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 Long Term Disability (Brochure) (Application) Available to Members Waiting periods available from 30 to 180 days Benefits of up to $10,000 per month available Benefits paid to age 65, if disabled before age 63 “Your Occupation” definition of disability included Benefits payable for up to two years or to age 70, if disabled at age 63 or after Underwritten by The Hartford Life and Accident Insurance Company 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 Accidental Death and Dismemberment (Brochure/Application) Available to Members and Member Spouses Coverage 24 hours a day, no matter where insured is injured No health questions or physical exams Up to $500,000 of coverage is available The AD&D Benefit amount is paid directly to insured, or in the case of death, to the beneficiary Underwritten by The Hartford Life and Accident Insurance Company Hospital Income Plan (Brochure/Application) Available to Members and Member spouses Choice of a daily hospital benefit amount from $100 to $250 Skilled nursing benefit included Intensive care confinement benefit included No health questions or physical exams 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