Financial Designs, Inc.Product Portfolio
REVISED 3/18/09
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 2
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Table of ContentsFinancial Designs Introduction 3Agent Commission Schedule 4
Financial Designs’ Group ProductsCarrier Comparison Grid 9Am Best Ratings 9
Proposal Request FormsProposal Request Form For Groups 2-99 10Census Form For Groups 2-99 11
Plan Options for Sole ProprietorsSmall Business Association Of Michigan (SBAM) 12
Groups 2 To 9: Employer Paid Dental and Vision PlansDental – AlwaysDental 14Dental - Allied National 15Dental - Security Life Insurance 15Vision – AlwaysVision 16Vision – AIG / American General 17Vision – Security Life Insurance 17
Groups 2 To 9: Employer Paid Life / AD&D / STD / LTD PlansLife / Accidental Death & Dismemberment – Group Summary 18Short-term Disability – Group Summary 18Long-term Disability – Group Summary 18
Voluntary PlansCincinnati Life 19Security Life 19AIG / American General 19
Chamber and Association PlansDetroit Regional Chamber Of Commerce 20Small Business Association Of Michigan (SBAM) 21
True Groups 10+ Employer Paid Dental and Vision PlansSecurity Life Insurance 24AIG 24
True Groups 10+ Employer Paid Life / AD&D / STD / LTD Plans Life / Accidental Death & Dismemberment – Group Summary 25Short-term Disability – Group Summary 25Long-term Disability – Group Summary 25
Plan Options for IndividualsAlways Dental & Vision 26
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 3
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
The Financial Designs TeamCatherine L. CooperExecutive Vice President
(800) 828-0759, [email protected]
Kitty Beard Manager of Financial Designs
(800) 828-0759, x440 Fax: (248) 675-2219 [email protected]
Larry Gillis Senior Agent Consultant
(800) 828-0759, x490 Fax: (248) 675-4580 [email protected]
Our HistoryFounded in 1970, the mission of Financial Designs, Inc. (FDI) has been clear: To provide agents with quality, cost-ef-fective programs that will protect their clients from financial hardships as a result of death, sickness, or disability.
FDI provides group and individual insurance products that meet the changing needs of today’s market. The carriers we represent have been selected based on their financial strength, competitiveness, and quality.
Our team is focused on providing exceptional service. That is why we strive, with every case, to make FDI your FIRST resource for ancillary products and services.
Contact Information39500 High Pointe Blvd., Suite 400Novi, MI 48375
Phone: (800) 828-1422 or (248) 348-8200 • Fax: (248) 348-1697www.financial-designs.com
Please contact FDI’s billing department at (800) 828-1422 and/or email [email protected]. Enrollments/ terminations may be faxed to (248) 675-4506.
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 4
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Agent Commission Schedules
Allied NationalHorizons Life and Disability
1st Year Renewal
Standard Plan – All Sizes 15% 10%
Custom Plan – 10-24 15% 10%
Custom Plan – 25+ 12% 8%
Horizons Dental
Both Dental plans 1 & 2 10%
Cincinnati LifeWorksite Plans:
LifeHorizons Payroll Deduction:
UL1 – (Unismoke) 62.5% 2.5% (2-5) 1% (6-10)
UL2 – (Non-Smoker/Smoker) 62.5% 2.5% (2-5) 1% (6-10)
Payroll Deduction Term Life 62.5% 2.5% (2-5) 1% (6-10)
Whole Life (ESP-Flex) 62.5% 3.75% (2-10)
Disability Income D1 (Unismoke) 40% 6% (2-10) 1% (11 on)
Disability Income D2 (Non-smoker/smoker) 40% 6% (2-10) 1% (11 on)
Fort Dearborn LifeLife 10%
Short-term Disability 10%
Long-term Disability 10%
Dental 10%
Security LifeDental 10%
Vision 10%
Small Business Assoc. of MI (SBAM)Michigan Dental Plan 6%
Fort Dearborn Life 15%
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 5
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Agent Commission Schedules (continued)
AlwaysCare Benefits, Inc. offers quarterly bonus payments in addition to our standard commissions to reward our partners for placing and maintaining books of business with us. Our insured group dental and vision plans are eligible for bonus payments. Any group with 2 or more enrolled employees is eligible for inclusion in the bonus calculation.
Agent Bonus ProgramHow to Qualify: • Sell 8 new coverages with a total of 300 enrolled employees within twelve months prior to the measurement period of the last day of each quarter or •8 renewal coverages with a total of 500 employees enrolled with AlwaysCare on the last day of qualifying quarter and 4 new coverages with a total of 100 employees sold within the twelve months prior to the measurement period-the last day of each quarter
What is a “Coverage?” A coverage is any AlwaysDentalSM or AlwaysVisionSM plan purchased by a 2+ enrolled employee group. If a group purchases dental and vision, then the group counts as 2 coverages. For example, a group with 25 employees enrolled in dental and vision plans counts as 2 coverages and 50 enrolled employees.
See back for further details and information.
AlwaysRewards Agent Commission and Bonus Plan
Agent Commission Program
Group Sales:
AlwaysDental CommissionsFirst Year & Renewal
(per group)
10%Employer Funded & Voluntary
AlwaysVision CommissionsFirst Year & Renewal
(per group)
10% Employer Funded12% Voluntary
Individual Dental Sales:
Earn Commissions and Bonuses for your AlwaysCare Sales!
Contacting AlwaysCare:
1-888-729-5433, ext 2013Monday–Friday: 7:30 A.M. to 8:30 P.M.
Saturday: 9 A.M. to 3 P.M. (CST)www.AlwaysCareBenefits.com
First Year (per individual applicant)
15%
Renewal(per individual applicant)
7%
GREATER
BAT
ON ROUGE B
USINES
S REP
ORT
2006
Com
pany o
f the Y
ear
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 6
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Agent Commission Schedules (continued)
Rewards 6/06
Agent Bonus Program Specifications:1. Bonuses are paid quarterly upon qualifying and will be issued 45 days after the last day of the quarter.2. Individual producers in national arrangements must qualify on their own.3. Each office of a firm with multiple offices must qualify on its own.4. A maximum of commissions associated with $250,000 in premium per coverage may be applied to bonus calculations.5. A maximum bonus payout to any one local firm under this program will be $100,000.6. This program does not apply to any form of general agent.7. The bonus program begins 7/1/05. Any subsequent programs are at the discretion of AlwaysCare, which also reserves the right to terminate
or change a program at any time. First Payment will be made in the calendar year, 4th quarter, for 3rd quarter results.8. The writing agent will receive the credit and bonus for groups in which agents share/split commissions.9. If you qualify for either the coverage or number of employees threshold, but not both, then your bonus calculation is based on the tier where both thresholds are met.10. Agent of record transfers and carve-outs of existing groups do not count as new coverages.11. Measurement periods include the twelve months prior to the end of a calendar year quarter.12. Individual Dental sales do not qualify toward the Bonus Program.
Bonus CalculationsBonuses are paid quarterly as soon as you qualify, and are based on commissions paid through the last day of a calendar quarter, e.g., March 31. Premium qualifies if coverage is still in-force as of the last day of the qualifying quarter. Extensions to an existing coverage do not count as a new coverage.
At the end of every calendar year quarter, a measurement of the bonus calculation will be made and new sales qualifications will go back twelve months for every measurement period. Groups that are in-force for a minimum of twelve months are treated as Renewal Business in the calculation.The following chart illustrates the bonus percentage, which grows as your renewal and new business blocks increase. If you have no in-force business with AlwaysCare, then you become eligible for the bonus once you have sold 8 coverages with a total of 300 employee lives.
Your bonus will be your quarterly paid commissions multiplied by your bonus percentage.
New Business
Coverages Sold within 12 month
measurement periodEmployee
Lives
A B C D E
0 Coverages & 0 Lives
8 Coverages& 500 Lives
16 Coverages& 1,000 Lives
24 Coverages& 1,500 Lives
32 Coverages& 2,000 Lives
AA 4 100 0% 8% 12% 16% 20%
BB 8 300 8% 12% 16% 20% 24%
CC 12 600 12% 16% 20% 24% 28%
DD 16 900 16% 20% 24% 28% 32%
Examples of Bonus Percentage Calculation:• If you have no existing business with AlwaysCare, but sell 12 new coverages with 600 lives within the twelve month bonus measurement period, your bonus percentage is 12% (Column A, Row CC).• If you have 16 renewal coverages with 1,000 lives with AlwaysCare at the start of the twelve month bonus measurement period, and sell 12 new coverages with 600 lives within the measurement period, your bonus percentage is 20% (Column C, Row CC).• If you have 16 renewal coverages with 1,000 lives with AlwaysCare at the start of the twelve month bonus measurement period, and sell 12 new coverages with 400 lives within the measurement period, you bonus percentage is 16% (Column C, Row BB).
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 7
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Agent Commission Schedules (continued)
2006 producer compensation programs
Great employee benefits products...Excellent service and support...Top-notch commission programs...AIG Employee Benefit Solutions delivers to you — and your clients.
06675006-1149 R03/06
WE KNOW BENEFITS.SM
Schedule AAnnual Amount of Premium Commissions on Premium
First $20,000 15.0 %Next 20,000 10.0Next 20,000 7.5Next 40,000 5.0Next 100,000 2.5Next 300,000 2.0Next 500,000 1.5Thereafter 1.0
Schedule BAnnual Amount of Premium Commissions on Premium
First $10,000 10.0%Next 10,000 4.0Next 20,000 3.0Next 20,000 2.0Next 140,000 1.5Next 300,000 1.0Thereafter .6
STD, LTD and NJTDB1
Annual Amount of Premium Commissions on PremiumFirst $15,000 15.0%Next 10,000 10.0Next 35,000 5.0Next 50,000 1.0Next 400,000 .5Thereafter .375
NYDBLAnnual Amount of Premium Commissions on Premium
First $5,000 17.5%Next 5,000 13.0Next 40,000 5.0Next 200,000 2.0Next 250,000 2.0Next 1,500,000 1.0Next 2,000,000 1.0Thereafter .5
STD advise to pay administrative services onlyAnnual Amount of Premium Commissions on Administration Fees
First $15,000 1.5%Next 10,000 1.0Next 35,000 .5Next 50,000 .1Next 400,000 .05Thereafter .0375
Group Short-Term Disability (STD), Long-Term Disability(LTD), New Jersey Temporary Disability Benefits (NJTDB)and New York Disability Benefits Law (NYDBL)
Group Dental and Vision
Annual Amount of Premium Commissions on PremiumFirst $10,000 10.0 %Next 10,000 7.5Next 10,000 5.0Next 20,000 2.5Next 200,000 1.5Next 250,000 1.5Thereafter 1.0
Group Term Life and AD&D
Employer-funded product commissions schedules
Annual Amount of Premium Commissions on PremiumAll Premium 2.75%
Work & Family Benefits, Inc.2 Values Package®
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 8
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Agent Commission Schedules (continued)
Producer first year target commissions program
Employee-paid product commissions schedules
Annual Amount of Premium Commissions on PremiumFirst $25,000 20.0%Next 25,000 17.5Next 25,000 15.0Next 25,000 12.1Next 100,000 10.0Next 100,000 7.5Next 100,000 5.0Thereafter 2.5
Annual Amount of Premium Commissions on PremiumAll Premium 10%
AIG Group Discount3 DentalSM
Annual Amount of Premium Commissions on PremiumFirst Year Thereafter
First $60,000 20.0% 8.5%Next 40,000 15.0 6.0Next 100,000 10.5 1.5Next 100,000 7.5 1.5Next 100,000 5.0 1.0Thereafter 2.5 1.0
Group Dental4 and Vision
Earn up to an extra 2.5 percent commission
Standard commission schedules will be in effect from January 1, 2006, toDecember 31, 2006. The First Year Target Commissions program is good onlyon non-New York cases underwritten by AIG Life Insurance Company,effective January 11, 2006 to December 31, 2006. Producers must remain ingood standing with AIG Employee Benefit Solutions underwriting companies.
www.aigebs.com
Products not available in all states. Insurance services provided by members of American International Group, Inc., 70 Pine Street, New York, New York.©2006 American International Group, Inc. All rights reserved.
1Calculated independently2Work & Family Benefits, Inc. services are provided exclusively by Work & FamilyBenefits, Inc. These services are not insurance and are not provided by one of theAIG member companies.
3AIG Group Discount Dental provides discounts only and is NOT insurance.4Includes Indemnity and PPO plans.
When you sell a target case you will be eligible for a flat 2.5 percentfirst-year commission, on a per-coverage basis, on manually ratedcases. This is in addition to your regular commission for the business.
Target cases are in certain SIC codes that have been historicallyunderserved by our competition. This is an almost untapped marketwaiting for you.
Go to our private Agents/Brokers site within www.aigebs.com for acomplete listing of the approved SIC codes.
Qualifications for a target case:• must be sold under a designated SIC code industry• a manually rated case
First Year Target Commissions make it well worth your while toseek out these underserved groups.
For more information contact your AIG Employee Benefit Solutions Sales Representative today.
Please note: Each state mandates that the producer hold an insurance license with linesof authority for life and health in the same state in which the policyholder is domiciled.If you are not licensed in the state of sale, the case will not qualify unless a valid licenseis received within the qualifying period.
06675006-1149 R03/06
Group Term Life, AD&D, STD and LTD
Eligibility
Back for 2006, our First Year Target Commissions program can help open often-overlooked markets – and offer you special first-year commissions.
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 9
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
LifeDependent
LifeAD&D
Short Term Disability
Long Term Disability
Dental Vision Other
AIG /American General ✓ ✓ ✓ ✓ ✓ ✓ ✓
Supplemental Life, Voluntary Life, STD, LTD, Vision, Dental
Allied National ✓ ✓ ✓ ✓ ✓
AlwaysCare ✓ ✓Voluntary Dental & Vision
Cincinnati LifeWorksite marketing, Universal, Whole Life, Term
Fort Dearborn Life (SBAM, DRC) ✓ ✓ ✓ ✓ ✓ ✓
Voluntary Life, Short-Term Disability, Long-Term Disability, Dental, Critical Illness
Michigan Dental Plan (SBAM) ✓
Security Life ✓ ✓Voluntary Vision & Dental
AM Best RatingAIG / American General A++
AlwaysCare (underwritten by National Guardian Life) A
Cincinnati Life A+
Fort Dearborn Life A+
Security Life B
Group Products
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 10
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Proposal Request Form ❒AIG ❒Allied National ❒AlwaysCare
❒Fort Dearborn Life ❒MI Dental ❒Security Life
AG
ENT Agent: Phone: Fax:
Email: Current AOR? ❒Yes ❒No Date Presenting to Client:
Date Proposal Needed: Send Proposal Via: ❒Mail ❒Fax ❒Email
GR
OU
P
Group Name: # Eligible Employees: # Participating:
Choose ONE Type: ❒Non-Contributory ❒Contributory ❒Voluntary Targeted Effective Date:
Address: City: State/ZIP:
SIC: Nature of Business:
LIFE
In-Force Plan Design: Requested Plan Design (if different):
Current Rates: Renewal Rates: Competitor Rates:
Dependent Life: ❒Yes ❒No Amount of Coverage: Spouse $ Child(ren) $
STD
In-Force Plan Design: / / ❒50% ❒60% ❒66 2/3% ❒70% Other: Max: $
Current Rates: Renewal Rates: Competitor Rates:
Requested Plan Design: / / ❒50% ❒60% ❒66 2/3% ❒70% Other: Max: $
LTD
In-Force Plan Design: ❒50% ❒60% ❒66 2/3% ❒70% Other: Max: $
Elimination Period: ❒90 Day ❒180 Day Duration: RBD SSNRA 5YR 2YR
Current Rates: Renewal Rates: Competitor Rates:
Requested Plan Design (if available): / / ❒50% ❒60% ❒66 2/3% ❒70% Other: Max: $
Elimination Period: ❒90 Day ❒180 Day Duration: RBD SSNRA 5YR 2YR
DEN
TAL
In-Force Plan Design: Requested Plan Design (if different):
In-Network: Deductible: Coinsurance% / / Max: $
Out-of-Network: Deductible: Coinsurance% / / Max: $
In-Force Rates: EE E+Spouse E+Child Fam
Renewal Rates: EE E+Spouse E+Child Fam
Competitor Rates: EE E+Spouse E+Child Fam
Endodontics: Type: ❒Basic ❒Major Oral Surgery Type: ❒Basic ❒Major
Periodontics: Type: ❒Basic ❒Major Orthodontics: % Lifetime Max: $
VIS
ION
In-Force Plan Design: Requested Plan Design (if different):
In-Network Copay or Reimbursement %: Out-of-Network Copay or Reimbursement %:
In-Force Rates: EE E+Spouse E+Child Fam
Renewal Rates: EE E+Spouse E+Child Fam
Competitor Rates: EE E+Spouse E+Child Fam
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 11
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Employee Name Birth Date M / F Salary Salary Paid Class Occupation Family Status
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
❒Weekly❒Bi-Monthly❒Monthly❒Yearly
❒Single❒EE + Spouse❒EE + Child❒Family
Group / Individual Census
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 12
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Small Business Association of Michigan
SBAM Plan
Fort Dearborn Life
Life / Accidental Death & Dismemberment
Trust Group (1-9 eligible) True Group (10+ eligible)
Guaranteed Issue Limit $15,000-$35,000 $50,000-$100,000
Dependent CoverageSpouse– $2,000 / $5,000 MaximumChildren– $1,000 / $2,000 Maximum
Spouse– $2,000 / $5,000 MaximumChildren– $1,000 / $2,000 Maximum
Rating 5 Year Age Band Composite Rating
Short-Term Disability
Trust Group (1-9 eligible) True Group (10+ eligible)
Weekly Maximum $750 $750
Duration 13 / 26 / 52 Weeks 13 / 26 / 52 Weeks
Percent of Annual Salary 66.7% 66.7%
Long-Term Disability
Trust Group (1-9 eligible) True Group (10+ eligible)
Own Occupation 24 Months 24 Months
Monthly Maximum $4,000 $5,000 or $6,000 $4,000 $5,000 or $6,000
Percent of Salary 60% 60%
Elimination Period 90 or 180 days 90 or 180 days
Supplemental Term Life
Trust Group True Group (10+ eligible)
Guaranteed Issue1-4 None5-9 $20,000
10-49 $30,00050-99 $80,000
Participation Minimum of 25% Participation
ScheduleFlat ($10,000 increments)Minimum-$10,000 / Maximum-$500,000
Plan Options for Sole Proprietors
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 13
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Small Business Association of Michigan
SBAM Plan
Michigan Dental PlanSole Proprietor Groups
Coverage and Amounts Plan A Plan BCopayment
(Amount Covered)
CombinedPlan Year
Deductible
Combined Plan Year Maximum
Copayment(Amount Covered)
Combined Plan Year
Deductible
Combined Plan Year Maximum
Class IPreventive and Diagnostic
50% 0 $1,000 100% 0 $1,000
Class IIRestorative Services, Oral Surgery, Endodontic and Periodontics
50% $50 $1,000 75% $50 $1,000
Class IIIInstallment And Repair Of Crowns, Bridges and Dentures
50% $50 $1,000 50% $50 $1,000
Special Provisions: 1. Installation and repair of crowns is a Class III benefit. 2. There is a “missing tooth” limitation whereby there is no reimbursement for dental services related to a
tooth missing at the inception of coverage until the individual has been covered for at least twenty-four (24) months.
3. Class II & III benefits are delayed six (6) months.
Basic Monthly Rates (By Area)
Plan A Plan B
Employee Only
Employee Plus 1
Dependent
Employee Plus Family
Employee Only
Employee Plus 1
Dependent
Employee Plus Family
AREA ILivingston, Macomb, Oakland, Washtenaw, Wayne Counties
$26.65 $48.58 $74.23 $47.59 $86.75 $132.61
AREA IIBay, Eaton, Genesee, Grand Traverse, Ingham, Lapeer, Midland, Saginaw, St. Clair, Tuscola Counties
$25.74 $46.84 $71.61 $45.94 $83.68 $127.94
AREA IIIClinton, Iosco, Isabella, Jackson, Kalamazoo, Kent, Mecosta, Monroe, Shiawassee Counties
$26.85 $42.97 $65.75 $42.15 $76.77 $117.38
AREA IVAll other counties
$21.92 $39.94 $61.13 $39.17 $71.41 $109.78
Plan Options for Sole Proprietors (continued)
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 14
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Groups 2 to 9Employer Paid Dental Plans
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 13
Financial Designs, Inc. Product Portfolio REVISED 05/08/06
Groups 2 to 9Employer Paid Dental Plans
AlwaysCare Benefits, Inc. (a Starmount Life Insurance company) andFinancial Designs, Inc. have teamed for a great opportunity to offer your clients dental insurance for little or no cost to them.
Dental Insurance–FOR LITTLE OR NO COST TO THE EMPLOYER!
Contacting AlwaysCare:Call Toll Free
888.729.5433,ext 2013Monday–Friday:
7:30 A.M. to 8:30 P.M. Saturday:
9 A.M. to 3 P.M. (CST)AlwaysCareBenefits.com
AlwaysDentalSM
AlwaysCareSM
This form is not a contract of insurance. Please note: this is a brief description of the AlwaysDental plan. It should be used only as a guide. It does not contain complete plan details. Terms and conditions, including a complete list of benefits, limitations and exclusions, are defined in the member certificate issued following enrollment in the plan. If questions arise concerning coverage, the subscriber certificate and riders will govern.
AlwaysDental is underwritten by National Guardian Life (NGL) and administered by AlwaysCare Benefits, Inc. (a Starmount Life Insurance company).
National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, Guardian Life.
Contact Larry Gillis ([email protected]) or Kellie Hauman ([email protected]) for a group proposal!
800.828.0759
Participation Guidelines:• If 2-4, 100% of eligible employees must enroll.• If 5 or more, the greater of 5 eligible employees or 20% must enroll AlwaysDentalSM
&
• Dental insurance is the number onerequested benefit behind health insurance.
• AlwaysDental allows the employee to choose any dentist.
• A fully insured plan with no in or out-of-network coinsurance differences.
• Employer determines their premium contribution amount, with the option of $0 contribution.
• Another great addition to a Section 125 Premium Only Plan or a Flexible Spending Account (FSA).
Outline of Benefits Dental PlanDeductible Group as a whole has a choice between:
$100 Lifetime. Applies to Class A, B, C. or$50 benefit year. Maximum 3 per family. Applies to Class B, C.
Benefit Year Maximum $1000 for Class A, B, C.
Class APreventive Services100%
Waiting Period: None• Routine exams (1 per 6 months)• Prophylaxis (1 per 6 months)• Bitewing X-rays (max 4 films; 1 per 12 months• Flouride to age 16 (1 per 12 months)• Sealants to age 16 (permanent molars, once)• Space maintainers to age 16 (1 per 24 months)
Class BBasic Services80%
Waiting Period: None• Full mouth X-ray (1 per 24 months)• Emergency pain• Fillings• Anesthesia• Simple extractions• Oral surgery• Crown, denture, bridge repair
Class CMajor Services50%
Waiting Period: 12 months*• Simple periodontics• Endodontics (root canals)• Surgical periodontics• Inlays and Onlays• Crowns, bridges, and dentures
Class DOrthodontics**50%(optional benefit)
Waiting Period: 12 months*• Annual maximum: $500• Separate Lifetime maximum: $1,000• Dependent children to age 19 only
* Takeover credit available. **Orthodontics available for groups of 10 or more.
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 15
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Allied National — Horizon Dental Design PlanHorizon Dental Design Plan Highlights
Maximum Benefit (per person per year) Indemnity$1,000
PPO$1,000
Preventive & Diagnostic Services Plan Pays (reasonable charges)
Plan Deductible/Copay
Waiting Period
100%
NONE
NONE
100% in network80% out of network$10 Copay per Visit(waived in-network)NONE
Basic Services Plan Pays (reasonable charges)
Waiting Period
80% after a $75 per person combined basic/major calendar year deductible
6 Months
Pays 80% in network, 60% out of network after a $75 per person combined basic/major calendar year deductible(deductible waived in-network)6 Months
Major Services Plan Pays (reasonable charges)
Waiting Period
Pays 50% after a $75 pp combined basic/major calendar year deductible – max 3 per family
12 Months
Pays 50% in and out of network after a $75 pp combined basic/major calendar year deductible – max 3 per family(deductible waived in-network)12 Months
Deductible for Basic & Major Services Per Person
Max # Deductibles per Family per Year
$50 Combined Per Year
3
$50 combined per year(waived in network)$100 combined life time deductible3
Orthodontia (children only)Optional for Both Plans Plan Pays (reasonable charges) Deductible Waiting Period Lifetime Maximum
50%$50 per person – one time12 Months$1,000
Additional Plan Options – Groups of 10+ Employees (for both plans)This option moves endodontics from Major to Basic Services and sets Basic Services waiting period to 0 months and Major Services waiting Period to 6 months.Takeover, Orthodontia benefits are all plan options and are available only if shown as included on proposal page.Please see the Allied Dental Design brochure for complete details on takeover and all other benefits. Network: AIG National Dental Network
Security Life InsurancePlan Deductible* Annual Maximum Orthodontia
100 / 80 / 50 $50 $1,000 / $1,500 Optional
80 / 80 / 50 $50 $1,000 / $1,500 Optional
100 / 50 / 50 $100 $1,000 / $1,500 Optional
*Deductible waived for Preventive ServicesWaiting Periods: Preventative = 0 Basic = 3 months Major = 12 months Ortho = 12 monthsNetwork: Indemnity
Groups 2 to 9 – Employer Paid Dental Plans (continued)
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 16
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 19
Financial Designs, Inc. Product Portfolio REVISED 05/08/06
Vision Insurance–FOR LITTLE OR NO COST TO THE EMPLOYER!
This form is not a contract of insurance. Please note: this is a brief description of the AlwaysVision plan. It should be used only as a guide. It does not contain complete plan details. Terms and conditions, including a complete list of benefits, limitations and exclusions, are defined in the member certificate issued following enrollment in the plan. If questions arise concerning coverage, the subscriber certificate and riders will govern.
AlwaysVision is underwritten by National Guardian Life (NGL) and administered by AlwaysCare Benefits, Inc. (a Starmount Life Insurance company).National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, Guardian Life.
AlwaysCareSM
AlwaysVisionSM
Contacting AlwaysCare:Call Toll Free
888.729.5433, ext 2013Monday–Friday:
7:30 A.M. to 8:30 P.M. Saturday:
9 A.M. to 3 P.M. (CST)AlwaysCareBenefits.com
AlwaysVisionSM
&
• Vision insurance is one of the fastest growing employee benefit offerings.
• AlwaysVision offers consumers state of the art facilities and an impressive selection of eyewear.
• Employer determines their premium contribution amount, with the option of $0 contribution.
• Another great addition to a Section 125 Premium Only Plan or a Flexible Spending Account (FSA).
AlwaysCare Benefits, Inc. (a Starmount Life Insurance company) andFinancial Designs, Inc. have teamed for a great opportunity to offer your clients vision insurance at little or no cost to them.
* If 2-4 eligible, 100% of eligible employees must enroll in both AlwaysDental and AlwaysVision. If 5-100 eligible, the greater of 5 or 20% of total eligible must enroll in AlwaysVision.** If 10-100 eligible, the greater of 10 or 80% of eligible employees must enroll in AlwaysVision.
Service In-Network Out-of-NetworkAllowances
Exam (once per 12 months) $10 co-pay Up to $35
Materials: $10 co-pay
Std. Plastic Lenses (once per 12 months):
Single VisionBifocalTrifocalLenticularProgressive
CoveredCoveredCovered$80 allowance$70 allowance
Up to $25Up to $40Up to $50Up to $50Up to $40
Frames (once per 24 months):Member may select any frame available
$120 retail allowance($94 at Wal-Mart and Sam’s Club)
Up to $50 retail allowance
Contact Lenses (once per 12 months):Fit, follow-up and materials • Elective• Medically Necessary
Up to $120 retail allowanceUp to $210 retail allowance
Up to $100 retail allowanceUp to $210 retail allowance
Rates:• Employee• Employee + Spouse• Employee + Child(ren)• Family
Base* Incentive**$ 8.09 $ 4.63
$ 16.18 $ 9.26 $ 14.00 $ 8.01 $ 22.09 $ 12.64
The above rates are valid through March 31, 2006.
Contact Larry Gillis ([email protected]) or Kellie Hauman ([email protected]) for more information!
800.828.0759
Groups 2 to 9Employer Paid Vision Plans
Groups 2 to 9Employer Paid Vision Plans
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 17
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
AIG / American General Premier-Plus Plan
Plan Provision Plan Details
In-Network Out-of-Network
Exam $10 co-pay $40 reimbursement
Exam Frequency Annual Same as In-Network Plan
Frames Frequency • Annual• Every 2 years (option)
Same as In-Network Plan
Frames (any frame available at provider location)
$0 copay, $120 allowance20% off balance over $120
$45 reimbursement
Standard Plastic Lenses Single vision, bifocal, trifocal, and lenticular $20 copay
Single Vision - $45 reimbursementBifocal - $60 reimbursementTrifocal - $80 reimbursementLenticular - $80 reimbursement
Other Lens Options $12 copay-$45 copay N/A
Contact Lenses $0 copay$105 allowance-$210 allowance
Elective-$80 reimbursementMedically Necessary-$210 reimbursement
Laser Vision Correction 15% off retail or 5% off promotional price from US Laser Network
N/A
Other Services, Materials,or Add-on features
20% discount, plus 45% savings through the Premier-Plus Secondary Purchase Plan
N/A
Network: EyeMed
Security Life InsuranceService* Benefit Plan 1 Plan 2
Eye Exam $40 Once per benefit year Once per benefit year
Single Pair Lens $60 Once per benefit year Every other benefit year
Bifocal Pair Lens $90 Once per benefit year Every other benefit year
Trifocal Pair Lens $130 Once per benefit year Every other benefit year
Progressive Pair Lens $150 Once per benefit year Every other benefit year
Contacts (pair) $90 Once per benefit year Every other benefit year
Frames $45 Once per benefit year Every other benefit year
*Contact lens benefit is in lieu of other material benefits. Benefit for one contact lens I half of benefit year allowance.Network: Indemnity Plan
Groups 2 to 9 – Employer Paid Vision Plans (continued)
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 18
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Groups 2 To 9
Employer Paid Life / AD&D / STD / LTD Plans
Life/Accidental Death & Dismemberment
AIG Allied National
Guaranteed Issue Limit 2-4: n/a5-9: $100,000(w/prior carrier proof)
2-4: $10,000$35,000 – takeover5-9: $50,000 – non-takeover$75,000 – takeover
Minimum Life Benefit $10,000 $10,000
Maximum Life Benefit $100,000 $100,000
Dependent Life Coverage Spouse - $10,000 Spouse - $10,000
Child - $2,000 Child - $2,000
Rating Composite Five (5) Year Age Band
Special Terms Can be purchased as a standalone benefit
Short–Term Disability
AIG Allied National
Weekly Maximum $1,000 $1,000
Duration 13/26 or 52 weeks 13/26 weeks
Percent of Annual Salary 60% 60%
Flat Amount Available May not exceed 60% of weekly pay May not be less than 25% or more than 60% of earnings w/out approval
Special Terms Can be purchased as a standalone benefit
Long–Term Disability
AIG Allied National
Own Occupation 24 months 24 months
Monthly Maximum $6,000 $6,000
Percent of Annual Salary 60% 60%
Elimination Period 90 or 180 days 90 or 180 days
Special Terms Can be purchased as a standalone benefit Can be purchased as a standalone benefit
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 19
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Cincinnati Life
Worksite Marketing Plans – Five (5) Employees Must Participate
Plans Available• Universal• Whole Life• Term
Benefits for the Employer• Provides quality, voluntary life insurance for your employees• Expands your fringe benefits at virtually no additional cost to you• Promotes goodwill with your employees• Encourages employees to take more responsibility for their financial security• Helps redirect a philosophy that the employer must pay for all benefits
Benefits for the Employee• Modern, competitive products• Low-cost life insurance protection• Coverage is available for employees’ spouse, children and grandchildren• Convenience of paying premiums through payroll deduction• Employee owns policy• Guaranteed paid-up life insurance option available at any time• Cash values accumulate on a tax-deferred basis• Portable coverage – employee keeps the coverage at the same cost, even it the employee is no longer with the company• If the amount of insurance is less than $100,000, no blood profile or urine analysis is needed• No medical examinations required
Security LifeVoluntary Dental – Groups of 3 or more are eligible. Only 1 employee needs to enroll.
PLAN Deductible* Annual Maximum Orthodontia
100/80/50 $50 $1,000 / $1,500 Optional
80/80/50 $50 $1,000 / $1,500 Optional
100/50/50 $100 $1000 / $1,500 Optional
*Deductible waived for Preventive Services
Waiting Periods: Preventive = 3 months, Basic = 6 months, Major= 12 months, Ortho= 12 monthsNetwork: Indemnity
AIG / American GeneralIndemnity & PPO Plan
Plan Deductible Annual Maximum Orthodontia
Passive PPO100/50/50100/80/50
$100 life time deductible$50 per year
$1,500$1,000
Optional
Network: AIG National Dental Network Note: Two plans available Voluntary PPO Voluntary indemnity
Voluntary Plans
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 20
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Chamber and Association Plans
Detroit Regional Chamber of Commerce(Underwritten by Fort Dearborn Life Insurance Company)
Life / Accidental Death & Dismemberment
1-4 Eligible 5-9 Eligible
Guaranteed Issue Limit $25,000 $35,000
Dependent Coverage
Plan DSpouse @ $5,000Children (15 days – 6 months) $250Children (6 Months – Age 21 & Age 23 (full time student)) $2,500
Plan ESpouse @ 2,000Children (15 days – 6 months) $100Children (6 Months – Age 21 & Age 23 (full time student)) $1,000
Rating 5 Year Age Band
Short-Term Disability*
1-9 Eligible
Guaranteed Issue Limit $500
Weekly Maximum $500 (May not exceed 66 2/3% of employee’s weekly salary)
Maximum Benefit Duration 13/26 Weeks
Percentage of Annual Salary 50%, 60%, or 66 2/3%
*Short Term Disability Coverage Available Only When Life and AD&D Is Selected.
Long-Term Disability*
Maximum Benefit $6,000
Percentage of Basic Monthly Earnings 60%
Elimination Periods 90, 180 days
Maximum Benefit Duration Period 5 year and to age 65 with reducing benefit duration
*Must be sold in combination with Life and AD&D benefits.
Call an FDI Consultant at (800) 828-1422 for details & information about Voluntary products offered through the Detroit Regional Chamber.
Groups of 10 or more will be composite rated.
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 21
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Chamber and Association Plans (continued)
Small Business Association of Michigan
SBAM Plan
Michigan Dental PlanGroups of 2–4 Lives
Coverage and Amounts Plan A Plan BCopayment
(Amount Covered)
CombinedPlan Year
Deductible
Combined Plan Year Maximum
Copayment(Amount Covered)
Combined Plan Year
Deductible
Combined Plan Year Maximum
Class IPreventive And Diagnostic
50% 0 $1,000 100% 0 $1,000
Class IIRestorative Services, Oral Surgery, Endodontic And Periodontics
50% $50 $1,000 75% $50 $1,000
Class IIIInstallment And Repair Of Crowns, Bridges And Dentures
50% $50 $1,000 50% $50 $1,000
Special Provisions: 1. Installation and repair of crowns is a Class III benefit. 2. There is a “missing tooth” limitation whereby there is no reimbursement for dental services related to a
tooth missing at the inception of coverage until the individual has been covered for at least twenty-four (24) months.
3. Class II & III benefits are delayed six (6) months.
Basic Monthly Rates (By Area)
Plan A Plan B
Employee Only
Employee Plus 1
Dependent
Employee Plus Family
Employee Only
Employee Plus 1
Dependent
Employee Plus Family
AREA ILivingston, Macomb, Oakland, Washtenaw, Wayne Counties
$23.03 $41.99 $64.15 $41.13 $74.98 $114.16
AREA IIBay, Eaton, Genesee, Grand Traverse, Ingham, Lapeer, Midland, Saginaw, St. Clair, Tuscola Counties
$22.26 $40.47 $61.90 $39.70 $72.32 $110.48
AREA IIIClinton, Iosco, Isabella, Jackson, Kalamazoo, Kent, Mecosta, Monroe, Shiawassee Counties
$23.20 $37.14 $56.82 $36.43 $66.36 $101.45
AREA IVAll other counties
$18.95 $34.52 $52.84 $33.86 $61.71 $94.34
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 22
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Chamber and Association Plans (continued)
Small Business Association of Michigan
SBAM Plan
Fort Dearborn Life
Life / Accidental Death & Dismemberment
Trust Group (1-9 eligible) True Group (10+ eligible)
Guaranteed Issue Limit $15,000-$35,000 $50,000-$100,000
Dependent CoverageSpouse– $2,000 / $5,000 MaximumChildren– $1,000 / $2,000 Maximum
Spouse– $2,000 / $5,000 MaximumChildren– $1,000 / $2,000 Maximum
Rating 5 Year Age Band Composite Rating
Short-Term Disability
Trust Group (1-9 eligible) True Group (10+ eligible)
Weekly Maximum $750 $750
Duration 13 / 26 / 52 Weeks 13 / 26 / 52 Weeks
Percent of Annual Salary 66.7% 66.7%
Long-Term Disability
Trust Group (1-9 eligible) True Group (10+ eligible)
Own Occupation 24 Months 24 Months
Monthly Maximum $4,000 $5,000 or $6,000 $4,000 $5,000 or $6,000
Percent of Salary 60% 60%
Elimination Period 90 or 180 days 90 or 180 days
Supplemental Term Life
Trust Group True Group (10+ eligible)
Guaranteed Issue1-4 None5-9 $20,000
10-49 $30,00050-99 $80,000
Participation Minimum of 25% Participation
ScheduleFlat ($10,000 increments)Minimum-$10,000 / Maximum-$500,000
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 23
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
True Groups
10+
Employer Paid Dental and Vision Plans
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 24
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
True Groups 10+ Employer Paid Dental and Vision Plans (continued)
Security Life InsuranceEmployer Paid Dental75% employee participation and 50% dependent participation is required.For Groups of 3 with a Minimum of 3 enrolled.
Plan Deductible* Annual Maximum Orthodontia
100 / 80 / 50 $50 $1,000 / $1,500 Optional
80 / 80 / 50 $50 $1,000 / $1,500 Optional
100 / 50 / 50 $100 $1,000 / $1,500 Optional
*Deductible waived for Preventive Services
Waiting Periods: Preventative = 0 Basic = 3 months Major = 12 months Ortho = 12 months
Network: Indemnity Plan
AIGPPO & Indemnity Plan
Plan
Dental • Quote down to 2 lives• Orthodontics at 10 employees who have insured dependent children• Partial contribution option (100% employee participation required, 75% dependent), will
discount rates• Indemnity and PPO (AIG National Dental Network) plans• $100 lifetime deductible option• Quick claim turnaround time• Take over benefits available
Waiting Periods:PPO Plan Preventive = 0 Basic = 3 months Major = 12 monthsIndemnity Plan Preventive = 0 Basic = 3 months Major = 12 months
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 25
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
True Groups 10+
Employer Paid Life / AD&D / STD / LTD Plans
Life/Accidental Death & Dismemberment
AIG
Guaranteed Issue Limit Groups 10-24 lives: up to $100,000;Groups 10-50 plus: up to $150,000
Minimum Life Benefit $10,000
Maximum Life Benefit Limit subject to underwriting approval
Dependent Life Coverage Spouse - $10,000
Child - $5,000
Rating Composite rating
Short–Term Disability
AIG
Weekly Maximum $1,000+
Duration 13/26 or 52 weeks
Percent of Annual Salary 60% or 66 2/3%
Special Terms
Long–Term Disability
AIG
Own Occupation 24 months
Monthly Maximum $10,000 – 50+ group size
Percent of Annual Salary 40%; 50%; 60%; 66 2/3%; 70%
Pre-Existing Exclusion 12/6/243/6/12 – for groups 25+
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 26
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Plan Options for Individuals
At Last! Affordable Quality Dental and Vision Coverage for You and Your Family!
AlwaysDental is now available to you as an individual insurance benefit. This program offers coverage for routine twice-annual exams and common dental procedures. We are including an annual vision exam performed by a licensed ophthalmologist or optometrist ($35 allowance—with no deductible—one visit per year).
Freedom of ChoiceChoose any dental provider you want for insured benefits. The plan pays a flat dollar amount per dental procedure based on the fee schedule for your specific region. You can also go to one of the over 54,000 dental providers (www.AlwaysDental.com) and generally pay even less. AlwaysDental pays the lesser of the provider’s actual charge and the amount listed in the Schedule of Covered Dental Procedures. The vision network provides vision discounts at over 10,000 locations nationwide (www.outlookvision.com).
Easy to GetIf you are age 19 to 64, simply enroll online at www.AlwaysCareBenefits.com or complete a simple application (available to download at www.AlwaysCareBenefits.com or by calling 888-729-5433, extension 2006), and mail it back to us. Your acceptance is guaranteed!
Flexible and AffordableWe offer many different coverage options: Individual; Individual & Spouse; One-Parent Family; or Two-Parent Family. Plus, you choose the billing option that’s most convenient for you. Premiums are based on your attained age (except in Florida) at each policy anniversary date. Please see accompanying rate information for details.
Hassle-FreeThere’s no guesswork. All you do is present your card and, in most cases, your dentist will submit your claim (Or you may send it to us.) For preventive care and basic dental services, coverage begins the very first day. No waiting!
AlwaysDentalSM
AlwaysCareSM
For IndividualsDid you know?Customer Service is the key to our business—we strive to be the company that is easy to do business with.
Tooth decay remains the most common chronic disease among children ages 5-17 with 59% affected.a
AlwaysDental gives you the affordable, first class benefits you seek.
Employed adults lose more than 164 million hours of work each year due to dental disease or dental visits.b
120 mental and physical diseases can be detected through the mouth.c
Our Customer Service Staff is available when you need us with extended and Saturday hours.
59% of Americans do not receive regular oral health care.d
a Issue Briefs on Challenge for the 21st Century: Chronic and Disabling Conditionb American Hygienist Association 02/03c Jed J. Jacobson, D.D.S., M.S., M.P.H. 2/06d Satcher D. Oral health in America: A report by the surgeon general. U.S Department of Health and Human Services. Rockville MD. NIH pub. 2000
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 27
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Plan Options for Individuals
Offering All the Services You Need AlwaysDental products include the dental care you need, the services and procedures you want, where you want it done. You can also choose your own dentist, or go to one of over 54,000 dental providers in our nationwide network and generally pay even less!
Deductible Just $50 per year for each covered family member.
Maximum Benefit $1000 per year for each covered family member.
Plan Reimbursement 100% of the scheduled amount for the service required.
Plus an Extra Vision Benefit!You’ll receive an annual $35 eye exam allowance (except in WA). You may also be eligible for special pricing from over 10,000 vision providers on other vision services.
Ind Den Flat 3/06
Please Note: See Schedule of Covered Services for a sampling of covered procedures. A full listing will be provided with your policy. Services and benefits paid vary according to region. This form is not a contract of insurance. Please note: this is a brief description of the AlwaysDental plan. It should be used only as a guide. It does not contain complete plan details. Terms and conditions, including a complete list of benefits, limitations and exclusions, are defined in the member certificate issued following enrollment in the plan. If questions arise concerning coverage, the subscriber certificate and riders will govern.
AlwaysDentalSM & Vision Discounts
For Individuals
Services Available Frequency of Services
PreventiveNo Waiting Period
• Oral Evaluations • 2 times per 12 months
• Bitewing X-rays • 1 time per 12 months
• Full Mouth X-rays • 1 time per 60 months
• Simple Cleaning • 2 times per 12 months
• Fluoride Treatment • 1 time per 12 months up to age 16
BasicNo Waiting Period
• Sealants • 1 time per molar per 36 months
• Space Maintainers • 1 per lifetime per arch
• Fillings • 1 time per tooth surface per 24 months
• Simple Extractions
• Palliative Emergency Treatment • 1 time per 12 months
Major12 MonthWaiting Period
• Anesthesia*
• Oral Surgery
• Endodontics
• Periodontics
• Single Tooth Restorations (Crowns, Inlays, Onlays)
• 1 time per 7 years
Prosthodontic (Dentures)24 MonthWaiting Period
• Fixed Prosthodontics • 1 time per 7 years
• Removable Prosthodontics • 1 time per 7 years
• Prosthodontic Repairs and Adjustments
OrthodonticsNo Waiting Period
In-Network Discounts only
*In conjunction with oral surgery subject to review.
Contacting AlwaysCare:
1-888-729-5433Monday–Friday: 7:30 A.M. to 8:30 P.M.
Saturday: 9 A.M. to 3 P.M. (CST)www.AlwaysCareBenefits.com
©2006, Starmount Life Insurance Company. All rights reserved.
Form Series NDNIND2005 NGL
AlwaysDental is underwritten by National Guardian Life Insurance Company and administered by AlwaysCare Benefits, Inc. (a Starmount Life Insurance company). National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, Guardian Life.
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 28
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Plan Options for Individuals (continued)
Rates for AlwaysDental & Vision vary according to the region in which you live. To find your region: Locate your state and the fiRst thRee Digits of your Zip Code in the Area table below. To find your rate: Consult the rate chart for that region to determine the rate for your age and the type of coverage you want. Product not yet approved in all states.
Individual Dental Product Rates
RAtes iND 3/06
Rates and Coverage Regions
AlwaysDentalSM & Vision Discounts
For Individuals
State/Zip Code RegionAlabama
All Areas 1
Alaska
All Areas 5
Arizona
850-857All Others
32
Arkansas
All Areas 1
California
902-922, 926-931933-935, 940-951954-961All Others
5554
Colorado
800-804All Others
43
Connecticut
062-065All Others
45
Delaware
All Areas 3
District of Columbia
All Areas 5
Florida
321-325All Others330-333
678
Georgia
304-310, 312-319All Others
23
Hawaii
All Areas 4
State/Zip Code RegionIdaho
All Areas 2
Illinois
600-608609-613, 627All Others
432
Indiana
462-466All Others
21
Iowa
500-503All Others
21
Kansas
660-666All Others
21
Kentucky
All Areas 1
Louisiana
700-702, 704, 709All Others
21
Maine
040-042All Others
32
Maryland
206-209All Others
43
Michigan
480-485All Others
32
Minnesota
550-555, 568-569All Others
21
Mississippi
All Areas 1
State/Zip Code RegionMontana
All Areas 2
Missouri
634-639, 644-648650-658All Others
112
Nebraska
All Areas 1
Nevada
All Areas 4
New Hampshire
All Areas 3
New Jersey
070-079, 085-089All Others
54
New Mexico
All Areas 2
North Carolina
All Areas 2
North Dakota
All Areas 1
Ohio
433, 437-439, 446448-449, 453, 455457-458All Others
1112
Oklahoma
730-732, 740-742All Others
21
Oregon
970-973All Areas
43
State/Zip Code RegionPennsylvania
189-194All Others
32
Rhode Island
All Areas 3
South Carolina & South Dakota
All Areas 1
Tennessee
370-372, 379, 381All Others
21
Texas
752-753, 770-772750-751, 760-762773-775, 787All Others
4332
Utah
All Areas 2
Virginia
220-223239-246All Others
412
Vermont
All Areas 3
Washington
980-986All Others
54
Wisconsin
532-534, 536-537All Others
32
West Virginia & Wyoming
All Areas 1
Area Table
Monthly Rates per person
Individual's Age*
Region Flat Rate for Child(ren) 19-39 40-59 60-64Region 1 $24.36 $19.40 $23.39 $25.88
Region 2 $27.66 $21.70 $26.16 $28.94
Region 3 $31.70 $24.52 $29.54 $32.68
Region 4 $36.11 $27.60 $33.23 $36.76
Region 5 $40.89 $30.93 $37.23 $41.17
Florida Flat Rate for Child(ren) Flat Rate for All AdultsRegion 6 (florida Only) $31.70 $29.54
Region 7 (florida Only) $36.11 $33.23
Region 8 (florida Only) $40.89 $37.23
to determine the total rate for the subscriber plus spouse and/or child(ren), simply find the rate for each person and add each person's rate together. OR Log on to our website at www.AlwaysCareBenefits.com and click "individual Dental." Our easy online enrollment will figure your rates for you!
Example: Joe smith, age 42, in Mississippi (Region 1) would have a rate of $23.39. if he were to enroll his spouse, Mary age 38, also in Region 1, her rate would be $19.40. Joe and Mary have two children they wish to enroll, so they would pay one flat rate for them, $24.36.
Joe's rate ($23.39)+ Mary's rate ($19.40)+ Child(ren) rate ($24.36) = $67.15Rates increase as each individual attains a new age bracket (except in fL).
NgLUnderwritten by National guardian Life insurance Company. © 2006, starmount Life insurance Company. All rights reserved. National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, Guardian Life.Policy form series NDNiND2005
Need a Quote?–Call our Team of Professionals at (800) 828-1422 or visit us online at www.financial-designs.com 29
Financial Designs, Inc. Product Portfolio REVISED 3/18/09
Plan Options for Individuals (continued)
the following is a partial listing of insured covered dental procedures (and a vision exam allowance), applicable limitations and reimbursement amounts. Benefits will be paid as listed in the schedule of Covered Procedures in your policy, subject to policy year deductible, annual maximum, and limitations and exclusions. Access to discount networks is also included.
a) Maximum of 2 procedure per 12 monthsb) Maximum of 1 procedure per 36 monthsc) Maximum of 1 procedure per 12 monthsd) Applications made to permanent molar teeth onlye) Maximum of 1 each quadrant per 24 monthsf) Maximum of 1 each per quadrant per 36 monthsg) Maximum of 1 per tooth surface per 24 monthsh) Replacement of existing only if in place for 24 monthsi) Maximum 1 time per tooth
j) Limited to 2 oral evaluation procedures per 12-month period in any combination
k) Limited to 1 bitewing x-ray procedure per 12-month period-up to 4 films
l) Limited to dependent children under age 16m) Maximum of 1 per 7-year periodn) Maximum of 1 per lifetime, per quadrant or archo) Limited to patients age 16 and overp) Limited to 1 x-ray procedure in any combination per
5-year period
KEy TO LIMITATIONS:
sAMPLe ReiM iND 3/06
ADA procedure codes copyrighted by American Dental Association.
Sample Reimbursement for Highly Used Procedures
AlwaysDentalSM & Vision Discounts
For Individuals
Procedure Code
Description Limitations Schedule AmountsRegion 1 Region 2 Region 3,6 Region 4,7 Region 5,8
Oral EvaluationsD0120 Periodic Oral evaluation j 14 16 18 20 22
D0150 Comprehensive Oral evaluation j 22 24 28 31 34
Prophylaxis (Simple Cleanings)D1110 Prophylaxis-Adult a 28 31 35 39 44
D1120 Prophylaxis-Child a 19 21 24 27 30
RadiographsD0210 intraoral-Complete series
(7 or more films, including Bitewings)p 40 45 50 56 63
D0272 Bitewings-two films k 12 13 15 17 19
D0330 Panoramic film p 32 36 40 45 50
SealantsD1351 sealant-Per tooth b, l, d 12 14 15 17 19
Space MaintainersD1510 space Maintainer-fixed-Unilateral l, n 80 89 100 112 125
FillingsD2140 Amalgam-One surface-Primary or Permanent h, g 30 34 38 43 48
D2150 Amalgam-two surfaces-Primary or Permanent h, g 38 43 48 54 60
D2331 Resin-two surfaces-Anterior h, g 44 48 54 61 68
ExtractionsD7140 extraction-single erupted tooth or exposed Root
(elevation and/or forceps Removal)i 35 39 44 49 55
D7230 Removal of impacted tooth-Partially Bony (6-month waiting period)
60 67 75 84 94
Palliative (Emergency) Treatment D9110 Palliative treatment of Dental Pain-Minor Procedure c 27 30 34 38 43
Endodontics (6 month waiting period)
D3310 Root Canal-Anterior (excluding final Restoration) 114 127 143 160 178
D3330 Root Canal-Molar (excluding final Restoration) 170 189 213 238 266
Periodontics (6 month waiting period)
D4260 Osseous surgery (including flap entry and Closure) Per Quadrant f 180 200 225 252 281
D4341 Periodontal scaling and Root Planing, Per Quadrant e 39 43 49 55 61
Single Tooth Restorations (6 month waiting period)
D2750 Crown-Porcelain fused to high Noble Metal m, o 170 189 213 238 266
D2950 Crown Buildup, including Any Pins m, o 39 43 49 55 61
D2952 Cast Post and Core in Addition to Crown m, o 63 70 79 88 98
Prosthodontics (12 month waiting period)
D5110 Complete Upper Denture m 200 223 250 280 313
D5213 Upper Removable Partial Denture-Cast Metal framework with Resin Denture Bases
m 234 260 293 328 366
Orthodontia
08000-08999 Network Discounts Apply
Visioneye exam (not applicable in WA) c $35 per year
NgL
Underwritten by National guardian Life insurance Company. © 2006, starmount Life insurance Company. All rights reserved. National Guardian Life Insurance Company is not affiliated with The Guardian Life Insurance Company of America, a.k.a. The Guardian, Guardian Life.Policy form series NDNiND2005