Arizona exclusions and limitations for group benefits

Basic and Supplemental Group Life and Accidental Death and Dismemberment (AD&D)

Group Short-Term Disability

Group Long-Term Disability

Critical Illness Insurance

Per-Occurrence Accident Insurance

Scheduled Benefit Accident Insurance

Fixed-payment indemnity insurance

Group benefits are insured by Symetra Life Insurance Company, 777 108th Avenue NE, Suite 1200, Bellevue, WA 98004. Benefits may not be available in all states and are not available in any U.S. territory. Policies may be subject to exclusions, limitations, reductions and termination of benefit provisions. For costs and complete details of the coverage, contact your Symetra representative.

Where available, the base policy form numbers are: LGC-13000 8/06 for group life and accidental death and dismemberment (AD&D), GDC-4000 12/05 for group short-term and long-term disability income insurance, SBC-00500 8/12 for fixed-payment insurance, SBC-04530 1/21 for critical illness, LGC-10011P 10/11 for per-occurrence accident coverage, and SBC-03510 1/18 for scheduled benefit accident coverage.

Wellness screening benefit rider base form number is SBC-03513-WEL 1/18. Selected at application and available for an additional cost, this rider provides an insured with a benefit if the insured incurs an expense as a result of receiving any of the screening tests described in the rider.

Child organized sport activity benefit rider base form number is SBC-03513-COS 1/18. Selected at application, this rider provides an additional 25%, up to $10,000, for benefits payable under the policy if the accident occurred while an insured dependent child was participating in an organized sport. The child must be insured by the policy on the date the accident occurred.