the United States Government. (Does not apply inMissouri & South Carolina).• In New Mexico, for any loss due to Cancer that is First Diagnosed within30 days after the Effective Date of coverage.

PRE-EXISTING CONDITIONSWe do not cover pre-existing conditions for the first 2 years after theEffective Date of coverage.By pre-existing conditions, We mean:(1) the existence of symptoms which would cause an ordinarily prudentperson to seek medical diagnosis, care or treatment during the 2 yearsbefore or within the 30 days after the Effective Date of his/her coverage;or(2) a condition for which medical advice or treatment was recommendedby or received from a Physician within the two years before or within the30 days after the Effective Date of his/her coverage.In New Mexico, no claim for loss incurred or disability (as defined in thepolicy) shall be reduced or denied on the ground that a disease orphysical condition not excluded from coverage by name or a specificdescription had existed prior to the effective date of coverage of thispolicy.In South Carolina, by pre-existing conditions, We mean a condition:(a) misrepresented or not revealed in the application; and(b) for which symptoms existed within the 2 years before or within the 30days after the Effective Date(1) that would cause an ordinarily prudent person to seek diagnosis, careor treatment: or(2) for which medical advice was recommended by or received from aPhysician.In Texas, for persons age 65 and over when their coverage becomeseffective, We do not cover pre-existing conditions for the first 6 monthsafter the Effective Date of their coverage.In Virginia, by pre-existing conditions, We mean a condition:(1) which manifests itself within the 6 months before or within the 30 daysafter the Effective Date of his/her coverage; or(2) which was diagnosed by a Physician prior to or within the 30 daysafter the Effective date of his/her coverage; or(3) for which medical advice or treatment was recommended by orreceived from a Physician within 10 years before or within the 30 daysafter the Effective Date of his/her coverage.This provision does not affect a newborn dependent child added after thePolicy Date.Pre-existing conditions specifically named or described as excluded inany part of this contract are never covered.

RENEWABILITYThis policy is a group renewable plan. You may renew and continue thispolicy in force by paying the correct premium when due or within theGrace Period. Plan coverage will continue as long as the master groupcontract remains in force.

Product underwritten by Kansas City Life Insurance Company

This brochure is presented as a matter of general information and only applies after the Effective Date of the policy.

The ABACUS Group

PROPOSAL: Just RatesheetsFaxedEmailed Date

Needed:

SHOW PREMIUMS: Semi-MonthlyMonthlyWeekly Bi-Weekly

NOTE: THESE INDUSTRIES REQUIRE UNDERWRITING APPROVAL: PLEASE INCLUDE A CENSUS.ALL PRODUCTS: LABOR UNIONS; COURTS; PRISONS; POLICE & FIRE PROTECTION.STD/LTD: BUSINESS, CIVIC, SOCIAL, FRATERNAL, POLITICAL & RELIGIOUSORGANIZATIONS; TRUSTS, EMPLOYMENT AGENCIES & PEO'S; ALL GOVERNMENT.LIFE ONLY: AGRICULTURE; FORESTRY; HUNTING; MINING; OIL & GAS EXTRACTION;WEAPONRY; POSTAL SERVICE; BUS, RAIL, AIR & WATER TRANSPORTATION; MOTIONPICTURES, VIDEOS.

AGENCY:

AGENT:

STREET:

PHONE #: FAX:

#

CITY/ST/ZIP:

EMAIL:

GROUP NAME:

ADDRESS/CITY:

NO. OF EMPLOYEES:

INDUSTRY:

PHONE #: STATE:

Full Proposal

Request forVOLUNTARY PRODUCTS

Minimum Hours worked per week is 20 hours.12/12 Pre-existing Condition limitations (in most states).

Minimum participation is 5 enrolled lives (10 in CO, 51 eligible in FL).

Proposal valid for up to 1,000 lives.

VOLUNTARY STD

2 year Injury / Sickness3 year Injury / Sickness

5 year Injury / SicknessAge 65 Injury / Sickness

03/2014

65% MAXIMUM BENEFIT:

ISSUE AGE RATE STRUCTURE:

PORTABILITY: YES NO

VOLUNTARY LTD180 DAYS90 DAYS 365 DAYSELIMINATION PERIOD:

OWN OCCUPATION: 1 YEAR 2 YEAR

BENEFIT DURATION: SURVIVOR INCOME BENEFIT:

YES NO

YES NO

YES NO

ACCIDENTAL DISMEMBERMENT &LOSS OF SIGHT:

YES NO

12/24 Pre-existing Condition limitations (in most states).

Proposal valid for up to 1,000 lives.Minimum Hours worked per week is 30 hours.

FULL COMMISSION ON REPLACEMENT: YES NO

YES NO

YES NO

TRADITIONAL PLAN OPTIONS: *

Minimum participation - Greater of 5 enrolled (10 in CO, 51 eligible in FL) or 25%.

PLAN OPTIONS:

PLAN OPTIONS:PORTABILITY:

* Selecting all Traditional Plan Options is the same as selecting the Premier plan.

BENEFITDURATION:

13 WK26 WK52 WK

104 WK

7/70/7 30/3014/140/14ELIMINATION PERIOD:

JOB COVERAGE:NON-OCC24 HR

PLAN TYPE:PREMIER (65%)TRADITIONAL (60%)

LOWER PRE-EX: 3/12 6/12

(Duration reduces gradually after Age 59-65, depending on plan)

RATE BASIS: ISSUE AGE ATTAINED AGE

LOWER PRE-EX: 3/12 6/12 12/12

SUPPLEMENTAL QUESTIONNAIRE REQUIRED FOR:HOTEL CHAINS OVER 999 LIVES, 1099'S, ASSOCIATIONS, PEO'S & UNIONS.

(5 enrolled for 2 year. Reduced Participation/Commission Option requires 15 enrolled.)

VOLUNTARY GROUP TERM LIFE

$10,000$5,000CHILD RIDER: Guarantee Issue based on eligible lives.

Minimum participation - greater of 5 enrolled (10 in CO) or 20%.

Proposal valid for up to 1,000 lives.EMPLOYEE AD&D

Minimum Hours worked per week is 30 hours.

SPOUSE & CHILD AD&D

FULL COMMISSION ON REPLACEMENT:

PRE-EXISTING BENEFIT: 25%100%For 4 Weeks

FIRST DAY HOSPITAL: YES NO

Issued through: Albany: Phone: 800-643-2212 Fax: 229-439-1644Knoxville: Phone: 800-653-5242 Fax: 865-539-5011

E-mail: [email protected]

COMMENTS: _____________________________________________________________________________________________________________________________________________________________________________

SIC CODE:

SHOWRATES: Semi-Monthly MonthlyWeekly Bi-Weekly

AGENCY:AGENT:STREET:

PHONE #: FAX:

#

CITY/ST/ZIP:

EMAIL:

GROUP NAME:ADDRESS/CITY:

NO. OF EMPLOYEES:INDUSTRY:

SIC CODE:PHONE #: STATE:

Affordable Supplemental Hospital Indemnity

Daily Hospital Confinement:

First Hospital Confinement:

Lump Sum Indemnity:

Hospital Injury Indemnity:

Intensive Care Unit:

Private Duty Nurse:

Emergency Accident:

Outpatient Sickness:

Surgical:

Specified Injury:

AD&D Employee:

AD&D Spouse:

AD&D Child:

Diagnostic & Health Screening:

(10 - 300, increments of 10)

(up to 5,000, 7,000 or 9,000)

(40 - 1,000, inc. 20)

(30 - 150, inc. 10)

(30 - 500, inc. 10)

(10 - 100, inc. 10)

(50 - 300, inc. 50)

(25 - 100, inc. 25)

(500 - 3,000, inc. 500)

(1 or 2 units)

(1,000 - 30,000, inc. 1,000)

(1,000 - 15,000, inc. 1,000)

(1,000 - 5,000, inc. 1,000)

(1, 2 or 3 units)

Plan A

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

_____ ____

Plan B

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

__________

_____ ____In CA: DS HS DS HS(Select separately in CA)

Cancer and Specified Dread Disease

First Occurrence:

Hospital Confinement:

Comprehensive Intensive Care:(Intensive Care in TN)

Comprehensive Care:

Surgical & Anesthesia:

X-ray, Radium & Chemo:

Physician's Attendance andPrivate Duty Nurse:

Hospice Care:

Disability Income (Employee):

(500 or 1,000)


(30 - 500, inc. 10)(30 - 1,000, inc. 10 in TN)

(500 - 5,000, inc. 100)

(1,000 - 10,000, inc. 1,000)

(10 - 100, inc. 10)

(25 - 150, inc. 25)

Plan A

__________

__________

__________

Yes

__________

__________

__________

__________

Yes

Plan B

__________

__________

__________

Yes

__________

__________

__________

__________

Yes

Basic Cancer

Basic Cancer:

Additional Daily Indemnity:

Comprehensive Intensive Care:

Hospital Injury Indemnity:

Intensive Care Unit:

Emergency Accident:

Surgical:

Specified Injury:

AD&D Employee:

AD&D Spouse:

AD&D Child:

Disability Income:


(30 - 500, inc. 10)

(50 - 300, inc. 50)

(500 - 3,000, inc. 500)

(1 or 2 units)

(1,000 - 30,000, inc. 1,000)

(1,000 - 15,000, inc. 1,000)

(1,000 - 5,000, inc. 1,000)

Affordable Accident InsurancePlan A

__________

__________

__________

__________

__________

__________

__________

__________

Plan B

__________

__________

__________

__________

__________

__________

__________

__________

______________ ______________ ______________Elimination Period Benefit Duration Benefit Amount(Optional)

Plan A

Yes

Yes

Yes

Plan B

Yes

Yes

Yes

NOTE: All Options Not Available in All States

($400 only in SC)

(50 - 150 in MO, TN)

(30 - 300 in MO, TN)

(Required in TN)

(Not available in TN)

(30 - 300 in MO)

(60 - 400 in MO)

(30 - 100 in MO)

(5,000 - 30,000 in MO)

(5,000 - 15,000 in MO)

(5,000 in MO)

The ABACUS Group

Request forVOLUNTARY PRODUCTS

Issued through: Albany: Phone: 800-643-2212 Fax: 229-439-1644Knoxville: Phone: 800-653-5242 Fax: 865-539-5011

E-mail: [email protected]

PROPOSAL: Just RatesheetsFaxedEmailed Date

Needed:Full Proposal

03/2014

COMMENTS: _____________________________________________________________________________________________________________________________________________________________________________

for more than 35 years, abacus - abacus...

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