ISI SALES DIRECT LINE 1-888-ISI-1959 ISI TOLL FREE SERVICE LINE 1-800-241-7753

INSURANCE PLANS AVAILABLE For more information (including costs, exclusions, limitations and terms of coverage) call ISI SALES DIRECT at 1-888-ISI-1959 Simplified Issue 65-3 Accident and Sickness Disability (Brochure/Application) Available to Members, Member spouses, and Member employees Benefits of up to $4,000 per month paid if insured is unable to work in own occupation Simplified Issue short form medical application Benefits payable to age 65 for accidents and for 3 years for sickness Coverage extends to age 70 Underwritten by The Hartford Life and Accident Insurance Company Simplified Issue 2-2 Accident and Sickness Disability (Brochure/Application) Available to Members, Member spouses and Member employees Benefits of up to $4,000 per month paid if insured is unable to work in own occupation Simplified Issue short form medical application Benefits are payable for up to 2 years for a covered accident or sickness Coverage extends to age 70 Underwritten by The Hartford Life and Accident Insurance Company Guaranteed Acceptance Accident Only Disability (Brochure/Application) Available to Members, Member spouses and Member employees Guaranteed medical acceptance Benefits up to $5,000 per month paid if insured is unable to work in own occupation Benefits payable for up to two years following a 30, 60, or 90 day waiting period Underwritten by The Hartford Life and Accident Insurance Company Comprehensive Accident Coverage (Brochure/Application) Available to Members and Member spouses Two plans (50/50/500 and 100/100/1,000) available If Totally Disabled due to Injury, policy pays a $500/$1000 monthly disability income benefit - up to 1 year In the event of death by accident, policy pays a $50,000/$100,000 benefit to the named beneficiary If confined to the hospital as a result of an accident, policy pays $50/$100 per day for up to 500 days Underwritten by The Hartford Life and Accident Insurance Company HOW TO APPLY If you are interested in applying for coverage select the appropriate application, print, complete and mail to: ISI Administrative Center P.O. Box 2327 Beaufort, SC 29901 CLAIM FORMS In the event of a claim or you wish to change your beneficiary, select the appropriate form below, print, complete and mail to: ISI Administrative Center P.O. Box 2327 Beaufort, SC 29901 If you have any questions please call us at: 1-800-241-7753 Ext 9993 The Hartford Accident Claim Form The Hartford Disability Claim Form The Hartford Business Overhead Claim Form The Hartford Beneficiary Change Form New York Life Claim Form New York Life Request For Change Form ReliaStar Request For Change Form ReliaStar Death Claim Form ReliaStar Change of Beneficiary/Name Form