Distributors’ Benefit Handbook January 1, 2012 ... · A Word from SoZo SoZo Global, LLC has introduced a breakthrough in the network marketing industry: Group health benefits for

Distributors’ Benefit HandbookJanuary 1, 2012 - December 31, 2013

2 of 22

A Word from SoZo 3A Word from ETMG, LLC 4A Word from Small Business United 5Important Information 6Terms of Enrollment 8Distributor Eligibility Table 9Medical Plan Summaries & Rates 10Value Added Benefits 11Dental Plan 12Paying for Your Medical Premiums 13Benefit Descriptions 14Plan Provisions 15Exclusions and Limitations 16Glossary of Terms 17How to Enroll 18“I have enrolled. What now?” 19Dental Enrollment Form 21

Contents

3 of 22

A Word from SoZo

SoZo Global, LLC has introduced a breakthrough in the network marketing industry: Group health benefits for the small business entrepreneur.

”“ We started SoZo to set a new standard for this industry.

We felt that outstanding products and an exceptional compensation plan were just the beginning, and with the clear need for health benefits across the country, SoZo could make a huge difference in the lives of our Distributors.

The program offers several options for a single individual up to a full family, and the higher the Distributor ranks, the lower the out-of-pocket costs. We have gotten such incredibly positive feedback that we are already planning for next year’s enhancements.

Mark AdamsPresident and CEO

SoZo Global, LLC

4 of 22

Enroll now at www.sbua.org/sozo or call a Benefit Specialist at 888-728-2467

A Word from ETMG, LLC

Congratulations on becoming a Distributor with SoZo Life! As an eligible Distributor for SoZo Life, you have access to a guaranteed issue group medical plan underwritten by AXIS Insurance, an A.M. Best A+ Rated company.

ETMG, LLC is here to act as your representative in your dealings with the insurance company. If you have any questions or issues regarding your coverage, contact a Benefit Specialist at ETMG to deal with the insurance company for you. We are here to help and educate!

Benefit Specialist Hotline 1-888-728-2467

Hours of Operation Monday - Friday, 8:30am - 6:00pm CST

Fax 512-682-8795

SoZo Broker Representative Albert Pomales [email protected]

SoZo Benefit Specialists Diana Gomez [email protected] Moser [email protected]

The following pages give a brief description of the benefit plans, eligibility requirements, and the specific benefits available to you.

SoZo Life provides three plans from which a Distributor may choose, based on his or her eligibility.

5 of 22


A Word from Small Business United

As a participant in the SoZo Life benefit program, you will join Small Business United (SBU). SBU is an association chartered in 1992 to be an advocate for small businesses, independent contractors, and associations of any size. SBU seeks out and pulls together helpful resources and services and pools the group purchasing power of its members to make it easier, cheaper, and more efficient for them to do business. SBU is licensed in all 50 states, so our benefits are available nationwide.

The Tools You Need to SucceedHealth BenefitsMembership in SBU provides access to a robust and affordable suite of insurance plan options, underwritten by some of the nation’s largest insurers. Members enjoy group-negotiated rates for several different medical insurance plans. SBU can also facilitate enrollment in individual coverage, traditional group major medical products, and a host of supplemental and ancillary benefits.

Small Business Legal PlanRunning a business is expensive. SBU makes small-business-friendly legal services available to its members to alleviate some of that financial pressure. Our legal plan provides access to a nationwide network of pre-qualified attorneys offering free and discounted legal care, from consultation and document review, to assistance with collections and dispute resolution.

Human Resources SolutionsThe idea of hiring, firing, and maintaining employees can seem daunting, but members of SBU don’t have to go it alone. SBU membership provides access to a Human Resources (HR) service developed specifically for small to mid-sized businesses and delivered via a customized website, phone, and email consultations. This service offers targeted HR content and access to competent administrative and consulting staff so you can run your business confidently and efficiently.

Office Supply DiscountsIncrease the efficiency of your small business by utilizing the group purchasing power afforded by membership in SBU. SBU has partnered with some of the nation’s largest office suppliers to bring you deep discounts on office supplies and consumables.

Each participating SoZo Life Distributor will have access to the benefits defined below in addition to the group medical program through SoZo Life.

6 of 22


Important Information

Important Things to Remember

• Although there is no penalty for visiting a doctor who is out-of-network, visiting an in-network doctor allows you to receive the plan’s deepest discount. To search for a provider please visit www.phcs.com.

• This handbook highlights some of the main features of your medical plan, but does not include all plan rules. The terms of your medical plan are governed by legal documents, including an insurance contract. Should there be any inconsistencies between this book and the legal plan documents, the plan documents are the final authority. SoZo Life reserves the right to change or discontinue its benefit plans at any time.

Pre-Existing Condition Limitation Notice

• Because this is a group plan, a Distributor who is eligible to participate in the medical plans is not subject to any Pre-Existing Condition Limitations. The plans are guaranteed issue with no medical underwriting.

Eligibility Requirements

• All SoZo Life Distributors must reach a qualifying rank defined on page 9 of your benefits booklet in order to be eligible for medical benefits offered through SoZo Life.

• Once you are eligible for the benefits and have enrolled, you are responsible for maintaining the associated qualifying production requirements and rank. If you fall below the production requirements within your rank, SoZo will place you on a 60-day probationary period during which you must maintain qualifying production. If you do not meet qualifying production during your 60-day probationary period, SoZo will be forced to cancel your coverage.

7 of 22


Important Information, Continued

Cancellation Process

• This is a voluntary plan, so you reserve the right to cancel at any time. In order to properly cancel your insurance, you must submit the cancellation form found on www.sbua.org/sozo to a Benefit Specialist by the 5th of the effective month. If cancellation is not received by the 5th of the effective month, premium will be collected and will not be refunded. You can also contact a Benefit Specialist at 1-888-728-2467.

Associated Fees

ETMG, LLC and Small Business United have teamed up to offer great medical benefits to all qualifying Distributors of SoZo Life. In order to maintain the lowest price for medical premiums, Distributors who join the medical plan offered through SoZo Life are responsible for the following fees:

• One-time $20 application fee• Payment processing fee of $6 per month• Small Business United Association Membership fee of $5 per month

(see the association membership benefits on page 5 of this handbook)

8 of 22


Terms of Enrollment

Enrollment• Each SoZo Distributor becomes eligible for SoZo Life medical benefits when he or

she reaches the ranks defined by the eligibility table on page 9.

• New Distributors have 30 days to enroll or decline coverage beginning on the exact

day they achieve the eligible rank defined by the eligibility table on page 9.

• Individuals may make changes or add dependents without having to provide proof of

insurability during the open enrollment period.

• Open enrollment applies to medical coverage.

• The open enrollment period is the only time employees may enroll in the medical

coverage without the occurrence of a qualifying event (see definition below).

• All distributors must reach and maintain an autoship of 200 PV to qualify, and to

remain qualified, for SoZo Benefits

Making Enrollment Changes During the YearIn most cases, your benefit elections will remain in effect for the entire plan year (January 1, 2012 – December 31, 2012). During the annual enrollment period, you have the opportunity to review your benefit elections and make changes for the coming year.

You may only make changes to your elections during the year if you have one of

the following status changes:

• Marriage, divorce or legal separation,

• Gain or loss of an eligible dependent for reasons such as birth, adoption, court order,

disability, death, reaching the dependent child age limit, or

• Significant changes in employment or employer-sponsored benefit coverage that

affect you or your spouse’s benefit eligibility.

Your benefit change must be consistent with your change in family status.

For enrollment due to a qualifying event defined above, IRS regulations require that change forms be submitted to Albert Pomales at ETMG, LLC within 30 days of that qualifying event. Please see www.sbua.org/sozo for these forms.

9 of 22


Distributor Eligibility Table

The following information defines how a Distributor becomes eligible for the medical plan being offered by SoZo Life and exactly what plan a Distributor is eligible for, based on production and rank.

Rank Health Insurance Coverage

Life + AD&D Coverage

Health Insurance Plan

Health & Life Contribution

Bronze Eligible $25,000 Plan 1 ---

Silver Eligible $25,000 Plan 1 ---

Gold Distributor $50,000 Plan 1 $125

Platinum Distributor + Spouse $50,000 Plan 1 $225

Sapphire Family $75,000 Plan 1 $325

Ruby Family $75,000 Plan 2 $425

Emerald Family $100,000 Plan 2 $525

Diamond Family $150,000 Plan 3 $700

Blue Diamond Family $250,000 Plan 3 $900

Black Diamond Family $350,000 Plan 3 $1,200

Presidential Family $500,000 Plan 3 $1,500

Sozo Personal Protection Plan

10 of 22


Medical Plan Summaries & Rates

PLAN #1 PLAN #2 PLAN #3

INPATIENT

Hospital Confinement

- Day 1 Benefit Amount $500 x 1 day $1,500 x 1 day $2,000 x 1 day

- Days 2+ Benefit Amount Per Day $500 x 29 days $750 x 29 days $1,000 x 29 days

- Days 1+ Additional ICU Benefit Amount Per Day $500 x 30 days $750 x 30 days $1,000 x 30 days

Surgery Benefit Amount (Including Maternity) Per Surgery $1,000 x 1 surgery $2,000 x 1 surgery $2,500 x 1 surgery

- Anesthesia Benefit, % of Surgery Benefit Paid 25% 25% 25%

OUTPATIENT

Physician Office Visit Pre-Pay (1,2) $10 $10 $10

- Benefit Amount Per Visit $50 x 5 visits $60 x 5 visits $70 x 5 visits

- Wellness Benefit Amount Per Visit $50 x 1 visit $75 x 1 visit $150 x 1 visit

- Well Child Care (Up to Age 4) Benefit Amount Per Visit $50 x 3 visits $75 x 3 visits $150 x 3 visits

Accident Maximum Benefit Amount Per Year $800 per year $800 per year $1,200 per year

-Benefit % Payable 100% 100% 100%

-Deductible Per Accident $0 $0 $0

Emergency Room (Sickness) Benefit Amount - Per Visit N/A $100 x 3 visits $150 x 3 visits

Surgery Benefit Amount Per Surgery $500 x 1 surgery $750 x 1 surgery $1,000 x 1 surgery

- Anesthesia Benefit, % of Surgery Benefit Paid 25% 25% 25%

Diagnostic, X-Ray, Lab - Benefit Amount Per Test

-Laboratory Tests & X-Ray Expenses $50 x 6 tests $60 x 5 tests $75 x 5 tests

-Major Outpatient Testing: MRI, Ultrasound, CT Scan N/A $100 x 1 test $200 x 1 test

PRESCRIPTION BENEFIT

-Retail: Generic RX Copay

Discount Only 2 Discount Only 2

$10

-Retail: Preferred Brand RX Copay $20

Prescription Benefit Maximum Per Month (Individual) $250 per month

Prescription Benefit Maximum Per Month (Family) $500 per month

Prescription Benefit Maximum Per Year (Individual) $3,000 per year

Prescription Benefit Maximum Per Year (Family) $6,000 per year

Inpatient Substance Abuse Treatment $250 x 30 days $375 x 30 days $500 x 30 days

Inpatient Mental Illness Treatment $250 x 30 days $375 x 30 days $500 x 30 days

Skilled Nursing Facility $250 x 60 days $375 x 60 days $500 x 60 days

CRITICAL ILLNESS

Critical Illness Benefit Amount Payable for 10 Conditions* Benefit amounts listed are for: Employee/Spouse/Child(ren)

N/A N/A $5k/$5k/$1,250

OTHER SERVICES

Vision Benefit-$50 exam per year

-$100 hardware every two years

-$50 exam per year-$100 hardware every two years

-$50 exam per year-$100 hardware every two years

Teladoc: Telephonic Doctor Office Visits - $38 Fee YES YES YES

Care24: EAP and Nurseline YES YES YES

PHCS PPO Discounts YES YES YES

MONTHLY RATES

Distributor Only $99.00 $139.00 $186.00

Distributor + Spouse $206.00 $291.00 $391.00

Distributor + Child(ren) $159.00 $225.00 $300.00

Family $286.00 $403.00 $539.00(1) The office visit pre-pay is a service through the PHCS PPO Network. (2) This service is not insurance and is not provided by AXIS Insurance Company. (3) Term Life is underwritten by Combined Insurance Company of America, part of the AXIS Group of Companies.

HealthSelect is a fixed indemnity medical plan which provides limited coverage for accidents, illness, and specified disease to help cover basic, minor-medical expenses.

11 of 22

Value Added Benefits

Value Added Services Enhance the Packaged Offering and Elevate the Consumer Experience for Employees

PPO Network Office Visit Pre-pay

Access to Network discounts at over 568,000 participating PHCS Network physicians and hospitals.

Service provides members affordable access to physicians by allowing them to pay a $10 Office Visit Pre-pay before insurance benefits are applied. MultiPlan delivers primary PPO network access under the PHCS Network, HealthEOS Network, and PHCS Savility brands. PHCS Network offers access in all states to 568,000 healthcare professionals, over 4,100 hospitals and 63,000 ancillary care facilities. No matter where health plan participants live, work, and seek healthcare, they have access to the largest independent primary PPO in the nation. Our passive approach to utilizing participating providers does not reduce insurance benefits or penalize a member for seeing a non-network provider. Using a network provider will discount the cost of services rendered and help to stretch our members’ insurance benefits. For members that happen to reach their insurance benefit maximums, they can continue to receive discounted prices from the network providers.

Prescription Drug Card With ScriptSave® members enjoy instant savings for their entire household on brand name and generic medications.

Savings average 22%, with potential savings of up to 50% on brand name and generic prescription drugs at over 50,000 participating pharmacies. With RxREDO, members can use their card for prescription fills and refills at over 56,000 participating pharmacies for co-pay benefits that will be processed in real-time at the point-of-purchase at the pharmacy.

Telemedicine Consult A Doctor™ offers convenient 24/7 access to physicians for phone and secure e-mail medical consultations.

Its proprietary nationwide cross-coverage network of U.S. licensed primary care physicians and specialists provide specific answers to medical questions and advice regarding non-emergency, routine medical conditions. Consult A Doctor’s physicians discuss symptoms, recommend treatment options, diagnose many common conditions, and prescribe medication when appropriate.

Consult A Doctor™ physicians are experts, with an average of 10 years’ experience. They are also progressive, with extensive training in telemedicine. All are board certified and state licensed, and are based in the U.S., so they are available at any time.

On Call Consult: FREE• Talk to a doctor immediately• On-demand informational consultation 24/7• Get answers to important health & medical questions

Priority Consult: $38• Talk to a doctor within 3 hours• Comprehensive diagnostic consultation• Request prescription medication (Rx) or refill*

By Appointment Consult: $38• Conveniently schedule a time to talk to a doctor• Comprehensive diagnostic consultation• Request prescription medication (Rx) or refill*

By Email: FREE• Email a doctore about sensitive medical issues• Secure, discreet, HIPPA-compliant• Doctor response within 24 hours

Nurseline and EAP OptumHealth Care24 provides a toll-free, 24/7/365 Nurseline which provides an immediate and reliable source for non-emergency health information and confidential medical counseling for emotional and personal challenges. Includes 3 face-to-face counseling visits per condition.

Members are enrolled in an Employee Assistance Program and Nurseline through OptumHealth. Consultations are provided by registered nurses and masters level counselors. Additional resources are available including legal, financial, dependent care specialists, and an audio health information library. In addition to the telephonic services, members also have access to up to 3 face-to-face counseling sessions per condition at no cost to the member.

How to Use Your New Plan 1. WHO IS THE INSURANCE COMPANY?• AXIS (A+ Rated)• You can see ANY doctor or hospital

of your choice, and the insurance plan will pay the same level of benefit - no penalties.

• For benefits and coverage questions call 1-800-964-7096

2. WHAT TO DO AT A DOCTOR’S OFFICE VISIT.• Give the doctor office staff your

ID Card• Have them call 1-800-964-7096

(on your ID Card) to verify coverage

• Pay your office visit fee (on your ID Card) at the time of service

• Have the doctor bill the insurance company on your behalf

3. ADDITIONAL SERVICES INCLUDED WITH YOUR PLAN.• If your doctor is part of the MultiPlan

PHCS Network, you will also receive discounts on their billed charges. 1-866-750-7427

• For only $38, you can have a doctor consultation over the phone from the convenience of your home or office with Consult A Doctor. 1-800-DOC-CONSULT

• At no additional cost, you can call Optum Care24 Nurseline to speak to a registered nurse immediately! 1-866-923-0018

12 of 22

Rates are guaranteed for 12 months following the effective association launch date and include Orthodontia if part of plan design.Rates include ID cards mailed to members home address.PLEASE NOTE: Rates assume enrollment in our electronic certificate (eCert) programContact your benefits administrator for details regarding these states.

COINSURANCE BASE PLAN BUY-UP PLAN

Type 1: 100% 100%

Type 2: 80% 80%

Type 3: 50% 50%

DEDUCTIBLE $75 per cal yr - Waived Type 1 (No Family Maximum)

MAXIMUM PER PERSON $1,000 per cal yr $2,000 per cal yr

PPO www.ameritasgroup.com/resources/419.asp

ALLOWANCE Type 1, 2, & 3 : 80th % of Usual and Customary

DENTAL REWARDS Dental Rewards is a program that if benefits used are less than $500 for the year then a $250 carryover will be awarded to your annual benefits maximum

WAITING PERIOD 3 months - Type 2 procedures & 6 months - Type 3 procedures (All Plan Members)

ORTHODONTIA SUMMARY Allowance All Plan Designs: In Network, discounted fee. Out of Network, U&C.

Coinsurance: 50%

Coverage for Adults: No

Lifetime Max: $1,000 per person

Waiting Period: 12 Months (All Plan Members)

TYPE 1: PROCEDURE (FREQUENCY)

Routine Exam (1 in 6 months) Bitewing X-rays (1 in 12 months)

Full Mouth/Panoramic X-rays (1 in 5 years) Periapical X-rays

Cleaning (1 in 6 months) Fluoride for Children 13 & under (1 per benefit period)

Routine Exam (1 in 6 months) Bitewing X-rays (1 in 12 months)

Full Mouth/Panoramic X-rays (1 in 5 years) Periapical X-rays

Cleaning (1 in 6 months) Fluoride for Children 13 & under (1 per benefit period)


Sealants (age 13 and under) Restorative Amalgams

Restorative Composites Denture Repair

Simple Extractions

Sealants (age 13 and under) Restorative Amalgams

Restorative Composites Denture Repair

Simple Extractions


Space Maintainers Onlays

Crowns (1 in 10 years per tooth) Crown Repair

Endodontics (nonsurgical) Endodontics (surgical)

Periodontics (nonsurgical) Periodontics (surgical)

Prosthodontics (1 in 10 years) (fixed bridge; removable complete/partial dentures)

Complete Extractions Anesthesia

Space Maintainers Onlays

Crowns (1 in 10 years per tooth) Crown Repair

Endodontics (nonsurgical) Endodontics (surgical)

Periodontics (nonsurgical) Periodontics (surgical)

Prosthodontics (1 in 10 years) (fixed bridge; removable complete/partial dentures)

Complete Extractions Anesthesia

MONTHLY RATE WITH ORTHODONTIA

AREA 1 AR, AL, IN, KY, LA, MO, MS, MT, ND, NC, NE, NM, OH, OK, SC, TN, UT, WV Not Approved in: NY, NH

Member Member + 1 Dependent

Member + 2 or More

$31.72 $60.32 $95.72

$36.16 $67.88

$105.56

AREA 2 AZ, CO, DC, DE, GA, ID, IL, KS, MD, ME, MI, MN, NV, OR, PA, RI, TX, VA, WI, WY Not Approved in: NY, NH


Member + 2 or More

$38.80 $76.08

$125.24

$45.76 $88.72

$143.80

AREA 3 AK, CA, CT, FL, HI, MA, NJ, WA, VT Not Approved in: NY, NH


Member + 2 or More

$47.52 $92.52

$150.28

$58.12 $111.56 $177.56

Dental Plan

13 of 22


Paying for Your Medical Premiums

• ETMG, LLC is a licensed Premium Collection Agency and will be responsible for collecting all medical premiums along with any associated fees.

• All premiums will generally be drafted (due to holidays and weekends) between the 20th and last day of each month; all premium payments will pre-pay for the upcoming month of coverage.

• If your premium payment is not honored by your financial institution for any reason, a Returned Payment Fee of $30.00 will be due along with your insurance premium, and may be billed separately.

• If your premium payment is not received by the last day of the month by close of business, your policy may not go into effect.

• After your initial payment is made, you will continue to be charged between the 20th and the last day of the month. If payment is not received in full by the 5th of the following month, your policy will be cancelled retroactive to the first day of the month for which payment is in default.

• The insurance carrier will not honor payment for any provider services after the date of retroactive cancellation and any payment made by the carrier to a provider after the date of retroactive cancellation will be reversed by the insurance company. You will be personally liable to the service provider(s) for any charges you incur after the retroactive date of cancellation.

14 of 22


Benefit Descriptions

BENEFIT DESCRIPTION

Office Visits We will pay benefits if a covered person visits a Doctor’s office for treatment, care or advice of an injury or sickness covered under the policy.

Emergency Room Visits (Sickness Only)We will pay benefits for Emergency Room Visits if a covered person requires treatment or services in a Hospital emergency room for a life-threatening condition due to sickness. Covered expenses include the attending Doctor’s charges, X-rays, laboratory procedures, use of the emergency room and supplies.

Wellness Visits

We will pay benefits for an annual routine examination or well child care. Covered Services include a medical history, physical examination, X-rays and laboratory tests including a Pap test, colorectal screening, prostate cancer screening, mammography and bone density screening. We will pay benefits for up to 4 well child visits up to age 4.

Outpatient Laboratory Tests, Diagnostics, and X-Ray Expenses

We will pay benefits for Outpatient Laboratory Tests and X-rays if a covered person is not confined in a Hospital and the tests or x-rays are ordered by a Doctor and performed by an appropriately licensed technician.

Outpatient Accident Only Medical Expense Benefit

We will pay benefits for medically necessary expenses that result directly from a covered accident. Initial treatment must begin within 72 hours of the accident and covered expenses must be incurred within 90 days after the accident. These benefits are subject to the Deductibles, Coinsurance Rates, Co-Payments, Benefit Periods, Benefit Maximums and other terms or limits, if any, shown in the Schedule of Benefits. Covered expenses include medical services and supplies, emergency care, ambulance expenses, treatment of an injured tooth, prescription drugs andrehabilitative braces or appliances prescribed by a doctor.

Hospital Confinement Benefit We will pay benefits if a covered person is confined in a hospital because of a covered injury or illness for at least 24 consecutive hours.

Surgery and Anesthesia BenefitWe will pay benefits if a covered person undergoes surgery at the direction of a doctor for a covered injury or sickness. We will also pay benefits for anesthesia services for pre-operative screening and the administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis.

Critical Illness

Payable for 10 conditions: Cancer, Heart Attack, Renal Failure, Stroke, Major Organ Transplant, Multiple Sclerosis, Coronary Artery Bypass Surgery, Alzheimer’s, ALS, Terminal Illness. After coverage has been in effect for 90 days or more, if an employee is then diagnosed with any of the conditions listed in the schedule of benefits, we will pay the amount shown in the Schedule of Benefits for this benefit. The covered person must be under 65 years of age and survive for a period of one-hundred-eighty (180) days after diagnosis of Multiple Sclerosis. The covered person must be under 65 years of age and must survive for a period of thirty (30) days after diagnosis for any other covered illness. We will pay this benefit only once regardless of whether the covered person is diagnosed with more than one of the covered illnesses.

Accidental Death and Dismemberment Benefit

If a covered person suffers a loss within 365 days of a covered accident we will pay the percentage of the principal sum shown opposite that loss. If multiple losses occur, only one benefit amount, the largest, will be paid for all losses due to the same covered accident.

Term Life Insurance Benefit*If an insured person dies of natural causes or as the result of a covered accident, we will pay the death benefit amount listed in the schedule of benefits. We will not pay a death benefit if an insured person dies by suicide, while sane or insane, within two years of the date his/her insurance starts.

Prescription Drug BenefitsWe will pay benefits for expenses incurred by a covered person for the purchase of generic and preferred brand name prescription drugs from a Participating or Non-Participating Pharmacy. The co-payment must be incurred for each prescription drug or authorized refill before benefits are payable.

15 of 22


Plan Provisions

Policy Structure and IssuanceThe fixed indemnity sickness and accident plans proposed in this document are not basic health insurance or major medical coverage. They provide limited coverage for accidents, illness, and specified disease. The HealthSelect, HealthValu, CriticalMed and DeductibleAssist plans are comprised of a package of group insurance policies which are issued on a separate and non-coordinating basis and include: fixed-indemnity, accident-only, and limited-scope prescription drugs.

Effective Date of CoverageFor insurance paid for in part or entirely by an employee, insurance for an employee is effective on the latest of the policy effective date, the date he or she becomes eligible, the date we receive the completed enrollment form, or the date payroll deduction is authorized for this insurance. Insurance for a Dependent becomes effective on the latest of the date he or she becomes eligible, the date we receive the completed enrollment form, the date payroll deduction is authorized for this insurance, or the date the employee’s coverage goes into effect. Coverage for an eligible employee or Dependent who is not in Active Service on the date insurance would otherwise be effective will not go into effect until the date he or she returns to Active Service.

Termination Date of CoverageAn insured employee’s coverage will end on the earlier of the date the policy terminates; the period ends for which premium is paid; or the date he or she is no longer in Active Service or no longer eligible. Coverage for a Dependent will end on the earliest of the date he or she is no longer a Dependent; the period ends for which premium is paid; or the date the employee’s coverage ends.

Plan YearBenefits are payable on a Plan Year basis. A Plan Year is a consecutive 12-month period during which the employee’s insurance is in force. The first Plan year begins on the effective date of the employee’s insurance under the Policy and ends after 12 consecutive months. Dependents will have the same Plan Year as the employee. Coverage is limited to the specific benefit limits shown in the plan designs on the prior pages.

ERISA, HIPAA, and COBRAThe proposed insurance plans are not ERISA qualified plans, not considered creditable coverage under HIPAA, but do comply with all HIPAA privacy regulations. Plans are not subject to COBRA, however the policies contain a continuation of coverage provision which will allow insured individuals and their dependents to continue coverage upon termination.

16 of 22

Exclusions and Limitations

For HealthSelect, we will not pay benefits for any loss, injury or sickness that is caused by, or results from:• Intentionally self-inflicted injury, suicide or attempted suicide.• War or any act of war, whether declared or not.• Service in the military, naval or air service of any country or international organization.• Piloting or serving as a crewmember or riding in any aircraft except as a fare-paying

passenger on a regularly scheduled or charter airline.• Commission of, or attempt to commit, a felony.• Commission of or active participation in a riot, or insurrection.• Bungee cord jumping, parachuting, skydiving, parasailing, hang-gliding.• Flight in, boarding or alighting from any aircraft except as a fare-paying passenger on a

regularly scheduled commercial airline.• An accident if the covered person is the operator of a motor vehicle and does not possess

a valid motor vehicle operator’s license, except while participating in Driver’s Education Program.

• Medical or surgical treatment, diagnostic procedure, administration or anesthesia, or medical mishap or negligence, including malpractice. [This exclusion applies to the Accidental Death and Dismemberment benefit only]

• Travel or activity outside the United States, Canada, or Mexico, except for a Medical Emergency.

• Travel in any Aircraft owned, leased or controlled by the Policyholder, or any of its subsidiaries or affiliates. An Aircraft will be deemed to be “controlled” by the Policyholder if the Aircraft may be used as the Policyholder wishes for more than 10 straight days, or more than 15 days in any year.

• Alcoholism, drug addiction or the use of any drug or narcotic except as prescribed by a Doctor unless specifically provided herein.

• Repair or replacement of existing dentures, partial dentures, braces, fixed or removable bridges, or other artificial dental restoration.

• Repair, replacement, examinations for, prescriptions, or the fitting of eyeglasses or contact lenses.

• While the covered person is legally intoxicated (as determined by that state’s laws) or while under the influence of any drug unless administered under the advice and consent of a Doctor.

• Elective Abortion. Elective Abortion means an abortion for any reason other than to preserve the life of the female upon whom the abortion is performed.

• Mental and Nervous Disorders.• Cosmetic surgery, except for reconstructive surgery needed as the result of an injury or

sickness.• Experimental or Investigational drugs, services, supplies or any procedure held to be

experimental or investigatory by Us at the time the procedure is done.• Treatment for being overweight, gastric bypass or stapling, intestinal bypass, and any related

procedures, including complications.• Sexual reassignment surgery, sexual transformation surgery, sexual transgendering surgery.• Services related to sterilization, reversal of a vasectomy or tubal ligation; in vitro fertilization

and diagnostic treatment of infertility or other problems related to the inability to conceive a child, unless such infertility is a result of a covered Injury or Sickness.

• Treatment or services provided by a private duty nurse, unless provided for in the Policy.• Organ or tissue transplants and related services.• Personal comfort or convenience items.• Rest or custodial cures.• Hearing aids.• Radial keratotomy.• Treatment by a family member or member of the Covered Person’s household.• Routine dental care and treatment, except for treatment of Injury as specified in the Policy.

In addition to the above Exclusions, We will not pay Accident Medical Expense Benefits for any loss, treatement or services resulting from or contributed to by:• Treatment by persons employed or retained by the Policyholder, or by any Immediate Family

or member of the Covered Person’s household. • Treatment of sickness, disease or infections except pyogenic infections or bacterial infections

that result from the accidental ingestion of contaminated substances.• Treatment of hernia, Osgood-Schlatter’s Disease, osteochondritis, appendicitis,

osteomyelitis, cardiac disease or conditions, pathological fractures, congenital weakness, detached retina unless caused by an Injury, or mental disorder or psychological or psychiatric care or treatment (except as provided in the Policy), whether or not caused by a Covered Accident.

• Pregnancy, childbirth, miscarriage, abortion or any complications of any of these conditions.• Mental and nervous disorders (except as provided in the Policy).• Damage to or loss of dentures or bridges, or damage to existing orthodontic equipment

(except as specifically covered in the Policy).• Expenses incurred for treatment of temporomandibular or craniomandibular joint

dysfunction and associated myofacial pain (except as provided by the Policy).• Injury covered by Workers’ Compensation, Employer’s LIability Laws or similar occupational

benefits or while engaging in activity for monetary gain from sources other than the Policyholder.

• Cosmetic surgery, except for reconstructive surgery needed as the result of an Injury.• Any elective treatment, surgery, health treatment, or examination, including any service,

treatment or supplies that: (a) are deemed by us to be experimental; and (b) are not recognized and generally accepted medical practices in the United States.

• Eyeglasses, contact lenses, hearing aids, examinations or prescriptions for them, or repair or replacement of existing artifical limbs, orthopedic braces, or orthotic devices.

• Expenses payable by any automobile insurance Policy without regard to fault. (This exclusion does not apply in any state where prohibited.)

• Conditions that are not caused by a Covered Accident.• Participation in any activity or hazard not specifically covered by the Policy.• Any treatment, service, or supply not specifically covered by the Policy.This insurance does not apply to the extent that trade or economic sanctions or regulation prohibit Us from providing insurance, including, but not limited to, the payment of claims.In addition, Critical Illness Benefits will not be paid for:• Injury or Sickness, other than one of the Covered Illnesses, even though such Injury or

Sickness may have been complicated by one of the Covered Illnesses;• The use, existence or escape of nuclear weapons, material or ionizing radiation from or

contamination by radioactivity from any nuclear fuel or waste from the combustion of nuclear fuel;

• Misuse of medication or the abuse of drugs or intoxicants;• Any Preexisting Condition, except where coverage has been in effect for a period of

twelve (12) consecutive months following the covered person’s effective date of coverage. “Preexisting Condition” means a Sickness suffered by a covered person for which he or she sought or received medical advice, consultation, investigation, or diagnosis, or for which treatment was required or recommended by a Doctor during the 12 months immediately prior to the covered person’s effective date of coverage, that directly or indirectly causes the condition to occur within the first 12 months from the covered person’s most recent effective date of coverage.

No Prescription Drug Benefits will be paid for:• All over-the-counter products and medications unless shown in the definition of Prescription

Drug. This includes, but is not limited to, electrolyte replacement, infant formulas, miscellaneous nutritional supplements, and all other over-the-counter products and medications.

• Blood glucose meters and insulin injecting devices.• Depo-Provera; condoms, contraceptive sponges, and spermicides; sexual dysfunction drugs.• Biologicals (including allergy tests); blood products; growth hormones; hemophiliac factors;

MS injectables; immunizations; and all other injectables unless shown in the definition of Prescription Drug.

• Medical supplies and durable medical equipment.• Liquid nutritional supplements; pediatric Legend Drug vitamins; prescribed versions

of Vitamins A, D, K, B12, Folic Acid, and Niacin – used in treatment verses as a dietary supplement; and all other Legend Drug vitamins and nutritional supplements.

• Anorexiants; any cosmetic drugs including, but not limited to, Renova and skin pigmentation preps; any drugs or products used for the treatment of baldness; and topical dental fluorides.

• Refills in excess of that specified by the prescribing Doctor, or refills dispensed after one year from the original date of the prescription.

• Any drug labeled “Caution – limited by Federal Law for Investigational Use” or experimental drugs.

• Any drug which the Food and Drug Administration has determined to be contraindicated for the specific treatment.

• Drugs needed due to conditions caused, directly or indirectly, by a covered person taking part in a riot or other civil disorder; or the covered person taking part in the commission of a felony.

• Drugs needed due to conditions caused, directly or indirectly, by declared or undeclared war or any act of war; or drugs dispensed to a covered person while on active duty service in any armed forces.

• Any expenses related to the administration of any drug.• Drugs or medicines taken while in or administered by a Hospital or any other health care

facility or office.• Drugs covered under Worker’s Compensation, Medicare, Medicaid or other governmental

program.• Drugs, medicines or products which are not medically necessary.• Diaphragms; erectile dysfunction Legend Drugs; and infertility Legend Drugs.• Epi-Pen, Epi-Pen Jr., Ana-Kit, Ana-Guard; Glucagon-auto injection; and Imitrex-auto injection.• Smoking deterrents, Legend or over-the-counter drugs.• Replacement of stolen medication (except under circumstances approved by us), or lost,

spilled, broken or dropped Prescription Drugs.• Vacation supplies of Prescription Drugs (except under circumstances approved by us).• All newly marketed pharmaceuticals or currently marketed pharmaceuticals with a new

FDA approved indication for a period of one year from such FDA approval for its intended indication.

This insurance does not apply to the extent that trade or economic sanctions or regulation prohibit Us from providing insurance, including, but not limited to, the payment of claims.

17 of 22


Glossary of Terms

The following definitions apply to the 10 payable conditions for the Critical Illness benefit:

“Cancer” means a malignant tumor characterized by the uncontrolled growth and spread of malignant cells and invasion of tissue. This includes Leukemia, Hodgkin’s Disease and invasive melanoma, but does not include:

1. non-invasive carcinoma in situ;2. Kaposi’s Sarcoma or other AIDS related cancers and cancer in the presence of Human Immunodeficiency Virus (HIV);3. Skin cancer or melanoma that is not invasive and has not exceeded .75 millimeters in depth; or4. early Prostate cancer diagnosed as T1NOMO or equivalent staging.

A Doctor certified as an Oncologist must confirm the diagnosis in writing. No coverage is provided if any symptom or medical problem which initiated the investigation leading to a diagnosis of Cancer commenced within 90 days following the effective date of coverage. In the event of any diagnosis based on such a symptom or medical problem, insurance for that covered person will terminate, and Our sole liability with respect to this benefit will be limited to a refund of premiums paid since the effective date.

“Heart Attack” means the death of a portion of heart muscle as a result of inadequate blood supply to the relevant area. Diagnosis must be confirmed in writing by a Doctor who is a certified cardiologist and should be based on new electrocardiograph changes consistent with heart attack as well as an elevation in cardiac enzyme levels.

“Renal Failure” or “Kidney Failure” means end-stage renal disease due to chronic irreversible failure of both kidneys’ ability to function, requiring the covered person to undergo regular hemodialysis, peritoneal dialysis, or renal transplantation. A Doctor who is certified in Nephrology must confirm the diagnosis in writing.

“Stroke” means that the covered person has suffered a cerebrovascular incident, excluding transient ischemic attack (TIA), producing infarction of brain tissue due to thrombosis, hemorrhage from an intracranial vessel or embolization caused by an extracranial source. There must be evidence of measurable permanent neurological deficit persisting for 30 consecutive days, supported by evidence that the deficit is resulting from the Stroke,confirmed in writing by a Doctor who is certified as a neurologist.

“Major Organ Transplant” means a surgery, as the recipient, for transplantation of any of the following organs or tissues: 1) heart2) liver3) lung4) kidney5) bone marrow.

“Multiple Sclerosis” means unequivocal diagnosis by a consulting Doctor who is a certified neurologist of a definite diagnosis of Multiple Sclerosis producing at least two episodes of well-defined neurological abnormalities lasting for a continuous period of at least 180 days and resulting in measurable disability. For a Covered Person diagnosed with Multiple Sclerosis, he or she must survive for a period of 180 days after diagnosis by a Doctor. The diagnosis must be supported by modern imaging techniques.

“Coronary Artery Bypass Surgery” means heart surgery to correct narrowing or blockage of one or more coronary arteries with bypass grafts, excluding:

1) non-surgical techniques such as balloon angioplasty;2) laser embolectomy; and3) other non-bypass techniques.

“Alzheimer’s Disease” means a degenerative brain disease of unknown cause that is the most common form of dementia. Memory impairment is a necessary feature for the diagnosis of this type of dementia. Change in one of the following areas must also be present: language, decision-making ability, judgment, attention, and other areas of mental function and personality. It results in a profound intellectual decline characterized by dementia and personal helplessness, and is marked histologically by the degeneration of brain neurons especially in the cerebral cortex and by the presence of neurofibrillary tangles and plaques containing betaamyloid.

“Lou Gehrig’s Disease” means amyotrophic lateral sclerosis (ALS), a rare fatal progressive degenerative disease that affects pyramidal motor neurons and is characterized by increasing and spreading muscular disease.

“Terminal Illness” means a Covered Person has a prognosis of twelve months or less to live, as diagnosed by a Doctor. For the purposes of determining the existence of a Terminal Illness, We will require that the Covered Person submit the following proof:

1) a written diagnosis and prognosis by two Doctors licensed to practice in the United States; and2) Supportive evidence satisfactory to Us, including but not limited to, radiological, histological or laboratory reports

documenting the Terminal Illness.

18 of 22


How to Enroll

ETMG, LLC is a licensed Third Party Administrator and therefore will be handling all enrollments on behalf of SoZo Life. We at ETMG know that as a self-employed business owner, your time is very valuable. That is why ETMG has created three ways to enroll in SoZo’s medical benefit program.

Online Self-EnrollmentBy visiting www.sozo.myternian.com, each Distributor will have access to our online enrollment system powered by Ternian. Upon arrival to the enrollment site there will be a section in which it asks you to enter your SoZo I.D. number. Your I.D. number must be an exact match to what is pre-loaded in the enrollment system in order to access enrollment.

All I.D. numbers will be uploaded into the Ternian system, which will have the ability to recognize exactly what plan you are eligible for based on your rank.

Benefit Specialist Hotline EnrollmentETMG, LLC provides access to ETMG-employed licensed Benefit Specialist. You can reach a Benefit Specialist by calling 1.888.728.2467. Benefit Specialists are available to assist, educate, and enroll all eligible Distributors Monday – Friday from 8:30am to 6:00pm Central Standard Time.

Downloadable Paper Application EnrollmentETMG has created a website specifically for SoZo’s medical benefits program at www.sbua.org/sozo. Medical enrollment forms can be downloaded on the right side under “Forms”. Application instructions will precede the actual application form. Once you have filled out your form, please fax it to 512.682.8795 attention Albert Pomales.

19 of 22


“I have enrolled. What now?”

Now that you have made your decision to enroll in SoZo’s group medical coverage, what can you expect? You will go through the same steps whether you enrolled by telephone with a Benefit Specialist, used online self-enrollment, or filled out a paper application. The following steps will guide you through your expectations.

1. You will receive an email confirming your enrollment.

2. In that email, there will be a link that directs you to create an account. For assistance setting up your account, visit www.sbua.org/sozo and watch the “Set Up Your Account” instructional video.

3. The checking or savings account that you provided at the time of enrollment will be debited between the 20th and the last day of the month by ETMG, LLC.

4. Your I.D. cards will arrive the first week of your effective coverage month.

5. If you have any questions or concerns about your coverage, please contact a Benefit Specialist at 1-888-728-2467.

SoZo Distributor Enrollment FormACE American Insurance Company

Step 1: SoZo Distributor ID Number: ____________________ Step 2: Select who you want to cover: CHECK ONLY ONE.

□ I want to cover myself only □ I want to cover myself and one dependent (spouse or child) □ I want to cover myself and my family

Step 3: Provide the information that we need in order to enroll you and/or your family members.

First Name M.I. Last Name Gender (M/F) Date of Birth

Social Security Number Hire Date

Street Address City State Zip Code

Email Address Primary Phone # □ Home □ Work □ Cell

DEPENDENT INFORMATION (IF ANY): For more than three dependents attach additional sheet.

Spouse/Child First Name M.I. Last Name Gender (M/F) Birth Date (mm/dd/yyyy)

BENEFICIARY INFORMATION:

First Name M.I. Last Name Gender (M/F) Relationship to You

WARNING: IT IS A CRIME TO PROVIDE FALSE OR MISLEADING INFORMATION TO AN INSURER FOR THE PURPOSE OF DEFRAUDING THE INSURER OR ANY OTHER PERSON. PENALTIES INCLUDE IMPRISONMENT AND/OR FINES. IN ADDITION, AN INSURER MAY DENY INSURANCE BENEFITS IF FALSE INFORMATION MATERIALLY RELATED TO A CLAIM WAS PROVIDED BY THE APPLICANT.

Employee’s Signature Date Signed

I have read the ACE American Insurance Company enrollment brochure, including the exclusions and limitations, and accept the terms and conditions of the

Comprehensive Medical coverage. I have read the enrollment brochure and understand my coverage is subject to the terms and conditions of the policy issued to my employer. I understand my coverage will go into effect on the date stated in the brochure only if I am in active service with my employer on that date. If I am not in active service on that date, my coverage will go into effect on the date I return to active service. If I have elected coverage for my dependents, their coverage will not go into effect prior to my effective date. I authorize my employer to deduct the required premium for the plan I have elected from my pay. To the best of my knowledge and belief, all information I have provided is true and complete. I understand my information is protected by privacy laws and will be released only in accordance with these laws. The only people who have access to this information are employees of the Insurance Company who service my policy or claim and other third parties authorized by the Insurance Company. Information may be disclosed to those who have an insurance-related regulatory or legal need for the information. In other situations, the Insurance Company will ask me for written authorization to disclose information about me.

Master Copy: Retain for new hires

FAX OR EMAIL COMPLETED FORM TO: 512-682-8795 ATTN: Albert Pomales | [email protected]? Call 1-888-728-2467

If needed, Request for Coverage forms are available at www.sbua.org/sozo

GR 875 Rev. 5-07 Page 1 of 1 113007L

enrollment/change/waivergroup insurance formPolicy and Div. # 010- ___________________ Cert. #____________________

Name and Address of Employer (Policyholder) ___________________________________________________________________________

1 to enroll � Dental � Eye Care � To terminate all coveragesemployee information Marital Status � Single � Married

Social Security number ____________________________________ Dept. number ____________________________________________

Employee’s last name, fi rst name, MI ___________________________________________________________________________________

Date of birth _____________________________________________ � Male � Female

Full time date of hire ______________________________________ � Rehire: Rehire date ____________________________________

Occupation _________________________________________________________________________________________________________

Hours worked each week __________________________________ Are your earnings paid: � Hourly or � Salaried

Street address ___________________________________________ City _________________________ State______ ZIP____________

E-mail address (limit of 60 characters) __________________________________________________________________________________Are you covered under another dental insurance plan? . . . . . . . . . . . . . . . . Employee: � Yes � No Dependents: � Yes � NoAre you covered under another eye care insurance plan? . . . . . . . . . . . . . . . Employee: � Yes � No Dependents: � Yes � Nodependent coverage information List all eligible dependents to be added or deleted. (Employee must be enrolled to cover dependents)print full legal name (last, fi rst. MI) add drop relationship sex date of birth social security number

1

2

3

4

5

6

please sign (employee/policyholder) The certifi cate provides dental and eye care benefi ts only. Review your certifi cate carefully. As an employee, I hereby apply for, or waive (if indicated), group insurance, for which I am eligible or may become eligible. If contributions are required, I authorize my employer to deduct premiums from my salary. THE FOLLOWING APPLIES ONLY TO SECTION 125 FLEXIBLE BENEFITS PLANS: I am signing up for coverage until the next enrollment period except in the case of a life event. This information was explained in the plan’s solicitation materials which I have read and understand. I represent that the information I have provided is complete and accurate to the best of my knowledge. The policyholder certifi es the date of employment, job title, hours worked and salary information are correct according to the Policyholder’s records.

XEmployee Signature (do not print) Date

XPolicyholder Signature (do not print) Date

In several states, we are required to advise you of the following: Any person who knowingly and with intent to defraud provides false, incomplete, or misleading information in an applica-tion for insurance, or who knowingly presents a false or fraudulent claim for payment of a loss or benefi t, is guilty of a crime and may be subject to fi nes and criminal penalties, including imprisonment. In addition, insurance benefi ts may be denied if false information provided by an applicant is materially related to a claim. (State-specifi c statements on back.)

Employee late entrant date _________________________________

Dependent late entrant date ________________________________

Effective Date Class Dep. Code

2 to change� Name change New Name _______________________________________ Old Name____________________________________

� Add dependent coverage� If due to marriage, what is the date of marriage? ____________________________________________________________________

� If due to birth/adoption, what is the date of event?___________________________________________________________________

� If due to loss of coverage, date and reason: ________________________________________________________________________

� If other, the date of event and please explain: ______________________________________________________________________

� Drop dependent coverage Number of dependents still covered: ______ Effective date of drop: _________________________� Due to divorce � Due to death � Due to annual election period

� Other (please explain) __________________________________________________________________________________________

3 to waive IF YOU DO NOT WANT COVERAGE, COMPLETE THE WAIVER SECTION. THE WAIVER MAY NOT BE ALLOWED FOR THIS PLAN, CHECK WITH YOUR EMPLOYER. I have been given an opportunity to apply for Group Insurance offered by my employer, and have decided not to accept the offer for:

� myself (does not apply to TRUST policies) � spouse only � child(ren) only � spouse and child(ren)because ___________________________________________________________________________________________________________

Name of insurance company and employer of dependent __________________________________________________________________Should I desire to apply for this group insurance in the future, I realize that a “late entrant” penalty may be applied.

P.O. Box 81889Lincoln, NE 68501-1889

800-659-2223 / Fax: 402-467-7338

COBRA: If individual is a continuee

Qualifying Event ____________________

Date of Event ______________________

CLEAR FORM

GR 875 Rev. 5-07 113007L

Tipsfor fi lling out this formTo enrollMissing, incomplete or illegible information can cause delays in adding new employees to the system and could create errors in billing. To ensure proper handling of your enrollment forms, please make sure the following areas are completed:Policy Name and Group Number – to make sure plan members are added to the correct group.Department/Division Numbers – so plan members are added in the proper locations, and appear in the appropriate section on the billing if the group has multiple departments or divisions.Social Security Numbers – the most important identifi er for plan members when calling in with claims or administrative questions. Please double check to make sure your social security number is accurate and written clearly.Full-time Employment Date – needed so the correct eff ective date is calculated for new members.Class Number – needed when the plan has more than one class of employees.

To changeChanging Dependent Codes – When adding or dropping depen-dents, please note whether this change is because of a “life event” or for some other reason. (Examples of life events: marriage, birth of a child, divorce . . . ) Please remember to include the date of the event. Late entrant status will be applied if a life event is not included. Be specifi c when changing status so all dependents who are still eligible will be covered.

ImagingIn order to provide better service, our administration system utilizes image technology. In the image environment, we scan your enrollment forms into our system, making them easier and faster to access. Better quality forms help us to process your enrollments faster. Unfortunately, certain forms are diffi cult or impossible to scan. Th e following list of helpful hints will make your forms easier to scan:

Do:1) submit clear, legible enrollment forms.2) underline or circle important information.3) use blue or black ink.

Don’t:1) submit dark copies as they appear black on imaging.2) highlight, which blackens the area so it cannot be read.3) write on the top or bottom margins. Th is information is not

always captured on the image system.

Note for California Residents: California law prohibits an HIV test from being required or used by health insurance companies as a condition of obtaining health insurance coverage.

For group policies issued, amended, delivered, or renewed in Cali-fornia, dependent coverage includes individuals who are registered domestic partners and their dependents.

Note for Colorado Residents: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fi nes, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyholder or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant with regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.

Note for Florida Residents: Any person who knowingly and with intent to injure, defraud or deceive any insurer fi les a statement of claim or an application containing any false, incomplete, or mislead-ing information is guilty of a felony of the third degree.

Note for New Jersey Residents: Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties.

Note for Georgia, Oregon and Virginia Residents: Any person who, with intent to defraud or knowing that he is facilitating a fraud against insurer, submits an application or fi les a claim containing a false or deceptive statement may have violated state law.

Note for Pennsylvania Residents: Any person who knowingly and with intent to defraud any insurance company or other person, fi les an application for insurance or statement of claim containing any materially false information or conceals for the purpose of mislead-ing information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

Distributors’ Benefit Handbook January 1, 2012 ... · A Word from SoZo SoZo Global, LLC has introduced a breakthrough in the network marketing industry: Group health benefits for

Documents