Table of Contents

Table of Contents

Important Notice PAGEREF _Toc13834771 \h 2

Policy/Certificate Description 4

Included Riders 6

Additional Critical Illness Rider (Form No. R G1716C; not available with Prime plan) (HSA compatible) 6

Optional Riders 7

Cardiopulmonary Rider (Form No. R G1717C) (HSA compatible) 7

Childhood Critical Illness Rider (Form No. R G1718C; not available with Prime plan) (HSA compatible) 7

Genetic Screening Test Rider (Form No. R G1719C; not available with Prime plan) 8

Health Screening Rider (Form No. R G1720C) (HSA compatible) 8

Increasing Benefit Rider (Form No. R G1721C; not available with Prime plan) (HSA compatible) 8

Specified Disease Rider (Form No. R G1722C; not available with Prime plan) (HSA compatible) 8

General Policy/Certificate Terms 18

Pre-Issue Guidelines 20

Pre-approval of Field-Produced Marketing Materials 20

Ordering Supplies 20

Enrollment Arrangement Checklist 20

Criteria for Eligible Employers 21

Association/Affinity/Union Groups 21

Criteria for Eligible Employees 21

Eligible Dependents 21

Enrollment Guidelines 22

Enrolling the Account/Completing the Paper Application 22

Submitting the Account 22

Policy/Certificate Issue Practices 23

Billing and Follow-Up 23

Underwriting Guidelines 24

Height/Weight Build Chart 24

Claims Guidelines 24

Claims Support 24

Health Screening Rider Claims Administration 24

Other Claims Administration 24

Premium Rates 25

Proposals/Rate Sheets 25

State Specific Information 25

Revisions to this Product Guide 25

About Assurity 26

Connect with us! 26

Why Assurity? 26