Short Term Disability Insurance

The Elise Insurance Group Value Rider may not be available in all states. In Arkansas, Rider A57653. In Delaware, Rider A57653DE. In Idaho, Rider A57653ID. In Oklahoma, Rider A57653. In Oregon, Rider A57653OR. In Texas, Rider A57653. In Virginia Rider A57653VA. Limitations and exclusions may apply. Benefits are determined by state and plan level selected. Contact your agent for details.

2 The above example is based on a scenario for Elise Insurance Group Short‐Term Disability in Nebraska (domicile state) that includes the following benefit conditions: ages 18–49, employed full‐time at the time disability began, $2,000 monthly disability benefit amount, $40,000 annual salary, elimination period 0/7 days, 3-month benefit period, benefits based on policy premiums being paid with after‐tax dollars. Benefit periods, elimination periods, monthly disability benefit amounts may vary by state, benefit option, and level of coverage selected.

• Benefits are paid directly to Elise Insurance Group policyholders, unless otherwise assigned.

This is a brief product overview only. The plans advertised herein offer supplemental insurance coverage and are not major medical insurance plans. Coverage may not be available in all states including but not limited to PR & RI. Benefits/premium rates may vary based on plan selected. Optional riders may be available at an additional cost. Policies and riders contain limitations and exclusions that may affect benefits payable. Policies and riders may also contain a waiting period. Refer to the policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Elise Insurance Group agent.

Coverage is underwritten by American Family Life Assurance Company of Columbus. In New York, coverage is underwritten by American Family Life Assurance Company of New York.

SHORT-TERM DISABILITY – A57600 SERIES

In Arkansas, Policies A57600AR & A57600LBAR. In Delaware, Policies A57600DE & A57600LB. In Idaho, Policy A57600IDR. In New York, Policy NY57600. In Oklahoma, Policies A57600OK & A57600LBOK. In Oregon, Policies A57600OR & A57600LBOR. In Pennsylvania, Policies A57600PAR & A57600LBPA. In Texas, Policies A57600TX & A57600LBTX. In Virginia, Policies A57600VA & A57600LBVA. This is a brief product overview only. Coverage may not be available in all states. Benefits/premium rates may vary based on plan selected. Optional riders are available at an additional cost. The policy has limitations and exclusions that may affect benefits payable. Refer to the policy for complete details, limitations, and exclusions. For costs and complete details of the coverage, please contact your local Elise Insurance Group agent.

Limitations and Exclusions for residents of Arizona:

Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition will not be covered unless it begins more than 12 months after the Effective Date of coverage. Elise Insurance Group will not pay benefits for a Disability that is being treated outside the territorial limits of the United States. Elise Insurance Group will not pay benefits whenever coverage provided by the policy is in violation of any U.S. economic or trade sanctions. If the coverage violates U.S. economic or trade sanctions, such coverage shall be null and void. Elise Insurance Group will not pay benefits whenever fraud is committed in making a claim under this coverage or any prior claim under any other Elise Insurance Group coverage for which you received benefits that were not lawfully due and that fraudulently induced payment. Elise Insurance Group will not pay benefits for a Disability that is caused by or occurs as a result of any bacterial, viral, or micro-organism infection or infestation, or any condition resulting from insect, arachnid, or other arthropod bites or stings as a Disability due to an Injury; such disability will be covered to the same extent as a Disability due to Sickness.

Elise Insurance Group will not pay benefits for a disability that is caused by or occurs as a result of your:

• Pregnancy or childbirth within the first ten months of the Effective Date of coverage (Complications of Pregnancy will be covered to the same extent as a Sickness);

• Using any drug, narcotic, hallucinogen, or chemical substance (unless administered by a Physician and taken according to the Physician’s instructions), or voluntarily taking any kind of poison or inhaling any kind of gas or fumes;

• Participating in any activity or event, including the operation of a vehicle, while under the influence of a controlled substance (unless administered by a Physician and taken according to the Physician’s instructions) or while intoxicated;

• Participating in, or attempting to participate in, an illegal activity that is defined as a felony;

• Intentionally self-inflicting a bodily injury, or committing or attempting suicide, while sane or insane;

• Having cosmetic surgery or other elective procedures that are not Medically Necessary;

• Having dental treatment, except as a result of Injury;

• Being exposed to war or any act of war, declared or undeclared;

• Actively serving in any of the armed forces, or units auxiliary thereto, including the National Guard or Reserve;

• Donating an organ within the first 12 months of the Effective Date of the policy;

• Mental or emotional disorders, including but not limited to the following: bipolar affective disorder, delusional disorders, psychotic disorders, eating disorders, schizophrenia, anxiety disorders, depression, stress, or post-partum depression. The policy will pay, however, for covered disabilities resulting from Alzheimer’s disease, or similar forms of senility or senile dementia, first manifested while coverage is in force.

Benefits will be paid for only one Disability at a time, even if the Disability is caused by more than one Sickness, more than one Injury, or a Sickness and an Injury.

PRE-EXISTING CONDITION LIMITATIONS: A “Pre-existing Condition” is an illness, disease, infection, disorder, condition, or injury for which, within the 12-month period before the Effective Date of coverage, medical advice, consultation, or treatment was recommended or received, or for which symptoms existed that would ordinarily cause a prudent person to seek diagnosis, care, or treatment. Disability caused by a Pre-existing Condition or reinjuries to a Pre-existing Condition, including deliveries for children conceived prior to the Effective Date of coverage, will not be covered unless it begins more than 12 months after the Effective Date of coverage.

Elise Insurance Group WWHQ | 1932 Wynnton Road | Columbus, GA 31999

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